16. Injuries To Children

Question 1

Why do children sustain injuries?

Answer 1

Children with learning difficulties may not be able to read warning sounds
Children are enquisitive
Children like to climb

Question 2

What is a buckle fracture?

Answer 2

Overlapping of bones due to no ossification of the bones

Question 3

What is the most common fractures seen in children

Answer 3

Broken clavicle
Heals by membranous ossification so heals very quickly
Sling or clavicular brace

Question 4

What is a toddlers fracture of the tibia?

Answer 4

Spiral crack of a tibia due to toddlers falling when running/walking
High suspicion in toddlers with ankle pain
Splint or just bed rest

Question 5

What is a green stick fracture?

Answer 5

Fracture of a long bones ossification
Children’s will come in with a Z shaped limb
Mainly entenox and fix
Polo mint

Question 6

Where are the most common places for bones to break?

Answer 6

At growth plates

Different types based off salter Harris classification

Question 7

What is key to know about child wounds?

Answer 7

You need to know the depth and extension of a wound before you close it

Question 8

What is important about scalds?

Answer 8

Scalds are moist, superficial, hot
Very sore
Treat with analgesia

Question 9

What do you think about at house fire injuries?

Answer 9

Smoke
Hydrogen cyanide
Trauma from jumping out of windows
Burns

Question 10

What external factors make a child respond differently to injury?

Answer 10

Cold
Hypoglycaemia
Alcohol
Drugs

Question 11

What changes the injuries or children?

Answer 11

They are smaller and therefore greater amount of energy is absorbed per area

Smaller therefore poorer heat control

Large head, easily injured

Skeleton provides less protection for vital organs

Smaller glycogen stores

Question 12

How do you measure the injury of an event?

Answer 12

Take a good history
Read the wreckage
Do the injuries fit the story
Non accidental injury- metacarpal bucket fracture,

Question 13

What is SCIWORA?

Answer 13

Spinal cord injury without radiological abnormality

Necks are poorly ossified, hard to read scan due to lots of cartilage and less bone. Therefore can have spinal cord injury and not recognise it

Question 14

What are the long term effects of trauma in children

Answer 14

Psychological recovery from trauma

Effects of normal growth and development

Question 15

What are the major life threatening traumas?

Answer 15

Respiratory failure
Circulatory failure- burns
Fluid maldistribution

Question 16

What is the aim of trauma resuscitation?

Answer 16

Restore normal tissue oxygenation as quick as possible

cABCDE
1st quick surgery and tests
2nd survey-check all over
Emergency treatment
Definitive care
Reassessment