Failure to secure a compromised airway, support breathing, and recognize and respond to intraabdominal and intracranial hemorrhage are - ANS-are the leading causes of unsuccessful resuscitation in pediatric patients with severe trauma. Injuries associated with motor vehicles are - ANS-the most common cause of death in children of all ages, whether they are occupants, pedestrians, or cyclists Child maltreatment accounts for the great majority of homicides in infants. (I.e.children younger than 12 months of age), whereas firearm injuries account for most of the homicides in children (over age 1) and adolescents. Falls account for the majority of all pediatric injuries, but infrequently result in death. - ANS-Child maltreatment accounts for the great majority of homicides in infants. (I.e.children younger than 12 months of age), whereas firearm injuries account for most of the homicides in children (over age 1) and adolescents. Falls account for the majority of all pediatric injuries, but infrequently result in death. Most serious pediatric trauma is - ANS-is blunt trauma that involves the brain. As a result apnea, hypoventilation, and hypoxia, occur five times more often than hypovolemia with hypotension in children who have sustained trauma. _____________________________________________ is a significant stress factor in children. - ANSThermal energy loss is a significant stress factor in children. The presence of skull and/or rib fractures in a child suggest - ANS-the transfer of a massive amount of energy; in this case, underlying organ injuries, such as traumatic brain injury and pulmonary contusions, should be suspected. Some evidence suggests that as many as 60% of children who sustain severe multisystem trauma have - ANS-residual personality changes at one year after hospital discharge, and 50% show cognitive and physical handicaps. Social, affective, and learning disabilities are present in one-half of seriously injured children. The inability to establish and/or maintain a patent airway with the associated lack of oxygen and ventilation - ANS-is the most common cause of cardiac arrest in children The large occiput results in - ANS-passive flexion of the cervical spine, leading to a propensity for the posterior pharynx to buckle anteriorly. Several anatomical features of children affect airway assessment and management - ANS-(tongue and tonsils) are relatively large compared with the tissues in the oral cavity, which may compromise visualization of the larynx. A child's larynx is funnel shaped, allowing secretions to accumulate in the retropharyngeal area The vocal cords are frequently more difficult to visualize when - ANS-the child's head is in the normal supine anatomical position during intubation than when it is in the neutral position required for optimal cervical spine protection. An infants trachea is approximately ______________ cm long and grows to _____________ cm by about 18 months. Failure to appreciate this short length can result in intubation of the right mainstem bronchus, inadequate ventilation, accidental tube dislodgment, and/or mechanical barotrauma. The optimal endotracheal tube depth can be calculated as three times the appropriate tube size. For example, a 4.o ETT would be properly positioned at 12 cm from the gums. - ANS-An infants trachea is approximately 5 cm long and grows to 7 cm by about 18 months. Failure to appreciate this short length can result in intubation of the right mainstem bronchus, inadequate ventilation, accidental tube dislodgment, and/or mechanical barotrauma. The optimal endotracheal tube depth can be calculated as three times the appropriate tube size. For example, a 4.o ETT would be properly positioned at 12 cm from the gums. Orotracheal intubation is indicated for injured children in a variety of situations, including: - ANS-A child with severe brain injury who requires controlled ventilation A child in whom an airway cannot be maintained A child who exhibits signs of ventilatory failure
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