Module 1: Initial Stabilization and Transfer of Pediatric Trauma
Learning Objectives
Epidemiology of Pediatric Trauma
Anatomic Risk Factors in Children
AHA Pediatric Chain of Survival
Components of Pediatric EMS
Pediatric Trauma Team
Initial Assessment
Triage
ATLS Primary and Secondary Surveys
Evaluation of General Appearance
Color Coded Broselow Tape
Cervical Spine Injury Risks
SCIWORA
Cervical Spine Management
Cervical Collar for C-spine Immobilization
Cervical Spine Clearance
Clinical Criteria to ExcludeCervical Spine Injury
Spine Board Use
Spinal Immobilization Pearls
Video Recap
Secondary Survey
Focused History - AMPLE
Secondary Survey
Goals of Stabilization and Transport
Interhospital Transfer
Preparation for Transport
Transport Equipment
Indications for Endotracheal IntubationPrior to Transport
Preparation for Transport of Intubated Patient
Ongoing Assessment During Transport
Transport - Potential Problems
Patient Transfer - Communication Between Referring and Receiving Facilities
Patient- and Family-Centered Communication
General Communication Pearls
Communication Pearls for Children
Helpful Staff Behaviors
Important Consideration: Child Abuse
Recognizing Child Abuse
Review: Question 1
Review: Question 2
Review: Question 3
Review: Question 4
Review: Question 5
Acknowledgments
Module 2: Pediatric Airway and Breathing
Learning Objectives
Assessment of Airway and Breathing
Assessment of Airway and Breathing
Video of Increased Work of Breathing / Respiratory Distress
Outcome of Airway Assessment
The Pediatric Airway
Utilizing a shoulder roll
Pediatric Airway - Physiology
Airway Patency
Airway Opening Manouevres
Suction
Use of airway adjuncts
Nasopharyngeal Airway Insertion
Oropharyngeal Airway Insertion
Video of oropharyngeal and nasopharyngeal airway insertion
Advanced Airway Management
Assessment of breathing
Support of Breathing
Single Provider Bag-Mask Ventilation (BMV) Technique
Two Provider BMV
Video Demonstration of BMV
Bag Mask Ventilation
Advanced Airway Techniques
Airway Sizing
Airway Sizing - Broselow Tape
Rapid Sequence Intubation (RSI)
RSI - Inductions
RSI - Equipment
RSI - Pre-oxygenation
High Flow Nasal Cannula (HFNC) Oxygen Therapy
RSI - Cricoid Pressure
RSI - Technique
RSI - In line neck stabilisation
Laryngoscope Choice
Videolaryngoscopes 1
Videolaryngoscopes 2
Predictors of difficult intubation in pediatric patients
Confirmation of Endotracheal Tube Position
ETT Position Confirmation by CO2 Colorimetry
Video Demonstration: Rapid Sequence Intubation
Gastric Decompression
Alternative airways
LMA Sizes in Children
Insertion of LMA
Surgical airways
Cricothyroid Membrane Anatomy
Needle cricothyroidotomy
Surgical Cricothyroidotomy
Summary
Review Question 1
Review Question 2
Review Question 3
Review Question 4
Review Question 5
Acknowledgments
Module 3: Pediatric Shock, including Vascular Access
Learning Objectives
Pediatric Trauma Fatalities - Pathophysiology
Cardiovascular VariablesAffecting Systemic Perfusion
Shock
Hemodynamic Response to Shock
Progression of Shock
Heart Rate Response to Shock in Children
Hemodynamic Responses to Shock in Children
Physical Examination - Circulation
Physical Examination - Circulation
Palpation of Pulses in Children
Pediatric Pulse Check Sites
Video Recap
Heart Rates in Children
Categorization of Shock in Pediatric Trauma Patients
Shock - Clinical Progression
Physical Examination - Circulation
Capillary Refill Time
Capillary Refill Time
Video Recap
Estimate of Minimum Systolic Blood Pressure
Evaluation of End-Organ Perfusion
Causes of Cardiopulmonary Deterioration in Pediatric Trauma Victims
Causes of Cardiopulmonary Deterioration in Pediatric Trauma Victims
Causes of Cardiopulmonary Deterioration in Pediatric Trauma Victims
Causes of Cardiopulmonary Deterioration in Pediatric Trauma Victims
Intravenous Access
Preferred IV Access Sites
Intravenous Catheter Size
Intraosseous (IO) Needle Placement
IO Needle Placement
IO Needle Setup
Video of EZ-IO Vascular Access
IO Access - Complications
