ATLS Module 10 - Pediatric Trauma
QUESTIONS AND ANSWERS
1. 10 yo male arrives to ED after bicycle crash. He is complaining of upper stomach pain.
Vitals: HR a hundred and fifteen & BP 100/sixty five. CT test of stomach shows large
splenic laceration with assessment extracasation. As he returns to ED from radiology,
HR increases to 150 and BP drops to 70/forty five. What are the maximum appropriate
next steps in management? - ANSWER-situation has swiftly deteriorated to surprise
state, and he needs resuscitation en direction to working room.
Administer 20mL/kg isotonic fluid bolus and 10 mL/kg type particular or O-
pRBCs.
Pt have to have emergent laparotomy/splenectomy
(angioembolization isn't suitable, until he responds to resuscitation and
interventional radiology is right away to be had)
2. 10 yo male struck head even as diving into swimming pool. On examination, he
demonstrates weakness in all extremities. Cervical spine movies display no fractures.
The pleasant next step in control have to be:
a. Reap urgent spine surgical treatment seek advice from
b. Flexion-extension movies
c. CT of cervical spine
d. Excessive dose steroids - ANSWER-A
3. CT & MRI will probably be required, but a neurosurgical/backbone doctor must be
involved
6 month vintage infant is introduced to ED after fall onto hard floor. She is crying and
appropriately interactive. Her eyes are open. She is moving all extremities. There's a
laceration on scalp, and anterior fontanelle is firm and bulging. What is the subsequent
maximum suitable step in management?
A. Skull collection simple films
b. CT of head
c. Own family reassurance & discharge
d. Laceration repair and remark - ANSWER-b
4. 7 yo male is struck via automobile at the same time as riding motorbike. At ED, he's
tachycardic, hypotensive, and hypoxic. He has faded breath sounds and a massive
contusion at the right side. The most suitable subsequent step in management:
a. Vascular access & fluid resuscitation
b. Endotracheal intubation
c. Perform immediate needle thoracostomy to proper chest
d. Carry out tube thoracostomy of right chest - ANSWER-c
although rare, tension pneumothorax is more commonplace in children than adults.
Decompression have to be finished right away earlier than another interventions
, 5. a 5 yr old boy is struck by using an automobile and taken to ED. He is lethargic however
withdraws from painful stimuli.
Vitals: BP ninety, HR 160, RR 40, oxygen sat eighty five%.
The excellent option for setting up vascular access after skilled nurses have did not reap
peripheral IV get right of entry to on 2 attempts is: - ANSWER-placement of
intraosseous device
6. a toddler's number one reaction to hypovolemia is tachycardia... That could also be due
to pain, worry, psychological pressure... What are the other greater diffused symptoms of
blood loss in youngsters? - ANSWER--progressive weakening of pulses
-narrowing pulse stress to <20mmHg
-skin mottling
-cool extremities compared to torso
-decrease in level of consciousness with dulled response to pain
7. an infants trachea is ~5 cm long and grows to 7 cm by about 18 months... What can
failure to appreciate this short length result in? - ANSWER-intubation of right
mainstem bronchus, inadequate ventilation, accidental tube dislodgement, and/or
mechanical barotrauma
8. children can sustain spinal cord injury without radiographic abnormalities (SCIWORA)...
A normal c spine series may be found in 2/3 of children with spinal cord injury... How do
you avoid missing this? - ANSWER-if injury is suspected on history & exam, normal
x-ray doesnt exclude significant spinal cord injury
*when in doubt about integrity of c spine or spinal cord, assume unstable injury
exists, limit spinal motion and obtain appropriate consultation
(red text)
9. CT scanning doesn't come without risk... 1/1000 kids can develop fatal cancers...When
CT scan is necessary, radiation must be kept As Low As Reasonable Achievable
(ALARA)... How do you achieve the lowest dose possible? - ANSWER-perform only
when medically necessary, scan only when results will change management, scan
only the area of interest, and use lowest radiation dose possible
red text
10.does vomiting and amnesia imply increased intracranial pressure in children? -
ANSWER-not necessarily... Vomiting and amnesia are common after brain injury in
children... However, if vomiting is/becomes persistent... That becomes more
frequent concern and mandates CT of head
11.FAST exam is used in children as extension of abdominal exam.... Why should it no be
relied upon as the sole dx test? - ANSWER-it is incapable of identifying isolated
intraparenchymal injuries which account for 1/3 of solid organ injuries in
children... & significant abdominal injuries may be present in the absence of any
free intraperitoneal fluid
12.following successful intubation of obtunded 2 yo male involved in MVC, he is transported
to CT scanner. During transport, there is sudden deterioration of oxygen saturation.
