Advances in the treatment of pediatric trauma.

Injury is the leading cause of death among US children over 1 year of age. The financial burden of acute care is over $15 billion annually. The unique anatomic and physiologic differences of children predispose them to certain types of injuries and require a specialized approach to pediatric trauma care. This article reviews the common etiologies of injuries to children and identifies injury subgroups at increased risk of mortality. Resuscitation and assessment are discussed, emphasizing fluid management, rapid intravenous access, and the physiologic evaluation of the child in shock. Protocols for evaluating head, thoracic, abdominal, and pelvic injuries are presented in light of recent advances in the diagnosis, treatment, and rehabilitation of children sustaining these injuries.