Pediatric Trauma Flashcards

Questions and Answers

What is Waddell's triad?

A pattern of injury seen in pedestrian children who are struck by motor vehicles.

What does Waddell's triad comprise of? (Select all that apply)

Lung contusion

Intra-thoracic or intra-abdominal injuries (correct)

Fractured femoral shaft (correct)

Contralateral head injury (correct)

What does CABG stand for?

Control major haemorrhage, Airway and cervical spine control, Breathing, Circulation.

What is a pulmonary contusion?

An injury to the lung tissue without actual structural damage. Signup and view all the answers

What causes a pulmonary contusion?

Blunt trauma or occasionally penetrating trauma to the chest wall. Signup and view all the answers

What is a sensitive indicator of vascular collapse?

Heart rate. Signup and view all the answers

How many seconds do you have before converting to IO access if IV access can't be established?

90 seconds. Signup and view all the answers

What is the most common cause of shock in paediatric trauma?

Hypovolaemic shock. Signup and view all the answers

What are different types of significant intra-cranial pathology in traumatic head injuries?

Subdural, Extradural, Subarachnoid, Diffuse Axonal Injury, Contusion, Base of skull fracture. Signup and view all the answers

What is diffuse axonal injury?

The shearing of the brain's axons that occurs when the head is rapidly accelerated or decelerated. Signup and view all the answers

What are 2 visible signs to look for in a suspected base of skull fracture?

Battle's sign (bruising of mastoid process) and Raccoon eyes (bruising around the eyes). Signup and view all the answers

What details of the physical examination would you carry out for a 5-year-old patient with a head injury?

Feel Fontanelle, Check haematoma size, Check GCS +/- AVPU, Check pupil size, Check cranial nerves, Check tone/power/reflex. Signup and view all the answers

How would you assess eye opening GCS scale for an infant?

4: Spontaneous, 3: To loud noise, 2: To pain, 1: No response. Signup and view all the answers

How would you assess verbal response GCS scale for an infant?

5: Smiles, coos, cries appropriately; 4: Cries but consolable; 3: Persistently irritable, crying; 2: Grunts or moans; 1: No response. Signup and view all the answers

How would you assess motor response GCS scale for an infant?

6: Spontaneous movement; 5: Withdraws to touch; 4: Withdraws to pain; 3: Flexion posturing; 2: Extensor posturing; 1: Does not respond. Signup and view all the answers

Is the GCS scale used for adults the same as used for children?

False Signup and view all the answers

What paediatric situations require an urgent CT scan?

GCS < 14 or for children under 1 yr old GCS < 15, Focal Neurological Deficit, Post traumatic seizure without epilepsy history, Signs of basal skull fracture, Suspected open or depressed skull fracture, Suspicion of non-accidental injury, Bruise, swelling or laceration of more than 5 cm on head for children under 1 yr old. Signup and view all the answers

What is a basal skull fracture?

A base of skull fracture. Signup and view all the answers

Study Notes

Waddell's Triad

Refers to a specific pattern of injury in children struck by vehicles.
Comprises:
- Fractured femoral shaft
- Intra-thoracic or intra-abdominal injuries
- Contralateral head injury

CABG Assessment

CABG stands for:
- Control major hemorrhage
- Airway and cervical spine control
- Breathing
- Circulation
Essential for primary trauma assessment.

Pulmonary Contusion

Defined as an injury to lung tissue without structural damage, often described as a bruised lung.
Can result from blunt or penetrating trauma to the chest area.

Indicator of Vascular Collapse

Heart rate serves as a sensitive indicator of vascular collapse.
Blood pressure may remain near normal until late stages of vascular collapse.

IV to IO Access Transition

IV access should be established within 90 seconds; if unsuccessful, switch to intraosseous (IO) access.

Common Cause of Shock

Hypovolaemic shock is the leading cause in pediatric trauma cases.

Types of Significant Intracranial Pathology

Subdural hematoma
Extradural hematoma
Subarachnoid hemorrhage
Diffuse axonal injury
Contusion
Base of skull fracture

Diffuse Axonal Injury

Involves shearing of brain axons due to rapid acceleration or deceleration, common in car accidents.

Signs of Base of Skull Fracture

Battle's sign: Bruising over the mastoid process.
Raccoon eyes: Bruising around the eyes.

Physical Examination for Head Injury

Evaluate fontanelle.
Assess size of any hematoma.
Determine Glasgow Coma Scale (GCS) +/- AVPU (Alert, Voice, Pain, Unresponsive).
Check pupil size.
Examine cranial nerves.
Assess tone, power, and reflexes.

Eye Opening GCS Scale for Infants

4: Spontaneous
3: To loud noise
2: To pain
1: No response

Verbal Response GCS Scale for Infants

5: Smiles, coos, cries appropriately
4: Cries but is consolable
3: Persistently irritable, crying
2: Grunts or moans
1: No response

Motor Response GCS Scale for Infants

6: Spontaneous movement
5: Withdraws to touch
4: Withdraws to pain
3: Flexion posturing
2: Extensor posturing
1: Does not respond

GCS Scale Comparison

The GCS scale for adults is applicable for children, but infants use a slightly altered version.

Urgent CT Scan Situations

GCS < 14 or < 15 for children under 1 year.
Focal neurological deficits.
Post-traumatic seizures without prior epilepsy history.
Signs of basal skull fracture.
Suspected open or depressed skull fractures.
Non-accidental injury suspicion.
For infants, any head bruise, swelling, or laceration over 5 cm.

Basal Skull Fracture

Defined as a fracture at the base of the skull.

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Description

This quiz covers essential concepts related to pediatric trauma, including Waddell's triad and its associated injuries, as well as the meaning of CABG in trauma assessment. Test your knowledge on critical terms and definitions crucial for understanding trauma in children.