Injuries In Children

Injuries in ChildrenInjuries in ChildrenDr. Vivek M. RegeDr. Vivek M. Rege

Pediatric & Neonatal Surgeon

Saifee HospitalSaifee Hospital

Bhatia HospitalBhatia Hospital

Wadia Hospital for ChildrenWadia Hospital for Children

Fortis HospitalFortis Hospital

Dr Vivek Rege Pediatric Surgeon

Types of InjuriesTypes of Injuries

• External blunt injuriesExternal blunt injuries

• External/Visible cut injuriesExternal/Visible cut injuries

• Internal blunt injuriesInternal blunt injuries

• Penetrating injuriesPenetrating injuries


Mechanism of injuryMechanism of injury

• Massage in newbornsMassage in newborns

• Fall while walking/running/sports/heightFall while walking/running/sports/height

• Vehicular accident: pedestrian/ in vehicleVehicular accident: pedestrian/ in vehicle

• Crush injury: door, heavy objectCrush injury: door, heavy object

• Sharp object : impalement/ bitesSharp object : impalement/ bites

• Large object falling on child: chest / Large object falling on child: chest / abdomenabdomen


Site of InjurySite of Injury

• Head injuryHead injury

• Face , neck, mouth injuryFace , neck, mouth injury

• Chest injuryChest injury

• Abdominal injuryAbdominal injury

• Limb injuryLimb injury


Breast abscess following massageBreast abscess following massage

Breast abscess following massageBreast abscess following massage

Abrasions due to dragging along ground by 3 Abrasions due to dragging along ground by 3 dogs who attacked this boydogs who attacked this boy


Following a dog bite - abrasions & woundFollowing a dog bite - abrasions & wound

Major cutMajor cut

AbrasionsAbrasions


Deep wound - includes skin & musclesDeep wound - includes skin & muscles


Dr. Vivek M. Rege

CLWCLW

• Scratched by a PumaScratched by a Puma

• Injury on the noseInjury on the nose

• Active bleedActive bleed

• Deep cutDeep cut

• Requires suturingRequires suturing

Dr. Vivek M. Rege

After suturingAfter suturing

Excellent healingExcellent healing

Good scarGood scar

Large cut across tongueLarge cut across tongue

Always to be done under anesthesiaAlways to be done under anesthesiaDr Vivek Rege Pediatric Surgeon

CLW tongue


After suturing with self absorbable suturesAfter suturing with self absorbable sutures

CutCutDr Vivek Rege Pediatric Surgeon

After suturing the under surface of the tongue woundDr Vivek Rege Pediatric Surgeon

Dr. Vivek M. Rege

Crush injury to the fingerCrush injury to the finger

Dr. Vivek M. Rege

Crush injury all around fingerCrush injury all around finger

Finger crushed in door Finger crushed in door

Finger crushed in door Finger crushed in door

After cleaning & suturing

Final result 10 days

Finger Finger was was

caught caught in the in the

door and door and the skin the skin

was was avulsedavulsed


Avulsed skin brought along in plastic Avulsed skin brought along in plastic bagbag


After total healing - excellent resultAfter total healing - excellent result


Child fell on the handle of cupboard

Injuries requiring suturesInjuries requiring sutures

• Must be recognised earlyMust be recognised early

• Referred to a surgeon earlyReferred to a surgeon early

• Stop all oral intake immediatelyStop all oral intake immediately

• Send to a hospital directlySend to a hospital directly

• Suturing must be within first 6 hours Suturing must be within first 6 hours ideallyideally


Head InjuriesHead Injuries

• Ask if child had unconsiousnessAsk if child had unconsiousness

• Ask if child had bleeding ear/nose/ mouthAsk if child had bleeding ear/nose/ mouth

• Ask if child had convulsionAsk if child had convulsion

• Ask if child has vomitedAsk if child has vomited

• Check if child is orientedCheck if child is oriented

• No oral feeds till seen by doctorNo oral feeds till seen by doctor


Blunt injury – Chest & AbdomenBlunt injury – Chest & Abdomen

• Blunt injury caused by fall, sports, an object falling on Blunt injury caused by fall, sports, an object falling on the bodythe body

• External injury may look small – bruise, scrape or External injury may look small – bruise, scrape or hematomahematoma

• Internal injury may be very major – tear of an organ or Internal injury may be very major – tear of an organ or vesselvessel

• NEVER take chest / abdomen injury casually – go to the NEVER take chest / abdomen injury casually – go to the nearest hospital and shownearest hospital and show


Blunt Injury ChestBlunt Injury Chest

• Child was playing around a scooterChild was playing around a scooter

• Scooter accidentally fell on her chestScooter accidentally fell on her chest

• She developed swelling from chest She developed swelling from chest upwards to face and down to abdomenupwards to face and down to abdomen

• Difficulty in breathing progressiveDifficulty in breathing progressive

• Time lag: 2 hours after injuryTime lag: 2 hours after injury




Swelling up to Swelling up to face , crepitations face , crepitations

all over upper all over upper body due to body due to

leakage of air leakage of air from the lungs from the lungs

outsideoutsideSternal fractureSternal fracture


Lung Lung collapsed, collapsed,

air air outside outside the lungthe lung

Tear in Tear in the right the right

main main bronchusbronchus

LungLung LungLung


Full Full recovery recovery

before going before going home from home from the Hospitalthe Hospital


Fall from the loft on an open stoveFall from the loft on an open stove

Chest Injury(Penetrating)


Penetrating injuryPenetrating injury

• Third rod of stove inside the childs’ chestThird rod of stove inside the childs’ chest

• No difficulty in breathingNo difficulty in breathing

• No gross bleedingNo gross bleeding

• No major organ/vessel damageNo major organ/vessel damage

• Child was very luckyChild was very lucky


Fall from the loft on an open stoveFall from the loft on an open stove

Chest Injury(Penetrating)


Trachea & Esophagus normal no subcut. emphysema

Penetrating Injury neck midline fall on an Iron rod


Fall on a sharp compound fenceFall on a sharp compound fence

Entry wound shows muscles cutEntry wound shows muscles cut


Exit wound in floor of mouth

Tongue


Glove finger seen inserted from entry wound


Tract of the iron rod seen


Muscles sutured in midline



Exit wound also closed


Post operative healing excellentDr Vivek Rege Pediatric Surgeon

Burns due to Kerosene can falling on the boys head Burns due to Kerosene can falling on the boys head & face due to rats on the loft. Boy was sitting in & face due to rats on the loft. Boy was sitting in

front of a stovefront of a stove


After local application of Amniotic membraneAfter local application of Amniotic membrane


Healing of burns on Healing of burns on the face and neck & the face and neck & trunk on the backtrunk on the back



Injuries In Children

Health & Medicine

rege crush injury

rege clwclw

injury massage

fingercrush injury

puma injury

vehicle crush injury

heavy objectcrush injury

large cut