Pediatric Trauma: Module 5

Remove child from entrapment.
- If extrication prolongued, begin treatment while pinned.
- Consider early use of a tourniquet if not able to control hemorrrhage of an entrapped extremity.
ABCS - manage airway and breathing while maintaining in-line stabilization during airway maneuvers.
Obtain IV/IO access and begin fluid resuscitation as soon as possible.
- Treatment of rhabdomyolysis involves correction of fluid and electrolyte abnormalities (e.g., hyperkalemia and acidosis) and prevention of precipitation of proteins in the renal tubules.
- This involves early aggressive hydration with isotonic NaCl at 2-3x maintenance.
- IV NaHCO₃ may be started after initial hydration (3 amps NaHCO₃ in 1L D5W). Do not place in saline, as solution will be hypertonic.

Splint extremity injuries - ensure external sources of compression are not overbinding.
Frequently reassess vital signs and extremity pulses, sensation and motor strength.
Close monitoring should continue uring transport to an appropriate facility.
Children do well if appropriate treatment is initiated early.