Central Venous Access - Anatomy
Fluid Resuscitation - ATLS Algorithm
Choice of Resuscitation Fluid
Review: Question 1
Review: Question 2
Review: Question 3
Review: Question 4
Review: Question 5
Acknowledgments
Module 4: Pediatric Head Injuries
Learning Objectives
Pediatric Head Injury - Epidemiology
Intracranial Pressure - Physiology
Raised ICP - Brain Herniation
CPP - Physiology
Head Injury - Pathophysiology
Respiratory Failure in Head-Injured Children
Signs and Symptoms of Head Injury
Glasgow Coma Scale (GCS)
Glasgow Coma Scale (GCS) in Infants and Children
Classification of Head Injury (HI) by GCS
AVPU Pediatric Response Scale for Disability
Common Lesions After Head Injury
Subdural Hematoma
Epidural Hematoma
Intracerebral Hematoma
Management of Head Injury
Hypotension Associated with Poor Outcome
Management of Raised ICP
Hyperventilation
Ventilation - Recommendation
Fluid Therapy for Head Injury
Sedation, Analgesia and Paralysis
Use of Paralytic Agents
Positioning Tips to Reduce ICP
Temperature Regulation
Management of Seizures
Anticonvulsants
Anticonvulsant Prophylaxis
Hyperosmolar Therapy
Ventricular Catheter/ Lumbar Drain for Draining CSF to Reduce ICP
Decompressive Craniotomy
Barbiturate Coma
Summary of ICP Management
Non-Accidental Injury (Shaken Baby Syndrome)
Shaken Baby SyndromeFamily Risk Factors
Bruises - Abuse or Accident?
Evaluation of Suspected Abuse
Evaluation of Suspected Abuse
Child Abuse - The Physician's Role
Review: Question 1
Review: Question 2
Review: Question 3
Review: Question 4
Review: Question 5
Acknowledgments
Module 5: Pediatric Blunt Abdominal and Chest Trauma
Learning Objectives
Anatomy relevant to blunt trauma
Trauma biomechanics
Pediatric Trauma Biomechanics
Tension pneumothorax
Tension pneumothorax
Tension Pneumothorax management
Hemothorax
Hemothorax Treatment
Mainstem intubation
Pericardial tamponade
Pericardial Tamponade treatment
Anatomy relevant to blunt abdominal trauma
Blunt abdominal trauma
Abdominal solid organ injury
CT scanning in pediatric patients
CT scanning in pediatric patients 2
Solid organ injury grading scales
Liver & Spleen Blunt Injury
Liver & Spleen Operative Management
National guidelines: liver and spleen injury
Vital signs in liver / splenic injury
Gastric distension in small children
Review question #1
Review question #2
Review question #3
Review question #4
Review question #5
References
Acknowledgments
Module 6: Pediatric Trauma Analgesia and Sedation
Learning Objectives
Evaluation of Pediatric Pain
Anxiolysis: Non-pharmacologic Strategies
Anxiolysis: Commonly Used Medications
Analgesia: Non-Pharmacologic Strategies
Analgesia: Non-sedating Medications
Analgesia: Sedating Medications
Regional Analgesia in Trauma
Regional Analgesia: Peripheral Nerve Blocks
Regional Analgesia: Neuraxial Blocks
Patient-controlled Analgesia (PCA)
Sedation: Overview
Sedation: Preparation
Sedation: Preparation
Sedation: Commonly Used Medications
Prepare Child for Procedures
Practice Cases
Acknowledgments
Module 7: Complications of Pediatric Multi-Organ Trauma and Other Injuries (Drowning, Burns)
Learning Objectives
Timing of Trauma Deaths
Immediate Deaths
Early Deaths ('Golden Hour')
Late Deaths
Survival Following Pediatric Trauma
Spinal Cord Injuries
Spinal Cord Injuries
Hypothermia
Harmful Effects of Hypothermia
Prevention/Treatment of Hypothermia
Acute Respiratory Distress Syndrome (ARDS)
Submersion and Drowning
Outcome After Submersion
Therapy for Submersion
Thermal Injuries - Flames and Scalds
Thermal Burns
Burns: epidemiology
Burns: inhalation injury
Burns: injury depth and extent
Burns: stabilization and fluids
Fluid Resuscitation for Burns
Fluid Resuscitation for Burns
Burns: transfer and additional considerations
Burn references
Management of Inhalation Injury
Further Resources for Burn Injuries
Post-Traumatic Stress Disorder
Common Triggers for PTSD
PTSD Symptoms
Caregivers Need Care Too
Review: Question 1
Review: Question 2
Review: Question 3
Review: Question 4
Review: Question 5
Burns: review question
Acknowledgments