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Whilst waiting for an operation, they need to be managed medically. The underlying heart defect determines the precise operation performed – you might have heard of the Norwood procedure , an example used for HLHS specifically. Six hours post-operatively, they become more mottled, with weak pulses – signs of poor systemic perfusion.
This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures). Lancet 2010; 376(9734): 23-32.
The Trauma Death Spiral Lethal triad of hypothermia, acidosis, and coagulopathy. Often children even with high-grade splenic and liver lacerations can be managed non-operatively. Unfortunately, a negative FAST cannot help with detecting or grading the laceration for non-operative management. 2010 Nov;19(4):286-91.
Nachi: Among metabolic abnormalities, patients can present with hyperthermia, hypoglycemia, hypokalemia, hyponatremia, and metabolic acidosis. From 2010 to 2011, the number of ED visits by children aged 12 to 17 years old due to synthetic cannabinoid use also has doubled. Chronic use has also been linked to severe periodontitis.
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