10 Trauma
Head Trauma
Epidural
strike to head: ball sports, skiing
walk, talk, die; loc
lens shaped hematoma
Subdural
path: kids brain full in skull. Takes a lot to shear bridging veins. Falling out of crib not enough force. < 3 = abuse
symptoms:
pedestrian struck: hit shoulder, fly
MVA: thrown from vehicle
shaking baby syndrome
symptoms: Loc, in coma, stay in coma
diagnosis: CT crescent shaped.,
Cerebral Contusion
path: deceleration injury. Brain stops too quick. Coup/contracoup. Sport injury, footbal
symptoms: loc
CT: punctate hemorrhage, intraparenchymal
Prevention
car safety
rear facing car seats in back, 0-2 yo
booster seats, 4'9", 8-12
seat belt: everyone
Helmets
any sports
trampolines: get rid
Concussion
Contusion:
path: deceleration injury. Brain stops too quick. Coup/contracoup. Sport injury, footbal
symptoms: loc
diagnosis: CT punctate hemorrhage, intraparenchymal
Concussion:
path: head trauma
pt: sports injury
diagnosis: no bleed on CT
2 types:
Mild: No CT scan, no treatment. Go home and monitor
Severe: CT scan ruleout brain bleed, admit
Both: return to play in step wise fashion, from sleeping, doing nothing, to leave house, to contact sports
Drowning
pt: poor swimmers
too young
too drunk
tubs, pools, buckets
flotation
floaties are bad. Keep only arms on top
use lifejackets
prevent: limit access (gates, fences) supervision (lifeguards, parental)
salt water drowning worse than freshwater drowning: pulmonary edema
cold water worse than warm water: hypothermia
Pediatric Burns
Parkland fluid
50% giving in first 8hrs
50% giving in next 16 hrs
Calculate % body surface area burned. Only include 2nd and 3rd degree burns
% BSA 4 kg
Kids: body bigger
heads: 9 (18 total)
chest and abd: each 9, front and back (36 total)
Arm: front and back combined 9 (18 total)
legs: 3 9's front and back combined
genitalia: 1
Total: 100%
Gun and Chemicals
Gun
eliminate
gun/chemical: up high, out of reach
gun lock
weapons separate from ammo
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