pediatric trauma

Question 1

t/f agitation and pain can produce tachycardia, but narcotics and sedatives are contraindicated during the initial assessment

Answer 1

true

Question 2

Bradycardia in the pediatric trauma patient is a dangerous sign that indicates what three issues

Answer 2

hypoxia
impending arrest
increased ICP

Question 3

a pediatric decrease in HR results in a proportionate fall in ___

Answer 3

cardiac output

Question 4

this value declines in shock and serves as an important indicator pf the patients hydration status

Answer 4

UOP

Question 5

blood in urine in pediatric trauma indicates trauma where?

Answer 5

intraabdominal trauma

Question 6

hypotension, as a result of hemorrhage correspond to a loss of what percent and what ml/kg

Answer 6

25% of blood volume or

20ml/kg

Question 7

hypotension in children is considered 
early
middle 
late 
sign?

Answer 7

late finding in shock

Question 8

as hypotension is a late signs in children - what does it require of the medical personal

Answer 8

identify
with
immediate and aggressive management

Question 9

what is the initial treatment of hypovolemic shock

Answer 9

resuscitation with crystalloid solution

Question 10

what three places are veins of adequate size found in the pediatric patient

Answer 10

AC
saphenous vein ankle
femoral vein

Question 11

LR is initial fluid resuscitation at rate of

Answer 11

20ml/kg

Question 12

Blood rate can be administered at

Answer 12

10ml/kg

Question 13

what can be applied to pediatric trauma to maintain blood pressure predominately by increasing cardiac afterload

Answer 13

MAST

Question 14

Complications associated with MAST use include

Answer 14

Complications associated with MAST use include compartment syndrome, exacerbation of cerebral edema, respiratory insufficiency, and cardiovascular collapse when the device is rapidly deflated.

Question 15

what is a common complication of children with blunt chest injury

Answer 15

Pneumothorax

1/4th under tension

Question 16

name 3 classic signs of tension pneumothorax

Answer 16

ipsilateral tympany
shift of the trachea to the contralateral side
distended neck veins

Question 17

elevated CVP seen in pericardial tamponade and tension pneumothorax may produce a bulging fontanelle in infants and mimic what

Answer 17

hemorrhage

Question 18

how many fluid boluses of crystalloids are administered prior to PRBC’s

Answer 18

3

Question 19

this solution may improve survival in patients with head injuries and increased ICP

Answer 19

hypertonic saline 7.5%

Question 20

what solution must be avoided

Answer 20

glucose containing solutions

Question 21

if oncotic pressure needs to be increased what solutions should be used

Answer 21

dextran
hetastarch
synthetic colloids
caution-decreased platelet function

Question 22

cvp location more reliable in children

Answer 22

inferior vena cava ex. femoral vein

Question 23

avoid___at all costs!!

Answer 23

hypothermia

Question 24

all trauma patients are considered __stomachs

Answer 24

full

Question 25

choice of induction agents depends on what two things

Answer 25

neurological and volume status

Question 26

unstable patient needs very little anesthesia, avoid high concentration of volatile agents as it may worsen hypotension judicious use of what two agents

Answer 26

fentanyl
and
ketamine

Question 27

for acidosis

Answer 27

sodium bicarbonate

Question 28

(2)inotropic agents such as

Answer 28

dopamine

dobutamine

Question 29

(2)amnestic agents

Answer 29

scopolamine

midazolam

Question 30

what is the most common cause of morbidity /mortality in head injuries

Answer 30

due to hypoxia from airway obstruction

Question 31

as hypotension is rare with head injuries what can it indicate

Answer 31

terminal events

Question 32

what do we use for neurologic function scale

Answer 32

GCS

Question 33

CT shows diffuse cerebral swelling

treatment

Answer 33

hyperventilation
diuresis
avoid HTN
elevate head and avoid obstruction to venous outlofw
intubation

Question 34

Corrosive substances NO NO

Answer 34

never induce vomiting