Situational awareness in the management of pediatric abdominal impalement

Non-firearm abdominal impalement is a rare presentation of pediatric trauma and presents unique challenges. Here, we present the case of a 13-year-old girl who sustained transabdominal impalement of a tree branch from a sledding accident in which she was being towed behind an ATV. Complicating her c...

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Autores principales:	Caroline M. Godfrey, Harold N. Lovvorn, III, Amber Greeno, Eunice Huang
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Pediatric trauma Impalement Sledding accident Disaster planning Pediatrics RJ1-570 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/9bf8a4b76fa34599b6e4f105b090678b
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spelling	oai:doaj.org-article:9bf8a4b76fa34599b6e4f105b090678b2021-11-22T04:25:10ZSituational awareness in the management of pediatric abdominal impalement2213-576610.1016/j.epsc.2021.102130https://doaj.org/article/9bf8a4b76fa34599b6e4f105b090678b2022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2213576621003511https://doaj.org/toc/2213-5766Non-firearm abdominal impalement is a rare presentation of pediatric trauma and presents unique challenges. Here, we present the case of a 13-year-old girl who sustained transabdominal impalement of a tree branch from a sledding accident in which she was being towed behind an ATV. Complicating her care was a concurrent, city-wide state of emergency in which internet and cellular communications were impaired after the bombing of a communication building. To characterize trajectory, computer tomographic (CT) scan imaging showed the branch traversed the right retroperitoneum, obstructing the ureter and inferior vena cava, passed adjacent to the inferior wall of the 4th portion of the duodenum, perforated the stomach, and exited the peritoneum through the left abdominal wall musculature. Laparotomy identified lacerations to the anterior and posterior gastric walls, a duodenal laceration, and significant debris throughout the abdomen. Three visceral defects were closed primarily. A contrast study on POD5 confirmed integrity of the repairs. She recovered well and was discharged on POD13. This case highlights the importance of evaluating patient-specific mechanism of injury (“look at”), assessing patients in real time when provider communications are limited due to any disaster (“look up”), and sharing with the community critical public health lessons (“look around”).Caroline M. GodfreyHarold N. Lovvorn, IIIAmber GreenoEunice HuangElsevierarticlePediatric traumaImpalementSledding accidentDisaster planningPediatricsRJ1-570SurgeryRD1-811ENJournal of Pediatric Surgery Case Reports, Vol 76, Iss , Pp 102130- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pediatric trauma Impalement Sledding accident Disaster planning Pediatrics RJ1-570 Surgery RD1-811
spellingShingle	Pediatric trauma Impalement Sledding accident Disaster planning Pediatrics RJ1-570 Surgery RD1-811 Caroline M. Godfrey Harold N. Lovvorn, III Amber Greeno Eunice Huang Situational awareness in the management of pediatric abdominal impalement
description	Non-firearm abdominal impalement is a rare presentation of pediatric trauma and presents unique challenges. Here, we present the case of a 13-year-old girl who sustained transabdominal impalement of a tree branch from a sledding accident in which she was being towed behind an ATV. Complicating her care was a concurrent, city-wide state of emergency in which internet and cellular communications were impaired after the bombing of a communication building. To characterize trajectory, computer tomographic (CT) scan imaging showed the branch traversed the right retroperitoneum, obstructing the ureter and inferior vena cava, passed adjacent to the inferior wall of the 4th portion of the duodenum, perforated the stomach, and exited the peritoneum through the left abdominal wall musculature. Laparotomy identified lacerations to the anterior and posterior gastric walls, a duodenal laceration, and significant debris throughout the abdomen. Three visceral defects were closed primarily. A contrast study on POD5 confirmed integrity of the repairs. She recovered well and was discharged on POD13. This case highlights the importance of evaluating patient-specific mechanism of injury (“look at”), assessing patients in real time when provider communications are limited due to any disaster (“look up”), and sharing with the community critical public health lessons (“look around”).
format	article
author	Caroline M. Godfrey Harold N. Lovvorn, III Amber Greeno Eunice Huang
author_facet	Caroline M. Godfrey Harold N. Lovvorn, III Amber Greeno Eunice Huang
author_sort	Caroline M. Godfrey
title	Situational awareness in the management of pediatric abdominal impalement
title_short	Situational awareness in the management of pediatric abdominal impalement
title_full	Situational awareness in the management of pediatric abdominal impalement
title_fullStr	Situational awareness in the management of pediatric abdominal impalement
title_full_unstemmed	Situational awareness in the management of pediatric abdominal impalement
title_sort	situational awareness in the management of pediatric abdominal impalement
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/9bf8a4b76fa34599b6e4f105b090678b
work_keys_str_mv	AT carolinemgodfrey situationalawarenessinthemanagementofpediatricabdominalimpalement AT haroldnlovvorniii situationalawarenessinthemanagementofpediatricabdominalimpalement AT ambergreeno situationalawarenessinthemanagementofpediatricabdominalimpalement AT eunicehuang situationalawarenessinthemanagementofpediatricabdominalimpalement
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Situational awareness in the management of pediatric abdominal impalement

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