Pediatric Trauma
Information Covered:
- Pediatric fractures
- Pathophysiology
- Review previous knowledge
- Types of fractures
- Epiphyseal – at bone growth plate
- Greenstick – incomplete fracture from bending bone
- Torus – buckling of cortex of bone
- Immature growth of bones
- Growth plates at end of bones and complications of epiphyseal fractures
- Special assessment findings
- Review previous knowledge
- MOI – assess for abuse
- Motor, sensory, pulse assessment distal to injury
- Child/parent interaction
- Age differences and reaction to trauma
- Assess for comorbidity
- Special management considerations
- Review previous knowledge
- AVO
- Transport with family members
- Consent issues when family not present, injury not serious
- Inform family, teachers, guardians of transport location
- Immobilization the same as adults
- Ice will reduce swelling
- Pathophysiology
- Pediatric Trauma
- Unique Pediatric Aspects of Trauma
- Pathophysiology
- Head – most common injured
- Larger than adults
- Large occiput flexes head compromising airway
- Suture flexibility in very young
- Newborns and infants can become hypotensive with head injuries
- Spine
- SCIWORA
- Chest
- Very compliant – injury requires great force
- Commotio cordis – sudden impact of blunt force to the chest resulting in cardiac dysfunction, even death
- Abdomen
- Larger solid organs
- Weak abdominal muscles
- Musculoskeletal
- Epiphyseal plate
- Bones heal faster
- Head – most common injured
- Special Considerations in assessment
- Airway, Breathing, and Circulation
- Circulation
- Hypotension appears late, use other signs of inadequate circulation
- Inadequate oxygenation cause bradycardia
- Capillary refill may be helpful
- LOC may indicate inadequate circulation
- B/P estimated as 80 + 2 times the age
- Appropriate B/P cuff size
- 80ml/Kg blood loss can cause shock
- Head
- Very vascular, even scalp laceration can cause shock
- Falls less than 5 feet are significant
- Beware of shaken baby syndrome
- GCS less than 8 means increased ICP
- Chest
- Significant internal injury can be present without any external signs
- Tension-pneumothorax is difficult to evaluate
- Abdomen
- Spleen most common injured
- Cullen’s sign
- Kehr’s sign
- Musculoskeletal Trauma
- Special considerations in management
- Airway, Breathing, and Circulation (improper management is the most common cause of preventable pediatric death)
- Circulation
- Head
- Spinal –
- adequate size C-collars are important
- padding with immobilization
- Abdomen
- Extremity
- Transportation
Content Creator: Chris Hunt
CAPCE Course Number: 21-EMTP-F3-6101
NJ Course Number: 141122
Total CE Hours: 1.5
Level: Basic
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.