Chapter 11 Structured approach to seriously injured child

Question 1

How to you tilt a pt to get a pat slide under them when worried about c-spine or other injuries?

Answer 1

20 degree tilt

Question 2

What is the dose of tranexamic acid?

Answer 2

15mg/kg IV/IO

Question 3

What is the bolus dose of warmed saline or warmed blood in trauma?

Answer 3

5 - 10ml/kg

Question 4

In trauma, what is your goal for platelet levels?

Answer 4

> 100 x 10>9

Question 5

In trauma what is your goal for fibrinogen levels and what can you give to increase it?

Answer 5

> 1g/L
Give cryoprecipitate

Question 6

What is your goal for calcium levels in trauma?

Answer 6

> 1mmol/L

Question 7

Why is a nasogastric tube important in major trauma?

Answer 7

Children easily develop distended abdomens and this can splint the diaphgram

Question 8

Why is an IDC important in trauma?

Answer 8

To monitor fluid status. Though avoid IDC unless the child is critically unwell. Risk of urethral stricture formation.

Question 9

Why is it important to prevent hypothermia in trauma?

Answer 9

Cause coagulopathy
Warm fluids
Cover patient

Question 10

What is the target urine output in a child?

Answer 10

1-2 ml/kg/hr

Question 11

If there has been an electrical burn or crush injury, what should the urine output be?

Answer 11

2-3ml/kg/hr

Question 12

High urine output often indicates excessive fluids, but in a head injured child, what else can cause a high urine output?

Answer 12

Diabetic insipidus.
Can develop a few hour after head injury