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ATLS > Paediatric trauma > Flashcards

Paediatric trauma Flashcards

1
Q

Risk of hypothermia in children

A

Large surface area to body mass

Hypothermia develops more quickly than adults

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2
Q

Bone fracture in children

A

Rarely have fractures as bones not calcified

If present implies transfer of a large amount of force

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3
Q

Most common cause of cardiac arrest in children

A

Hypoxia

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4
Q

Correct positioning of children on resuscitation table for airway maintenance

A
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5
Q

Appropriate ETT depth (in cm) calculation in children

A

3 times the tube size

eg a 4.0 ETT, should be positioned at 12 cm from gums

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6
Q

What type of ETT is used in infants

A

Uncuffed

The narrowest part of the airway (cricoid ring) forms a natural seal around the ETT

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7
Q

Use of cuffed airway in paeds

A

Previously avoided as risk of necrosis

However, newer models are much better, cuff pressure <30mmHg is safe

Cuffed ETT for toddlers and small children provides improving ventilation and CO2 management

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8
Q

Sizing of ETT tube

A

Diameter similar to the end of the little finger

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9
Q

Heart rate changes in infants undergoing intubation

A
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10
Q

Needle and tube thoracostomy landmarks in children

A

Needle decompression over the top of 3rd rib in the midclavicular line

Chest tube 5th intercostal space, anterior to the midaxillary line

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11
Q

Estimation of the mean systolic pressure with age

A

SBP= 90+ 2*age(yrs)

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12
Q

Estimation of lower limit of normal for SBP in kids

A

70 + 2 * age (in yrs)

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13
Q

Estimation of diastolic pressure in kids

A

Around 2/3 of SBP

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14
Q

Normal physiological obs values for children

A
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15
Q

Ways of getting children’s weight

A

Ask caregiver

Use length based resuscitation tape

Last resort: use wt= 2*age + 10 in kg

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16
Q

The blood volume in infant, child age 1-3 and child over 3

A

Infant 80mls/kg

Child 1-3 yr 75ml/kg

child over 3 70ml/kg

17
Q

The preferred IV access methods in kids

A
  1. IV ACF or saphenous vein
  2. IO anteromedial tibia or distal femur
  3. percutaneous femoral vein line
  4. percutaneous external or internal jugular or subclavian vein
18
Q

Complications of IO access

A

Cellulitis

OM

Compartment syndrome

Iatrogenic fracture

19
Q

Preferred site of IO access

A

Anteromedial tibia

Distal femur

20
Q

Fluid resus protocol in kids

A

Traditionally:

Up to 3 boluses of 20ml/kg of warm isotonic solution

Followed by 10ml/kg of RBC

Evidence emerging:

One 20ml/kg bolus of isotonic solution

Followed by 1:1:1 of RBC, platelets and FFP at 10-20ml/kg

21
Q

Risk of malignancy with CT scanning in children

A

1 in 1000 will develop fatal cancers

22
Q

Developmental milestones

A
23
Q

How HR and blood pressure change in children with various degrees of blood loss

A

Heart rate compensates for longer

24
Q

CT head criteria in children

A

ATLS (14 decks)

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