Evaluation and Resuscitation

Question 1

Normal Pediatric vitals by age?

Answer 1

Newborn: HR 100-160/BP75/50/RR30-50
1-5 months: 90-150/75/50/ RR25-40
6-12 months: 80-140/75/50/20-30
1-3 yrs: 80-130/80/50/20-30
3-5 yrs: 80-120/80/50/20-30

Question 2

Peds GCS scale?

Answer 2

Eyes (1-4): spontaneous/ to voice or touch/ to pain/ no response
Verbal (1-5): interacts appropriately/ consolable crying/ moaning (inconsistently consolable)/ inconsolable (agitated)/ no verbal response.
Motor (1-6): normal spontaneous/ withdraws to touch/ withdraws to pain/ flexion/ extension/ flaccid

Question 3

Waddel’s Triad

Answer 3

pattern of injury in children hit by car:

• femur #
• chest/abdo injury
• head injury

Question 4

When do you suspect SCIWORA

Answer 4

non-accidental trauma in infants or sports related injuries.
transient neurological complaints after trauma.

Question 5

C-spine collar on presentation for:

Answer 5

1) Altered LOC
2) symptoms related to spine injury: - sensory or motor symptoms
- pain over spine
3) Mechanism: car vs ped
- MVC with ATV or motorbike
- falls > 10ft or 3x height
- thrown from bike/skateboard
- other concerning mechanism

Question 6

Criteria for clearing without imaging:

Answer 6

• no focal defecits
• GCS or 15 with no distracting injuries with minimal analgesia
• full active range of motion and no midline tenderness

Question 7

Criteria for radiographic clearance:

Answer 7

• normal 3 views of the spine
• may require swimmers view to visualize lower spine
• CT of levels not adequately seen on xray.
• MRI if neuro defecits present

Question 8

Is chest CT essential?

Answer 8

no. unless clinical concern or abnormality on CXR.

Question 9

Indications for intubation?

Answer 9

• Resp distress
• GCS < 8
• impending airway compromise

Question 10

Age cutoff for Cricothryoidotomy?

Answer 10

10 years and up. below 10 there is a significant risk to larynx.

Question 11

Tube size for Cric?

Answer 11

4-5.5 ET tube

Question 12

surgical airway management below age cuttoff?

Answer 12

angio cath connected to high flow O2 (one second on 3 seconds off)
convert to trach ASAP

Question 13

Indications for thoractomy due to blood loss?

Answer 13

Initial loss of 15-20 ml/kg OR ongoing loss 2/kg/hr for 3 hours