Damage Control Resuscitation and Surgery (DCR/DCS) in Children

Description

In this comprehensive presentation, Dr. Suren Arul, a pediatric surgeon with experience in military trauma care, discusses the protocols and principles for managing pediatric blast injuries. His insights, derived from his work in conflict zones, emphasize the importance of applying adult trauma management techniques to children, highlighting the need for immediate hemorrhage control and a systematic approach known as the ABCDE framework (Airway, Breathing, Circulation, Disability, Exposure).



Dr. Arul shares essential guidelines, such as the concept of damage control surgery, which prioritizes stopping bleeding and minimizing contamination before comprehensive surgical repair. He stresses the significance of calm communication among surgical teams, as well as recognizing and addressing the unique physiological challenges children face in trauma settings, including acidosis, coagulopathy, hypothermia, and hypercalcemia.



He underscores the advantages of damage control methods in pediatric cases, such as performing quick laparotomies to pack bleeding areas and leaving abdominal wounds open to prevent compartment syndrome. His approach includes using a low-pressure suction method for open abdomen management and advocating for timely re-evaluation and subsequent surgeries once the patient's condition stabilizes.



Dr. Arul also addresses the specific surgical techniques suitable for children, such as avoiding extensive resections, prioritizing organ conservation, and employing innovative methods for assessing injuries (like CT scans) even days after initial trauma if the child is unstable.



Ultimately, he demonstrates successful case studies, illustrating how early nutritional support and proper postoperative care facilitate recovery. His final message reinforces that with careful planning, team coordination, and adherence to pediatric trauma principles, significant advancements can be achieved in saving young lives.

DOI: 10.1302/3114-230176

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