In this phase, all of the child's injuries are managed definitively, or the child is stabilized sufficiently to allow safe transfer to a facility that can provide a higher level of care. Continual reassessment is crucial, because some injuries may be only manifest over time and complications from therapeutic interventions can occur. Emphasis is placed on monitoring the airway and circulatory status of pediatric trauma patients. Endotracheal tube dislodgment, development of a pneumothorax, regurgitation of stomach contents, occult hemorrhage causing shock, and worsening neurologic function are all frequently seen in injured children. Careful monitoring of fluid administration will prevent inadvertent overhydration. Analgesia and sedation should be used judiciously; often these elements are neglected in injured pediatric patients.
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