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MD 3: Paeds > Trauma & first aid > Flashcards

Flashcards in Trauma & first aid Deck (7):
1

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

Breathing
- O2 if sats <95-92%
- If circumferential chest burn consider axial line escharotomy (cut through burns as burn tissue is restrictive to breathing)

Circulation
- 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

Disability
-Use AVPU (alert, response to voice or pain and unresponsive) in stead of GCS
-Cervical collar <2 not effective, need manual stabilisation
-Pupils

2

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

3

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)

4

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

5

What does the primary survery/Ax of trauma in children involve?

1. ABCD
2. Adequate exposure
3. AMPLE history
- allergies, medications, tetanus status, past medical/hospitalisations, last meal, event/environment surrounding accident
4. Imagine
- CTB - if poor conscious state/AVPU, pupil signs or severe injury
- XRAYs - lateral c-spine, chest +/- pelvis

6

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

7

If suspect NAI what should you do?

If <3 years ALWAYS
- Full Skeletal survey (XRs to cover whole body) - looking for signs of fractures AND
- Whole body bone scan

Consider imaging of head and neck - shaking