ITLS Pediatric Trauma Considerations 2

Question 1

A 4-year-old child struck by a car presents with altered mental status but stable vital signs. Why is the ITLS provider particularly concerned about intra-abdominal injury in this patient?

Accepted Answer

Children have proportionally larger solid organs, less protective subcutaneous fat, and more flexible rib cages that provide less protection, making abdominal organs more vulnerable

Answer

Children have stronger abdominal muscles that mask injuries

Answer

Pediatric abdominal injuries are always minor

Answer

Children cannot have internal bleeding from blunt trauma

Question 2

What is the most common cause of cardiac arrest in pediatric trauma patients, and how does this influence resuscitation priorities?

Accepted Answer

Hypoxia from airway and breathing problems, making aggressive airway management and ventilation the primary resuscitation focus

Answer

Ventricular fibrillation from cardiac contusion

Answer

Hemorrhagic shock identical to adult patterns

Answer

Tension pneumothorax in all cases

Question 3

How do you calculate appropriate fluid resuscitation volumes for a pediatric trauma patient?

Accepted Answer

Administer 20 mL/kg isotonic crystalloid boluses, reassessing after each bolus, with consideration for blood products after 40-60 mL/kg without improvement

Answer

Give the same volumes as an adult

Answer

Use the Parkland formula for all pediatric trauma

Answer

Give 10 mL/kg per hour as a continuous infusion

Question 4

Why are children at higher risk for hypothermia in the trauma setting compared to adults?

Accepted Answer

Children have a larger body surface area to mass ratio, thinner skin, less subcutaneous fat, and limited shivering capacity, causing more rapid heat loss

Answer

Children produce less body heat than adults

Answer

Children are always outdoors when injured

Answer

Pediatric trauma patients receive colder IV fluids

Question 5

What anatomical difference makes children more susceptible to cervical spine injuries at the C1-C3 level compared to the adult pattern of lower cervical injuries?

Accepted Answer

Children have proportionally larger and heavier heads, higher fulcrum of cervical motion (C1-C3 vs. C5-C6 in adults), and more horizontal facet joints that allow greater mobility

Answer

Children have stronger neck muscles

Answer

Children have fused cervical vertebrae

Answer

There is no difference in cervical injury patterns between children and adults

Question 6

An infant has a large, tense anterior fontanelle following a fall from a changing table. What does this finding suggest?

Accepted Answer

Increased intracranial pressure, possibly from intracranial hemorrhage, requiring urgent evaluation

Answer

Normal finding in all infants

Answer

Dehydration

Answer

The infant is crying, which causes fontanelle bulging