The injured child Flashcards
What is a buckle?
Deformation within cortex
Are boys or girls more likely to suffer trauma?
Boys
What is worse for children between blunt and penetrating trauma?
Blunt
What are common fractures in children?
Buckle fracture
Clavicle fracture
Toddlers fracture
Greenstick fracture
What causes toddlers fracture?
Toddler falls, twists ankle, spiral fracture
What is a greenstick fracture?
Periosteum breaks on one side and cortex gives way, but opposite periosteum remains as a hinge
Where do children’s bones tend to break?
Growth plates
What is important to know about a wound?
Depth and extent
Type
Mechanism
What is the most common site of burn?
Hand - toddler touches ring
How is scald managed?
Give adequate analgesia and protect from further harm
What should be considered in family’s that have been in fire?
Thermal injury
Trauma from jumping out building
Inhaled poisoning
What can affect how a child reacts to injury?
Cold
Alcohol
Drugs
Hypoglycaemia
What aspects of a child’s size increases risk from injury?
Smaller target - greater energy absorbed for same force of impact
Relatively large head - easily injured
What aspects of a child’s skeleton affect injury?
Incompletely calcified - soft, springy, deforms rather than breaks, poor at absorbing energy
Provides less protection for vital organs
What aspects of metabolism affect children in injury?
Thermoregulation
Hypoglycaemia
What should be considered in mechanism of injury?
Take a good history
Look at wreckage if vehicle accident
Do injuries fit with the story - NAI
What are different injury patterns in vehicle injury?
Lap belt syndrome - injury caused by seatbelt
Spinal cord injury without radiological abnormality
What is normal RR, systolic BP and HR in an <1y/o?
RR -30-40
SBP - 70-90
HR - 110-160
What is normal RR, systolic BP and HR in a 2-5y/o?
RR - 25-30
SBP - 80-100
HR - 95-140
What is normal RR, systolic BP and HR in a 5-12y/o?
RR - 20-25
SBP - 90-110
HR - 80-120
What is normal RR, systolic BP and HR in a >12y/o?
RR - 15-20
SBP - 100-120
HR - 60-100
What are lifethreatening causes of resp failure?
Resp obstruction
Foreign body inhalation
Pneumothorax
What is the most common cause of resp depression?
Raised ICP - head injury
What can cause fluid loss in injury?
Burns
Trauma
What are second peak of deaths?
Die from significant ABCD problems unless adequately resuscitated - significantly improve outcome if managed within an hour
What is the aim of trauma resus?
Restore normal tissue oxygenation ASAP
What are third peaks of deaths?
Delayed deaths despite resus, surgery, and intensive care - sepsis
