Trauma in children
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Presentation to ACT Ambulance Service
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Trauma in children
- 1. TRAUMA IN CHILDREN Jamie Ranse : Critical Care Education Coordinator, Staff Development Unit, ACT Health.
- 21. injuries in trauma: spinal trauma Management
- 24. injuries in trauma: head trauma Best motor response Spontaneous or obeys verbal command 6 Localises to pain or withdraws to touch 5 Withdraws from pain 4 Abnormal flexion to pain 3 Abnormal extension to pain 2 No response to pain 1 Best verbal response Alert, babbles, coos, words to usual ability 5 Less than usual words spontaneous irritable cry 4 Cries only to pain 3 Moans to pain 2 No response to pain 1 Eye opening Spontaneously 4 To verbal stimuli 3 To pain 2 No verbal response 1 < 4 Years of age
- 25. injuries in trauma: head trauma Best motor response Obeys verbal command 6 Localises to pain 5 Withdraws from pain 4 Abnormal flexion to pain 3 Abnormal extension to pain 2 No response to pain 1 Best verbal response Orientated and converses 5 Disorientated and converses 4 Inappropriate words 3 Incomprehensible sounds 2 No response to pain 1 Eye opening Spontaneously 4 To verbal stimuli 3 To pain 2 No verbal response 1 > 4 Years of age
- 28. injuries in trauma: chest trauma
- 37. BURNS IN CHILDREN Jamie Ranse : Critical Care Education Coordinator, Staff Development Unit, ACT Health.
- 44. assessment
- 45. management
Notes de l'éditeur
- Differences – large surface area in comparison to adults, - small airway - compliant skeleton - abdominal organs more susceptible to injury Teenages – risk taking, toddler – exploring and lack of judgement
- Clearance – gentle suction Intubation – age/4 +4 - cuffed v uncuffed INFANT - Neutral, with chin lift CHILD – Sniffing, with chin lift Tidal volume 7 -10ml/kg
- Would not do all of this in the primary survey
- Everyone gets O2 Everyone gets IV access Consider: Volume expansion Inotropic drugs
- Fulcrum higher until age 8
- Positioning Head tilt (high C) prayer positioning (arms accross chest – c4or 6)
- Brusising = severe injury No bruising = possibility of injury
- Protection chemical - sebum - antibacterial; pH physical - keratin and lipid layer biological - phagocytes Temp - vasculature and sweat glands Cutaneous - receptors for temperature, touch, pressure and pain Metabolic - Vitamin D synthesized from cholesterol by epidermal cells Blood reservoir - extensive vascular supply Excretion - sweat contains small amounts of nitrogenous wastes
- Ectoderm, 1 of 3 basic tissue types in uterus development – also nervous tissue. Lanugo – downy hair Vernix - Fatty substance made up of epithelial cells that covers fetal skin inside the uterus, white, greasy, cheese-like substance. Sebaceiys – Oil glands activated