Major Trauma (Paed) Flashcards
(15 cards)
Recite the Major Trauma (Paed) CPG
Recite the Major Trauma (Paed) CPG
What is the first priority in paediatric trauma?
Immediate control of major haemorrhage.
When should an OPA be used?
Only if the airway is not patent.
When should an SGA be used?
If there is no gag reflex and prolonged ventilation is required.
What is the guideline for intubation in paediatric trauma?
Intubation as per CPG P0301 Endotracheal Intubation if indicated. Transporting the patient unintubated is preferred if safe.
What are the ventilation targets for paediatric trauma?
Vt (Tidal Volume): 6–8 mL/kg
Rate by Age:
* <3 months: 25 bpm
* 3–12 months: 25 bpm
* 1–4 years: 20 bpm
* 5–11 years: 16 bpm
* 12–15 years: 14 bpm
SpO₂: >95%
EtCO₂: 30–35 mmHg
When should chest decompression be considered?
As per CPG P0802 Chest Injury if indicated.
What is the goal of fluid resuscitation in paediatric trauma?
To target adequate perfusion based on age-appropriate HR and SBP:
* Age
* HR (bpm)
* SBP (mmHg)
* 12–15 yrs: 60–130, 90
* 5–11 yrs: 80–140, 80
* 1–4 yrs: 90–160, 70
* 3–12 mo: 100–180, 60
* <3 mo: 100–180, 50
What is the initial fluid resuscitation?
Normal saline IV (max 40 mL/kg), titrated to response.
When should blood be used?
Seek consent from parents/guardian. If available, give PRBC 10 mL/kg IV in preference to normal saline, titrated to response.
When is a pelvic splint indicated?
For blunt trauma to the pelvis or in all unconscious multi-trauma patients.
What are supportive care measures in paediatric trauma?
- Warm the patient
- Provide pain relief as required
- Spinal immobilisation if required
- Manage wounds/fractures
- Manage seizures as per CPG P0703
- Manage hypoglycaemia as per CPG P0702
- Pressure care
When is Sodium Chloride 3% IV indicated?
For intubated neurotrauma with:
* Signs of deterioration (e.g. one or two dilated pupils)
* HEMS transport > 20 minutes
What is the dose of hypertonic saline in this setting?
Sodium Chloride 3% at 3 mL/kg IV (max 250 mL) over 5–10 minutes.
