Trauma

Question 0

Grade I splenic injury is:

Answer 0

Hematoma: subcapsular, less than 10% surface area

Laceration: capsular tear, less than 1cm parenchymal depth

Question 1

In hemodynamically stable children, what’s initial treatment for splenic injury?

Answer 1

Admit for observation and serial abdominal exams

Question 2

Grade II splenic injury is:

Answer 2

Hematoma: subcapsular, 10-50% surface area or intraparenchymal, less than 5cm in diameter

Laceration: capsular tear 1-3cm parenchymal depth that doesn’t involve trabecular vessel

Question 3

Grade III splenic injury is:

Answer 3

Hematoma: 1. subcapsular, greater than 50% surface area or expanding 2. Ruptured subcapsular or parenchymal hematoma 3. Intraparenchymal hematoma greater than/equal to 5cm or expanding

Laceration: greater than 3cm parenchymal depth or involving trabecular vessels

Question 4

Grade IV splenic injury is:

Answer 4

Laceration: involving segmental or hilar vessels producing major devascularization (greater than 25%)

Question 5

Grade V splenic injury is:

Answer 5

Laceration: completely shattered spleen

Vascular: Hilar vascular injury that devitalizes the spleen

Question 6

A child admitted for splenic injury is admitted for serial and exams and placed on bedrest. Child should be let out of the bed when

Answer 6

Abdominal pain resolves and hematocrit stabilizes

Question 7

For pediatric splenic injuries treated nonoperatively, activity should be restricted for how many weeks?

Answer 7

Total of splenic injury grade +2 weeks

Question 8

Patients who have splenectomy on an urgent or emergent basis should be vaccinated within what time period?

Answer 8

Within two weeks

Question 9

Which vaccinations should post-splenectomy patients receive?

Answer 9

Pneumococcal, Hib, and meningococcal