MedBugs: SAQ #547

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Case: Paediatric polytrauma with tension pneumothorax

A 13 month old girl has been taken to the ED by the ambulance service. She was run over in her family’s driveway by a reversing car at low speed. On arrival her vital signs are: AVPU responds to pain Pulse 180 /min

BP 70/40 mmHg

RR 60 /min

O2 sats 89% 15L via non-rebreather mask Cap refill 4 seconds Her chest X-ray is provided :

Paediatric polytrauma with tension pneumothorax

1. State the (2) main pathologies present providing (2) supportive radiographic features for each. 6 marks

2. Interpret the pelvic X-ray. 1 mark

FAST scan is negative. You intend to perform intubation with simultaneous inter-costal catheter (ICC) insertion.

3. State (3) potential difficulties that might be encountered. For each, provide a management strategy. 6 marks

4. List (5) safety steps in the performance of ICC insertion. Include the relevance of each. 5 marks

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Case: Paediatric polytrauma with tension pneumothorax

1. State the (2) main pathologies present providing (2) supportive radiographic features for each. 6 marks

2. Interpret the pelvic X-ray. 1 mark

3. State (3) potential difficulties that might be encountered. For each, provide a management strategy. 6 marks

4. List (5) safety steps in the performance of ICC insertion. Include the relevance of each. 5 marks

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