ATCN 2020 Chapter 10 Outline Pediatric
Trauma Page 188
______________________________ and poor
________________________________________ are the only keys to early recognition of
hypovolemia and the early initiation of appropriate fluid resuscitation. - ANS-Tachycardia and
poor skin perfusion
\_________________________________ Bladder rupture is. More common in children due to a
shallow pelvis. - ANS-Bladder rupture
\_________________________________________ is a significant stress factor in children. -
ANS-Thermal energy loss is a significant stress factor in children.
\____________________________________________________________________________
_________is the preferred method of obtaining a definitive airway control. - ANS-Orotracheal
intubation under direct vision with restriction of cervical motion is the preferred method of
obtaining a definitive airway control.
\A return toward hemodynamic normality is indicated by: - ANS-Slowing of the heart rate
Clearing sensorium
Return of peripheral pulses
Return of normal skin color
Increased warmth of extremities
Increased systolic blood pressure
Increased pulse pressure (> 20 mm hg)
Urinary output 1 to 2 ml / kg / hr
\A simple technique to gauge the ETT size needed for a specific patient is to: -
ANS-Approximate the diameter of the child's external nares or tip of the child's smallest finger
and use the tube with the smaller diameter.
\Appropriate sequential assessment and management of the brain injury focused on: -
ANS-Preventing secondary brain injury that is, hypoxia and hypoperfusion
\Blood a distraction in children is calculated _____________________ - ANS-10 ml/kg
\Bradycardia in infants is more likely due to ________________________. - ANS-Hypoxia
\Damage control Resuscitation (limited crystalloid administration)
Administration of a balanced ratio of? - ANS-RBC's
Fresh Frozen Plasma
Platelets
This approach appears to interrupt the lethal triad of hypothermia, acidosis and trauma induced
DIC
\Do not perform __________________________________ in children - ANS-Do not perform
nasal intubation in children
\DPL - - ANS-use 10 ml/kg warmed crystalloid solution for the lavage
\Estimated Circulating blood volume in:
Infant
, Child 1 - 3 yrs of age
Children over 3 years of age - ANS-Infant. - 80 ml/kg
Child 1 - 3 yrs of age. - 75 ml/kg
Children over the age of 3 70 ml /kg
\Estimating a child's weight ? - ANS-Ask a caregiver
Length based tape
(2 x age in years) +10
\Evidence of hemorrhage may be evident with the loss of ________________% of the child's
circulation blood volume - ANS-25%
\Fluid Bolus of ____________________________ crystalloid followed by one or two additional
boluses (in children ) - ANS-20 ml/kg
\Hypotension in a child represents a state of decompensated shock and indicates severe blood
loss greater than - ANS-45% of the circulating blood volume.
\Infants have a more pronounced _______________________________________ to
endotracheal intubation than do children and adults, and they may experience bradycardia with
direct laryngeal stimulation. - ANS-Vagal response
\List complications of Intraosseous cannulation - ANS-Cellulitis
Osteomyelitis
Com apartment syndrome
Iatrogenic fracture
\List more subtle signs of blood loss in children (besides tachycardia and poor skin perfusion) -
ANS-Progressive weakening of peripheral pulses
Narrowing of pulse pressure to less than 20 mm hg
Skin mottling
Cool extremities compared to torso
Decrease level of consciousness with dulled response to pain
Decrease in blood pressure
\List preferable sites for venous access in children: - ANS-Peripheral (a/c or saphenous veins at
the ankle)
Anterior tibia
Distal femur
Proximal tibia (preferred site)
Distal femur
Percutaneous placement
Femoral veins
External or internal jugular
Subclavian veins
Venous cut down - saphenous veins at the ankle
\List the anatomical differences in children to be considered in treating spinal injury including the
following: - ANS-Interspinous ligaments and joint capsules are more flexible
Vertebral bodies are wedged anteriorly and tend to slide forward with flexion
The facet joints are flat
Trauma Page 188
______________________________ and poor
________________________________________ are the only keys to early recognition of
hypovolemia and the early initiation of appropriate fluid resuscitation. - ANS-Tachycardia and
poor skin perfusion
\_________________________________ Bladder rupture is. More common in children due to a
shallow pelvis. - ANS-Bladder rupture
\_________________________________________ is a significant stress factor in children. -
ANS-Thermal energy loss is a significant stress factor in children.
