Advanced Pediatric Studies for Paramedic - Essay Example

15% of them are considered severe.Traumatic brain injury (TBI) is devastating with catastrophic consequences. Early recognition of injury and prompt delivery of focused care of the traumatic brain injured patient is essential to patient outcome. Resuscitative fluids are one of the cornerstones in the management of the critically ill. Of particular importance is the way paramedic professionals manage TBI in children and the way fluids in TBI are applied. In this paper, the advantages and challenges of administering fluids in pediatric TBI are evaluated and discussed.

From where you bring the statistics (15%). I read the reference and I do not find them. Also, I need brief definition of Trumatic brain injury.Body Physiology of TBI in children and implications for fluid management: TBI is the leading contributor to children’s mortality after trauma.Much has been written and said about the nature and physiology of TBI in children. This knowledge has far-reaching implications for the use of fluids in paramedic management and their potential benefits for small patients.

The fact is in that the physiology and mechanism of TBI is directly related to the demographic characteristics of the patient (Bruns & Hauser, 2007). The majority of TBIs in Australia occurs as a result of road traffic accidents (40%), recreation and sports (25%), and falls (21%) (Bruns & Hauser, 2003). Falls predominate as a cause of TBI in children, regardless of their gender or race (Bruns & Hauser, 2003). This is why paramedic professionals should be particularly cautious in the analysis and choice of fluids to manage TBI in their small patients.

Fluids used to manage TBI in paramedic settings: The current state of literature provides abundant information regarding the use of fluids in the management of TBI in small patients. Resuscitative fluids are crucial in management of critically ill patients following TBI (Brackney, Diaz, Milbrandt, Al-Khafaji & Darby, 2010). However, central to the fluid-TBI debate is the choice of fluids and their optimization in paramedic settings, where decision making should be fast but reasonable. Albumin versus saline fluids continues to generate professional controversies among pediatric paramedics.

As of today, there is no clear consensus as to the validity of albumin and its quality in TBI management. Albumin is believed to cause higher mortality and less favorable results in children with severe TBI (Brackney et al., 2010). However, these findings are inconsistent and require further analysis and validation. According to Cooper et al. (2004), prehospital administration of hypertonic saline in patients with TBI can increase their survival. In Europe, for example, saline solutions have been used extensively in the management of TBI since 1991 (Cooper et al., 2004). The principal benefit of using saline resuscitation is in that it “may decrease secondary brain injury compared with standard resuscitation protocols alone” (Cooper et al., 2004, p.1351).

Particularly in patients with severe TBI, where hypotension is the most common cause of increased mortality, saline resuscitation is the only way to improve cerebral perfusion and, consequently, improve pediatric patients’ neurological outcomes (Cooper et al., 2004). However, even with all benefits of fluid resuscitation in pediatric patients with TBI, its challenges and problems should be also considered. In Australia, crystalloids are the primary instrument of fluid management in pediatric TBI, as they impose few negative effects on small patients with brain traumas.

Mannitol 0.25-1g/kg remains the most popular fluid administered to