to the lower body Patients with traumatic asphyxia usually present with subconjunctival and upper body petechial hemorrhages, cyanosis, periorbital edema, respiratory distress, altered mental status, and associated injuries The primary goal of treatment is to stabilize the patient and evaluate associated injuries The external appearance of a child with traumatic asphyxia is quite impressive, but initial attention should be paid to the cardiopulmonary status Pulmonary contusions and hepatic injuries are commonly seen with traumatic asphyxia, and CT scan is helpful in identifying head and abdominal injuries Because the most severe injuries cause immediate death, the prognosis is good for any patient surviving the first few hours Cutaneous manifestations will resolve with time, and neurologic sequelae are rare Suggested Readings and Key References General Balci AE, Kazez A, Eren S, et al Blunt thoracic trauma in children: review of 137 cases Eur J Cardiothorac Surg 2004;26(2):387–392 Bliss D, Silen M Pediatric thoracic trauma Crit Care Med 2002;30(11):409–415 Cooper A, Barlow B, DiScala C, et al Mortality and truncal injury: the pediatric perspective J Pediatr Surg 1994;29(1):33–38 Exadaktylos AK, Sclabas G, Schmid SW, et al Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with “normal” chest radiograph? J Trauma 2001;51(6):1173–1176 Gittelman MA, Gonzalez-del-Rey J, Brody AS, et al Clinical predictors for the selective use of chest radiographs in pediatric blunt trauma evaluations J Trauma 2003;55(4):670–676 Grisoni ER, Volsko TA Thoracic injuries in children Respir Care Clin N Am 2001;7(1):25–38 Hall A, Johnson K The imaging of paediatric thoracic trauma Paediatr Respir Rev 2002;3(3):241–247 Holmes JF, Sokolove PE, Brant WE, et al A clinical decision rule for identifying children with thoracic injuries after blunt torso trauma Ann Emerg Med 2002;39(5):492–499 Inan M, Ayvaz S, Sut N, et al Blunt chest trauma in childhood ANZ J Surg 2007;77(8):682–685 Peclet MH, Newman KD, Eichelberger MR, et al Patterns of injury in children J Pediatr Surg 1990;25(1):85–90