\____________________________________________________________________________
_________is the preferred method of obtaining a definitive airway control. - ANS-Orotracheal
intubation under direct vision with restriction of cervical motion is the preferred method of
obtaining a definitive airway control.
\A return toward hemodynamic normality is indicated by: - ANS-Slowing of the heart rate
Clearing sensorium
Return of peripheral pulses
Return of normal skin color
Increased warmth of extremities
Increased systolic blood pressure
Increased pulse pressure (> 20 mm hg)
Urinary output 1 to 2 ml / kg / hr
\A simple technique to gauge the ETT size needed for a specific patient is to: -
ANS-Approximate the diameter of the child's external nares or tip of the child's smallest finger
and use the tube with the smaller diameter.
\Appropriate sequential assessment and management of the brain injury focused on: -
ANS-Preventing secondary brain injury that is, hypoxia and hypoperfusion
\Blood a distraction in children is calculated _____________________ - ANS-10 ml/kg
\Bradycardia in infants is more likely due to ________________________. - ANS-Hypoxia
\Damage control Resuscitation (limited crystalloid administration)
Administration of a balanced ratio of? - ANS-RBC's
Fresh Frozen Plasma
Platelets
This approach appears to interrupt the lethal triad of hypothermia, acidosis and trauma induced
DIC
\Do not perform __________________________________ in children - ANS-Do not perform
nasal intubation in children
\DPL - - ANS-use 10 ml/kg warmed crystalloid solution for the lavage
\Estimated Circulating blood volume in:
Infant
, Child 1 - 3 yrs of age
Children over 3 years of age - ANS-Infant. - 80 ml/kg
Child 1 - 3 yrs of age. - 75 ml/kg
Children over the age of 3 70 ml /kg
\Estimating a child's weight ? - ANS-Ask a caregiver
Length based tape
(2 x age in years) +10
\Evidence of hemorrhage may be evident with the loss of ________________% of the child's
circulation blood volume - ANS-25%
\Fluid Bolus of ____________________________ crystalloid followed by one or two additional
boluses (in children ) - ANS-20 ml/kg
\Hypotension in a child represents a state of decompensated shock and indicates severe blood
loss greater than - ANS-45% of the circulating blood volume.
\Infants have a more pronounced _______________________________________ to
endotracheal intubation than do children and adults, and they may experience bradycardia with
direct laryngeal stimulation. - ANS-Vagal response
\List complications of Intraosseous cannulation - ANS-Cellulitis
Osteomyelitis
Com apartment syndrome
Iatrogenic fracture
\List more subtle signs of blood loss in children (besides tachycardia and poor skin perfusion) -
ANS-Progressive weakening of peripheral pulses
Narrowing of pulse pressure to less than 20 mm hg
Skin mottling
Cool extremities compared to torso
Decrease level of consciousness with dulled response to pain
Decrease in blood pressure
\List preferable sites for venous access in children: - ANS-Peripheral (a/c or saphenous veins at
the ankle)
Anterior tibia
Distal femur
Proximal tibia (preferred site)
Distal femur
Percutaneous placement
Femoral veins
External or internal jugular
Subclavian veins
Venous cut down - saphenous veins at the ankle
\List the anatomical differences in children to be considered in treating spinal injury including the
following: - ANS-Interspinous ligaments and joint capsules are more flexible
Vertebral bodies are wedged anteriorly and tend to slide forward with flexion
The facet joints are flat
