Paeds Trauma_Scenario

Question 1

Paeds Trauma_Scenario

Answer 1

1. History
   
   1. Paeds ATLS - ABCDEs
   2. Age/Sex/Race
   3. O nset
      
      1. MOI
      2. Previous Injury
   4. P osition
   5. Q uality/Quantity
   6. R adiation
   7. S ymptoms associated
      
      1. Neurologic
      2. Mechanical
      3. Local
   8. T iming
      
      1. When injury occurred
   9. PSHX, PMHX, Meds, Allergies
   10. Social Hx (EtOH, tobacco)
   11. Handedness
   12. ROS
   13. Last Meal
2. Physical Exam
   
   1. Look
      
      1. Gait
      2. Body habitus, Dysmoprhic features
      3. S welling
      4. E rythema
      5. A trophy
      6. D eformity
      7. S kin changes
         
         1. Midline lesions
         2. Skin lesions
   2. Feel
   3. Move
   4. NV Exam
   5. Special Tests
3. Imaging
   
   1. Xrays, other modalities
4. Diagnosis or DDx
   
   1. Implications (AVN risk, infection, etc.)
5. Acute Rx and work-up
   
   1. Reduce/splint/post reduction xray/traction, ER tests/consults, admit, further imaging, plan OR for trauma
6. Treatment plan
   
   1. Goals
   2. Non-operative Rx (options, follow-up)
   3. Operative
      
      1. Discuss options
      2. Plan OR – consult specialist PRN
   4. Consent
      
      1. Outcome
      2. Risks
         
         1. immediate
         2. late
   5. Pre-op
      
      1. labs (x-match), tests (ECG, CXR), old OR reports, consults
   6. Post the case
      
      1. patient, surgery, implants, adjuncts (teams, consultants, special equipment), table, flouro, monitoring
7. Technique
   
   1. Position, ABX
   2. Incision, approach, fixation
8. Post-op
   
   1. NV exam, compartment check
   2. Xrays
   3. Immobilization
   4. Weight Bearing Status, Physio
9. Disposition and Follow-up
   
   1. F/U plan
10. Complications
    
    1. List potential complications
    2. Prevention
    3. Treatment