Management of traumatic shock.

Trauma is the leading cause of death in the pediatric age group. About 25,000 children die each year and one million children are injured each year in the USA. Aggressive resuscitation determines the outcome of these injured children. The initial hour following the traumatic injury is referred to as the "golden hour" during which we have an opportunity to intervene and improve the outcome. It is not only the first hour which is important but every minute in trauma resuscitation is important. The outcome of traumatic children has a direct correlation to resuscitation. In order to manage traumatic shock there are four basic principles: (a) control of active hemorrhage, (b) assessment of circulatory status, (c) rapid intravascular access, and (d) aggressive fluid resuscitation. Following the four principles of management of traumatic shock and aggressive resuscitation improves the outcome.