Flashcards in Trauma & first aid Deck (7):
What are the differences in ABCD approach for trauma/resus in children?
Airways - as per adults
- If crying patent airway
- Insert gadels with direct vision (no turning)
- Same airway maneouvres
- O2 if sats <95-92%
- If circumferential chest burn consider axial line escharotomy (cut through burns as burn tissue is restrictive to breathing)
- Maintenance rule - 4/2/1 for 1st, 2nd 10kg and rest of weight
- If burns consider increased fluid needs and poor glycogen storage - need maintance with dextrose to avoid hypoglycaemia
-Use AVPU (alert, response to voice or pain and unresponsive) in stead of GCS
-Cervical collar <2 not effective, need manual stabilisation
What are key considerations & Rx in trauma from burns?
Circumferential chest burns can restrict breathing
Circumferential lower limb burns can act as torniquet - consider escharotomy or elevation of limbs
Wound care - assess TBSA affected and deepth/circumference burns
Consider hypoglycaemia, hypovolaemia and hypothermia
- Dextrose maintenance fluids
- Plastic wrap over wounds to retain heat and moisture
- Warm the evironment and patient with bear huggers etc
Pain assessment and management
What are key considerations & Rx in abdominal trauma?
Children more suscepetible to abdo trauma - smaller torso, less protective habitus and compliant ribs
Consider pelvic CT/XR if abdo tenderness, high riding selt belt bruising
Need to insert urinary catheter and gastric decompresion tube (prevent acute gastric dilation, vomiting and aspiration and improves imaging quality)
What is the first aid Rx for burns?
Perform early and lasts ~3 hours - if not performed properly and within 3 hours should do it
Exposure to cool, clean running water for 20 mins - more not effective
Never Ice - does more damage than good
What does the primary survery/Ax of trauma in children involve?
2. Adequate exposure
3. AMPLE history
- allergies, medications, tetanus status, past medical/hospitalisations, last meal, event/environment surrounding accident
- CTB - if poor conscious state/AVPU, pupil signs or severe injury
- XRAYs - lateral c-spine, chest +/- pelvis
Red flags/risk factors for non-accidental injury?
Hx DHS involvement
Hx parental substance use, domestic violence, MH, poverty
Bruising - Patterned, tram track, periorbital
Location of injury important
Subdural haemorrphages, posterior rib fractures - signs of shaken baby syndrome