TRAUMA - PAEDIATRIC

ResponseThin abdominal wall (muscle + fat) providing less protection
Ribs are more pliable, providing less protection.
Liver and spleen take up a larger proportion of abdominal cavity
The diaphragm is more horizontal, pushing the spleen and liver below the rib cage
Small size of patient allows single impact to injure multiple organs.
Bladder is an intra-abdominal organ in small children.
Adult protection systems (seatbelts) often fitted incorrectly causing abdominal injury

ResponseChildren have a relatively fixed SV so the only way they can increase CO is by increasing HR. Hypotension is a late sign when this compensation can no longer compensate for volume loss

ResponsePermissive hypotension is contraindicated in paeds trauma - hypotension is a late sign/sign of decompensation in this age group.
Further, if the child has a likely head injury - excludes from consideration even in an adult patient

ResponseMedian SBP = 90 mmHg + (2 x Age in years)
Minimum SBP = 70 mmHg + (2 x Age in years)
Weight = (age + 4) x 2
... or = (age + 5) x 2
...or = (age x 3) + 7
Blood volume = 70-80 mL/kg