What is the most likely cause of deterioration? - ANSWER-dislodgement of tube
13.how do you estimate a child age >3 years old blood quantity? - ANSWER-70 mL/kg
QUESTIONS AND ANSWERS
1. 10 yo male arrives to ED after bicycle crash. He is complaining of upper stomach pain.
Vitals: HR a hundred and fifteen & BP 100/sixty five. CT test of stomach shows large
splenic laceration with assessment extracasation. As he returns to ED from radiology,
HR increases to 150 and BP drops to 70/forty five. What are the maximum appropriate
next steps in management? - ANSWER-situation has swiftly deteriorated to surprise
state, and he needs resuscitation en direction to working room.
Administer 20mL/kg isotonic fluid bolus and 10 mL/kg type particular or O-
pRBCs.
Pt have to have emergent laparotomy/splenectomy
(angioembolization isn't suitable, until he responds to resuscitation and
interventional radiology is right away to be had)
2. 10 yo male struck head even as diving into swimming pool. On examination, he
demonstrates weakness in all extremities. Cervical spine movies display no fractures.
The pleasant next step in control have to be:
a. Reap urgent spine surgical treatment seek advice from
b. Flexion-extension movies
c. CT of cervical spine
d. Excessive dose steroids - ANSWER-A
3. CT & MRI will probably be required, but a neurosurgical/backbone doctor must be
involved
6 month vintage infant is introduced to ED after fall onto hard floor. She is crying and
appropriately interactive. Her eyes are open. She is moving all extremities. There's a
laceration on scalp, and anterior fontanelle is firm and bulging. What is the subsequent
maximum suitable step in management?
A. Skull collection simple films
b. CT of head
c. Own family reassurance & discharge
d. Laceration repair and remark - ANSWER-b
4. 7 yo male is struck via automobile at the same time as riding motorbike. At ED, he's
tachycardic, hypotensive, and hypoxic. He has faded breath sounds and a massive
contusion at the right side. The most suitable subsequent step in management:
a. Vascular access & fluid resuscitation
b. Endotracheal intubation
c. Perform immediate needle thoracostomy to proper chest
d. Carry out tube thoracostomy of right chest - ANSWER-c
although rare, tension pneumothorax is more commonplace in children than adults.
Decompression have to be finished right away earlier than another interventions
, 5. a 5 yr old boy is struck by using an automobile and taken to ED. He is lethargic however
withdraws from painful stimuli.
Vitals: BP ninety, HR 160, RR 40, oxygen sat eighty five%.
The excellent option for setting up vascular access after skilled nurses have did not reap
peripheral IV get right of entry to on 2 attempts is: - ANSWER-placement of
intraosseous device
6. a toddler's number one reaction to hypovolemia is tachycardia... That could also be due
to pain, worry, psychological pressure... What are the other greater diffused symptoms of
blood loss in youngsters? - ANSWER--progressive weakening of pulses
-narrowing pulse stress to <20mmHg
-skin mottling
-cool extremities compared to torso
-decrease in level of consciousness with dulled response to pain
7. an infants trachea is ~5 cm long and grows to 7 cm by about 18 months... What can
failure to appreciate this short length result in? - ANSWER-intubation of right
mainstem bronchus, inadequate ventilation, accidental tube dislodgement, and/or
mechanical barotrauma
8. children can sustain spinal cord injury without radiographic abnormalities (SCIWORA)...
A normal c spine series may be found in 2/3 of children with spinal cord injury... How do
you avoid missing this? - ANSWER-if injury is suspected on history & exam, normal
x-ray doesnt exclude significant spinal cord injury
*when in doubt about integrity of c spine or spinal cord, assume unstable injury
exists, limit spinal motion and obtain appropriate consultation
(red text)
9. CT scanning doesn't come without risk... 1/1000 kids can develop fatal cancers...When
CT scan is necessary, radiation must be kept As Low As Reasonable Achievable
(ALARA)... How do you achieve the lowest dose possible? - ANSWER-perform only
when medically necessary, scan only when results will change management, scan
only the area of interest, and use lowest radiation dose possible
red text
10.does vomiting and amnesia imply increased intracranial pressure in children? -
ANSWER-not necessarily... Vomiting and amnesia are common after brain injury in
children... However, if vomiting is/becomes persistent... That becomes more
frequent concern and mandates CT of head
11.FAST exam is used in children as extension of abdominal exam.... Why should it no be
relied upon as the sole dx test? - ANSWER-it is incapable of identifying isolated
intraparenchymal injuries which account for 1/3 of solid organ injuries in
children... & significant abdominal injuries may be present in the absence of any
free intraperitoneal fluid
12.following successful intubation of obtunded 2 yo male involved in MVC, he is transported
to CT scanner. During transport, there is sudden deterioration of oxygen saturation.
What is the most likely cause of deterioration? - ANSWER-dislodgement of tube
13.how do you estimate a child age >3 years old blood quantity? - ANSWER-70 mL/kg
