The Injured Child Flashcards
What type of injury is most common in children?
Head injury
Why do children get injured?
Interaction between stage of development, environment and those around them
Think about audio visual clues, written warnings, climbing, inquisitive nature, playing and risky behaviour
Describe children’s skeleton
Soft, springy, deforms rather than breaks and poor at absorbing energy
Provides less protection for vital organs
Describe inside body of children
Less elastic connective tissue - sheering and degloving
Crowding of poorly protected vital organs
Thermoregulation is different
Hypoglycaemia - exacerbated by hypothermia
What are important injury patterns to look for?
SCIWORA - spinal cord injury without radiological abnormality
Lap belt syndrome
What is the approach for an injured child?
Teamwork, preparation, challenges, primary survey and secondary survey
What is used in preparation for an injured child?
WETFLAG - weight, energy, tube size + length, fluids, lorazepam, adrenaline and glucose
Equipment
Major haemorrhage protocol
Drug calculations
Trakcare
What is involved in primary survey?
cABCDE - ATOMFC
Catastrophic haemorrhage control is c
How is airway assessed?
Look at c-spine
SCIWORA
See if child is talking and if have clear airway
What breathing injuries can be seen?
Tension pneumothorax, haemothorax, open pneumothorax, pulmonary contusions and flail chest
What is involved in circulation assessment?
Look for source of haemorrhage - pelvis, abdomen, chest, thighs and long bones
Good IVA
Do they need pelvic or femoral splint
What is looked at in disability?
Look for communications and neurological examination
What is involved in exposure?
Exposure full, keep warm and don’t forget glucose
What imaging is used for an injured child?
CT, X-ray, US and re-examination
What is involved in secondary survey?
Top to toe assessment, pick up other injuries that may not be life-threatening, help decrease morbidity and tertiary survey
What is the process of fracture assessment?
Analgesia, history, consider mechanism, examine all of the joint and distraction
What are types of common fractures in children?
Buckle fracture of distal radius - usually splint for 3 weeks and watch doing activity
Supracondylar fracture - displaced then operation
Greenstick fracture - don’t fracture all the way through
Clavicle fracture
Toddler’s fracture of the tibia - subtle crack
Growth plate injuries
How are growth plate injuries classified?
Salter Harris
Describe wounds in children
Fingers and toes
Head injuries
Tissue glue
LAT gel
Theatre and sedation
Describe burns/ scalds in children
First aid is really important
Chemical burns
COBIS - guidance on complex burns
Functional
Plastics
What are some head injury guidelines in children?
NICE guidelines
Don’t forget NAI - non-accidental injury
Concussion - ACORN
Sport - headway
