Paediatric Trauma
OVERVIEW
- APLS-style approach to pediatric trauma
MECHANISM
- Pedestrian
- Unrestrained passenger
- HI
- NAI
CLINICAL FEATURES
- Tachycardia
- Vasoconstriction
- Tachypnoea
- Decreased LOC
PRIMARY SURVEY
Airway with C-spine control
- intubate if indicated
Breathing with supplemental O2
- FiO2 1.0
- inspect, palpate, percuss, auscultate -> exclude life threatening injury
Circulation with controlled of external haemorrhage
- IV access
- 20mL/kg crystalloid
Disability and check glucose
- pupils
- AVPU
Exposure
- check temperature
- keep warm
SECONDARY SURVEY
Head to Toe
- give blood (10 mL/kg) for 3rd and subsequent boluses
- catheter
- NGT
- ventilate to normocarbia
- stabilise before transferring
- femoral IV
- IO line (angle away from grow plate)
NEVER FORGET!
- involve parents early
- check temperature
- check glucose
- consider non-accidental injury
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC