Emergency Care of Children 2

Question 1

Indications for CT in children at high risk of significant intra-abdominal injuries include:

Answer 1

Polytrauma victims with a history suggestive of severe intra-abdominal injury

Concerning physical exam findings: abdominal tenderness, peritonitis, a seatbelt sign or other bruising

Aspartate aminotransferase >200 IU/L or alanine aminotransferase >125 IU/L

Decreasing hemoglobin or hematocrit

Gross hematuria

Question 2

The Pediatric Emergency Care Applied Research Network (PECARN) developed a rule to identify patients at very low risk for intra-abdominal injury requiring intervention (surgery, embolization, transfusion for abdominal bleeding, IV fluid requirement >48 hours). Children are classified as very low risk and may forgo CT imaging if they meet the following criteria:

Answer 2

No evidence of abdominal or thoracic wall trauma

Glasgow Coma Scale score >13

No abdominal pain or tenderness

Normal breath sounds

No vomiting after injury

Question 3

Posttraumatic Headache Symptoms Resembling Primary Headache Disorders:
*** Treat posttraumatic headaches based on the primary headache disorder they most resemble

Bilateral, moderate severity, dull pressure/squeezing sensation. Location is variable. Triggers are stress, reading, sustained poor posture.

Answer 3

Tension type

Question 4

Posttraumatic Headache Symptoms Resembling Primary Headache Disorders:
*** Treat posttraumatic headaches based on the primary headache disorder they most resemble

Unilateral, severe, pulsating, associated nausea, vomiting, photophobia, sensory and visual changes. Location may vary. Triggers can be exercise, lights, and sounds.

Answer 4

Migraine

Question 5

Posttraumatic Headache Symptoms Resembling Primary Headache Disorders:
*** Treat posttraumatic headaches based on the primary headache disorder they most resemble

Unilateral, severe, throbbing, autonomic activation,
lacrimation, and rhinorrhea. Pain is often described
as retro-orbital or periorbital.

Answer 5

Cluster

Question 6

Posttraumatic Headache Symptoms Resembling Primary Headache Disorders:
*** Treat posttraumatic headaches based on the primary headache disorder they most resemble

Unilateral, mild to severe in quality, often described as aching. Location is focal, involving the neck. Triggers are neck movement. There is often a history of whiplash.

Answer 6

Cervicogenic

Question 7

Classically presents between 6 weeks and 6 months of age and is the most common surgically correctible cause of vomiting in newborns.

Answer 7

Pyloric stenosis