Two studies find proven methods for predicting internal injuries in children

Thoracic injuries are second only to head injuries as the leading cause of death in children who have experienced blunt trauma. University of California-Davis Medical Center investigators found in this study published in the May 2002 Annals of Emergency Medicine that pediatric patients with blunt trauma injuries exhibit one or more of the following symptoms: low systolic blood pressure, elevated respiratory rate, abnormal thoracic examination results, abnormal sounds heard in the chest, femur fracture, and a Glasgow Coma Scale score of less than 15. Children with any of these symptoms should have a chest x-ray. If a child does not exhibit any of these symptoms, the likelihood of a thoracic injury is low, said the study’s authors. (A Clinical Decision Rule for Identifying Children With Thoracic Injuries After Blunt Torso Trauma)

In another study, that same team of investigators finds that laboratory testing, combined with physical examination findings, contribute significantly to the identification of children with internal abdominal injuries. Missed abdominal injury, which is difficult to diagnose, is a leading cause of preventable death and disability, according to the study. The role of laboratory testing in evaluating pediatric trauma patients has been controversial because it is expensive and the benefits were unknown. However, researchers said the laboratory tests used in this study were accurate, inexpensive and widely available. (Identification of Children with Intra-Abdominal Injuries After Blunt Trauma)

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