ITLS - International Trauma Life Support Pediatric Trauma Considerations Questions and Answers

Question 1

The Pediatric Assessment Triangle (PAT) is a rapid assessment tool used to form a general impression of a sick child. Which of the following are the three components of the PAT?

Accepted Answer

Appearance, Work of Breathing, Circulation to Skin

Answer

The Pediatric Assessment Triangle (PAT) consists of three key observational components: Appearance (evaluating tone, interactiveness, consolability, look/gaze, and speech/cry), Work of Breathing (assessing for abnormal sounds, positioning, and retractions), and Circulation to Skin (checking for pallor, mottling, or cyanosis). This tool allows for a rapid 'from the doorway' evaluation without touching the patient.

Question 2

When positioning an infant trauma patient for airway management, what modification is often necessary to achieve a neutral airway alignment?

Accepted Answer

Placing padding under the shoulders and torso.

Answer

Infants and young children have a proportionally large occiput (back of the head), which causes passive neck flexion when they are laid supine. To counteract this and achieve a neutral or 'sniffing' position that properly aligns the airway axes, padding should be placed under the shoulders and upper torso.

Question 3

A 5-year-old child weighing 20 kg is in decompensated hemorrhagic shock following blunt abdominal trauma. According to ITLS guidelines, what is the correct initial isotonic crystalloid fluid bolus?

Accepted Answer

A 400 mL bolus (20 mL/kg) administered as quickly as possible.

Answer

The standard initial fluid bolus for a pediatric trauma patient in shock is 20 mL/kg of an isotonic crystalloid solution (like Normal Saline or Lactated Ringer's). For a 20 kg child, this calculates to 20 kg * 20 mL/kg = 400 mL. This bolus should be administered rapidly.

Question 4

Which of the following best describes a key physiological difference in how children compensate for hemorrhagic shock compared to adults?

Accepted Answer

Children can maintain a normal blood pressure despite significant blood loss.

Answer

Children have very effective compensatory mechanisms, including intense vasoconstriction and an increased heart rate. This allows them to maintain a normal systolic blood pressure until they have lost a substantial percentage of their circulating blood volume (up to 45%). Hypotension is therefore a late and ominous sign of decompensated shock in a child. Tachycardia is the earliest sign.

Question 5

A 6-year-old pedestrian is struck by a motor vehicle. The provider should maintain a high index of suspicion for Waddell's Triad, which is a classic pattern of injuries consisting of:

Accepted Answer

Femur fracture, intra-abdominal/thoracic injury, and contralateral head injury.

Answer

Waddell's Triad describes the three-part injury pattern commonly seen in pediatric pedestrian-versus-vehicle collisions. The sequence involves: 1) The car's bumper striking the femur; 2) The child's torso striking the hood or fender, causing thoracic or abdominal injuries; and 3) The child being thrown to the ground, resulting in a head injury on the opposite side of the initial impact.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Pediatric Trauma Considerations Questions and Answers