Summary

INITIAL MANAGEMENT

  1. Cardiorespiratory monitoring; 100% 0 2 by non-rebreather mask
  2. 2 large-bore antecubital IVs; IO access if 2 failed IV attempts
  3.  Trauma labs :
    • Type & Screen
    • Complete Blood Count (CBC)
    • Electrolytes, BUN, Creatinine
    • Liver Function Tests (LFT)s
    • Amylase/lipase
    • Lactate
    • Fibrinogen
    • INR/PTT

4. Point of Care Testing (POCT) glucose if Loss Of Consciousness (LOC); if glucose < 2.6 mmol/L, give D10W 5 mL/kg IV push; recheck glucose in 5 min

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Pediatric Major Trauma
  • ALERT Pediatric Referral Center EARLY
  • Arrange for Critical Care Transport
  •  Resuscitate before intubation
  •  Avoid hypoxia, hypotension and hyper/hypocarbia
  •  Do NOT rely on hypotension as marker of shock in kids
  •  If signs of shock: limit crystalloid and initiate blood early
  •  Prevent hypothermia

 

Child Health BC. Pediatric Major Trauma [Internet]. 2024. Available from: https://www.childhealthbc.ca/trauma/pediatric-major-trauma-poster 

Trauma Fluid Resuscitation
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Trauma Fluid Rescusitation

CW Emergency Department – Trauma Manager. PEDIATRIC TRAUMA FLUID RESUSCITATION [Internet]. Available from: https://shop.healthcarebc.ca/phsa/BCWH_2/BC%20Children%27s%20Hospital/C-05-01-62393.pdf.

Cardiac Arrest in Trauma
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Cardiac Arrest in Trauma

BCCH Emergency Department – Trauma Manager. PEDIATRIC TRAUMATIC CARDIAC ARREST CLINICAL SUPPORT TOOL [Internet]. 2022. Available from: https://shop.healthcarebc.ca/phsa/BCWH_2/BC%20Children%27s%20Hospital/C-05-01-60085.pdf.