The Injured Child

Question 1

What is the classification system used for growth plate injuries?

Answer 1

• Salter Harris clasification

Question 2

How does the size of children affect how they are injured?

Answer 2

• smaller target
• greater amount of energy is absorbed for the same force of impact
• lare surface area:volume ratio
• significant heat loss
• relatively large head
• easily injured
• smaller mass
• drug doses + fluid requirements differ
• different equipment + techniques

Question 3

How does the skeleten of children affect how they are injured?

Answer 3

• incompletely calcified
• soft
• springy
• deforms rather than breaks
• poor at absorbing energy
• provides less protection for vital organs

Question 4

How does the insides of children affect how they are injured?

Answer 4

• less elastic connective tissue
• shearing + de-gloving
• crowding of poorly protected vital organs
• liver, spleen, bladder are intra-abdominal

Question 5

How does the metabolism of children affect how they are injured?

Answer 5

• thermoregulation
• little brown fat + immature shivering
• pokilothermic
• environmental considerations
• hypoglycaemia
• little glycogen stored in liver
• exacerbated by hypothermia + vice versa
• develops quickly in sick children

Question 6

What are different types of injury patterns in children?

Answer 6

• SCIWORA
• Spinal, Cord, Injury, Without, Radiological, Injury
• lap belt syndrome
• Waddell’s triad (pedestrian RTC)
• fractured femoral shaft
• intra-thoracic/intra-abdominal injuries
• contralateral head injury

Question 7

What are the normal ranges for vital signs in children?

Answer 7

Question 8

What are some life-threatening traumas in children?

Answer 8

• respiratory failure
• respiratory obstruction (e.g. foreign body, pneumothorax)
• respiratory depression (e.g. poison, raised ICP)
• circulatory failure
• fluid loss (e.g. burns, trauma)
• fluid maldistribution (e.g. sepsis)

Question 9

What is involved in a primary survey?

Answer 9

• catastrophic haemorrhage control
• Airway with C-spine + O²
• Breathing with ventilation
• Circulation + haemorrhage control
• Disability
• Exposure/Environment
• don’t ever forget glucose