The injured child

Question 1

What is a buckle?

Answer 1

Deformation within cortex

Question 2

Are boys or girls more likely to suffer trauma?

Answer 2

Boys

Question 3

What is worse for children between blunt and penetrating trauma?

Answer 3

Blunt

Question 4

What are common fractures in children?

Answer 4

Buckle fracture
Clavicle fracture
Toddlers fracture
Greenstick fracture

Question 5

What causes toddlers fracture?

Answer 5

Toddler falls, twists ankle, spiral fracture

Question 6

What is a greenstick fracture?

Answer 6

Periosteum breaks on one side and cortex gives way, but opposite periosteum remains as a hinge

Question 7

Where do children’s bones tend to break?

Answer 7

Growth plates

Question 8

What is important to know about a wound?

Answer 8

Depth and extent
Type
Mechanism

Question 9

What is the most common site of burn?

Answer 9

Hand - toddler touches ring

Question 10

How is scald managed?

Answer 10

Give adequate analgesia and protect from further harm

Question 11

What should be considered in family’s that have been in fire?

Answer 11

Thermal injury
Trauma from jumping out building
Inhaled poisoning

Question 12

What can affect how a child reacts to injury?

Answer 12

Cold
Alcohol
Drugs
Hypoglycaemia

Question 13

What aspects of a child’s size increases risk from injury?

Answer 13

Smaller target - greater energy absorbed for same force of impact
Relatively large head - easily injured

Question 14

What aspects of a child’s skeleton affect injury?

Answer 14

Incompletely calcified - soft, springy, deforms rather than breaks, poor at absorbing energy
Provides less protection for vital organs

Question 15

What aspects of metabolism affect children in injury?

Answer 15

Thermoregulation

Hypoglycaemia

Question 16

What should be considered in mechanism of injury?

Answer 16

Take a good history
Look at wreckage if vehicle accident
Do injuries fit with the story - NAI

Question 17

What are different injury patterns in vehicle injury?

Answer 17

Lap belt syndrome - injury caused by seatbelt

Spinal cord injury without radiological abnormality

Question 18

What is normal RR, systolic BP and HR in an <1y/o?

Answer 18

RR -30-40
SBP - 70-90
HR - 110-160

Question 19

What is normal RR, systolic BP and HR in a 2-5y/o?

Answer 19

RR - 25-30
SBP - 80-100
HR - 95-140

Question 20

What is normal RR, systolic BP and HR in a 5-12y/o?

Answer 20

RR - 20-25
SBP - 90-110
HR - 80-120

Question 21

What is normal RR, systolic BP and HR in a >12y/o?

Answer 21

RR - 15-20
SBP - 100-120
HR - 60-100

Question 22

What are lifethreatening causes of resp failure?

Answer 22

Resp obstruction
Foreign body inhalation
Pneumothorax

Question 23

What is the most common cause of resp depression?

Answer 23

Raised ICP - head injury

Question 24

What can cause fluid loss in injury?

Answer 24

Burns

Trauma

Question 25

What are second peak of deaths?

Answer 25

Die from significant ABCD problems unless adequately resuscitated - significantly improve outcome if managed within an hour

Question 26

What is the aim of trauma resus?

Answer 26

Restore normal tissue oxygenation ASAP

Question 27

What are third peaks of deaths?

Answer 27

Delayed deaths despite resus, surgery, and intensive care - sepsis