Critical care of the injured child.

Critical care of the injured child should be an effective extension of aggressive resuscitation, stabilization, and definitive care. In the hours and days after acute injury, initially unnoticed lesions may emerge, secondary organ dysfunction may develop, and complications of primary injury or initial management may occur. We approach critical care of the severely injured child as a continuation of care begun in the trauma center. We follow an organ system, problem oriented protocol, and attempt to anticipate problems before they occur. This article defines our approach in general terms, with specific emphasis on the more common problems encountered in caring for seriously injured children.