This case was written by Dr. Audrey Marcotte who is a third year, and co-chief, resident in Emergency Medicine at McGill University. Her interests include trauma and resuscitation.
WHY IT MATTERS
Children are susceptible to polytrauma via blunt force mechanisms. Pediatric trauma resuscitation is stressful and often involves multiple competing priorities. The presence of emotional family members adds significantly to the cognitive load and stress, so practicing CRM principles is important to reduce the impact of human factors in real life. This case allows both senior and junior physicians to practice CRM principles and medical management of complex pediatric polytrauma patients including intubation and hemodynamic resuscitation, as well as communication skills with family members and consultants.
A 2.5 year old patient brought straight to the resuscitation room after a fall from a 9m balcony. The child is crying, responding to pain, and is not yet on monitors nor do they have IV access.
A 2.5 year old child falls from the 3rd floor balcony and presents to a community hospital. The team is expected to coordinate a thorough trauma survey. The patient will initially demonstrate compensated shock requiring aggressive resuscitation. After this initial phase, findings of severe head injury will become apparent. The team must optimize the patient for transfer to definitive care.