PHTLS PHTLS - Prehospital Trauma Life Support Pediatric Trauma 2 — Questions and Answers
Question 1: When using the pediatric assessment triangle (PAT), which three components are evaluated?
- Pulse, respirations, temperature
- Appearance, work of breathing, circulation to skin (Correct answer)
- Level of consciousness, pupil response, motor function
- Heart rate, blood pressure, oxygen saturation
Correct answer: Appearance, work of breathing, circulation to skin
The PAT assesses appearance (tone, interactiveness, cry), work of breathing (sounds, positioning, retractions), and circulation to skin (color, mottling, pallor).
Question 2: A 2-year-old trauma patient has a GCS of 9. Using the modified pediatric GCS, what adjustment must be made to the verbal component?
- Score is not modified for children under 5
- Verbal responses are scored based on age-appropriate vocalizations rather than adult criteria (Correct answer)
- The verbal score is doubled for children under 3
- Eye opening replaces verbal scoring in non-verbal children
Correct answer: Verbal responses are scored based on age-appropriate vocalizations rather than adult criteria
The pediatric modification of the GCS verbal score accounts for age-appropriate vocalizations such as crying, babbling, or words rather than adult verbal responses.
Question 3: What is the estimated normal systolic blood pressure for a child aged 4 years using the PHTLS formula?
- 70 mmHg
- 80 mmHg (Correct answer)
- 86 mmHg
- 100 mmHg
Correct answer: 80 mmHg
The PHTLS formula for minimum acceptable systolic BP in children is 70 + (2 × age in years); for a 4-year-old: 70 + 8 = 78, with 80 mmHg being the standard approximation.
Question 4: In a pediatric patient with suspected tension pneumothorax, which needle decompression site is preferred?
- Fifth intercostal space, mid-axillary line (Correct answer)
- Second intercostal space, mid-clavicular line
- Third intercostal space, anterior axillary line
- Fourth intercostal space, mid-clavicular line
Correct answer: Fifth intercostal space, mid-axillary line
Current guidelines favor the fifth intercostal space at the mid-axillary line for needle decompression in both adults and pediatric patients due to higher success rates.
Question 5: Why are children more susceptible to hypothermia following trauma than adults?
- Higher baseline metabolic rate increases heat generation
- Larger body surface area relative to mass and less subcutaneous fat (Correct answer)
- More efficient peripheral vasoconstriction in children
- Higher circulating blood volume per kilogram
Correct answer: Larger body surface area relative to mass and less subcutaneous fat
Children have a larger body surface area-to-mass ratio and less insulating subcutaneous fat, causing faster heat loss and increased hypothermia risk.
Question 6: Which fracture pattern in a young child, when identified without a plausible mechanism, should raise concern for non-accidental trauma (NAT)?
- Greenstick fractures of the radius
- Spiral fractures of the humerus in a non-ambulatory infant (Correct answer)
- Torus fractures of the distal radius
- Transverse fractures of the clavicle
Correct answer: Spiral fractures of the humerus in a non-ambulatory infant
Spiral fractures of long bones, especially the humerus in non-ambulatory infants, are classic high-suspicion injuries for non-accidental trauma when no consistent history exists.
PHTLS PHTLS - Prehospital Trauma Life Support Pediatric Trauma 2
When using the pediatric assessment triangle (PAT), which three components are evaluated?