pediatric trauma cpt james r. rice emergency medicine physician assistant interservice physician...
TRANSCRIPT
Pediatric Trauma
CPT James R RiceEmergency Medicine Physician Assistant
Interservice Physician Assistant Program
References
Objectives
Identify the concepts associated with evaluating and resuscitating the pediatric trauma casualty
Introduction to the BroselowHinkle system
Pediatric Trauma
Basic same approach as with adults Requires a team approach Same injury patterns
May see slightly more blunt trauma
Children are NOT little adults
Vital Signs
Use as a rough guide to your clinical decision making
The pulse is much more sensitive than BP Children often maintain a normal BP until
vascular collapse
Vital Signs
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
References
Objectives
Identify the concepts associated with evaluating and resuscitating the pediatric trauma casualty
Introduction to the BroselowHinkle system
Pediatric Trauma
Basic same approach as with adults Requires a team approach Same injury patterns
May see slightly more blunt trauma
Children are NOT little adults
Vital Signs
Use as a rough guide to your clinical decision making
The pulse is much more sensitive than BP Children often maintain a normal BP until
vascular collapse
Vital Signs
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Objectives
Identify the concepts associated with evaluating and resuscitating the pediatric trauma casualty
Introduction to the BroselowHinkle system
Pediatric Trauma
Basic same approach as with adults Requires a team approach Same injury patterns
May see slightly more blunt trauma
Children are NOT little adults
Vital Signs
Use as a rough guide to your clinical decision making
The pulse is much more sensitive than BP Children often maintain a normal BP until
vascular collapse
Vital Signs
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Pediatric Trauma
Basic same approach as with adults Requires a team approach Same injury patterns
May see slightly more blunt trauma
Children are NOT little adults
Vital Signs
Use as a rough guide to your clinical decision making
The pulse is much more sensitive than BP Children often maintain a normal BP until
vascular collapse
Vital Signs
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Vital Signs
Use as a rough guide to your clinical decision making
The pulse is much more sensitive than BP Children often maintain a normal BP until
vascular collapse
Vital Signs
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Vital Signs
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Airway
Nasal breathers Be careful not of occlude the nasal passages
Relatively large occiput Do not pad under the head-may cause excessive
flexion Keep in the ldquosniffingrdquo position
Relatively larger tongue May make intubation difficult
Narrow larynx in the subglottic region Uncuffed ET tubes only
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Airway
Intubate VERY early in the case of facial burns
Surgical airway Surgical cricothyroidotomy is NOT
recommended in children under 12 Needle cricothyroidotomy can be performed-
but is temporary
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Airway
Intubation The child may become bradycardic during
stimulation of the posterior pharynx Pre-medicate with atropine
ndash 0015-020 mgkg IVndash 002 mg minimum dose
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Breathing
Look for respiratory distress Tachypnea Stridorwheezing Grunting Nasal flaring
Auscultate in both axillae Lung sounds are easily transmitted across the
small chest
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Circulation
Venous access can be VERY difficult Will require small IV catheters Go IO early Use central lines (femoral) as a second choice
If you have a pediatric central line kit
Venous cut down may be a real option
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Circulation
For shock Crystalloid fluid bolus of 20mLkg
If an inadequate response is noted you may repeat a 20mLkg bolus
If there is still a poor response start a third 20mLkg bolus and initiate 0-neg whole blood transfusion at 10-20mLkg IV bolus
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Circulation
Once you have stabilized with fluids Start a fluid maintenance
24hr fluid requirementsndash 100mlkg for the first 10kg of body wtndash 50mlkg for the next 10kg of body wtndash 10mlkg for each kg over 20kg
ndash Patients weighing over 40kg should be managed as an adultbull 2000-2500mlday
Watch the urine outputndash Minimum should be 10mlkghr
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Secondary Survey
Your approach should be the same as with the adult casualty Thorough head-to-toe exam
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Head Injury
Leading cause of death due to injury Blunt MOI SS
Vomiting Lethargy Headache Asymmetric pupils Asymmetric motor movement Decreased mentation Irritability
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Head Injury
Evaluation GCS AVPU
Considering communication problems with the casualty the AVPU system will probably be the best approach
A-Alert V-responds to Verbal stimuli P-responds to Painful stimuli U-Unresponsive
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Glasgow Coma Scale
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Head Injury
Management Elevate head of bed to 20-30 degrees Give IV mannitol at 1gkg Lasix at 1mgkg may help as well Mild hyperventilation EVAC
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Head Injury
Post traumatic seizure Relatively uncommon Prophylactic seizure management is
controversial and has not been shown to be beneficial
Acute seizure management Lorazepam Midazolam or Diazepam
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Spine
C-spine Apply an appropriately sized collar Place a towel under the shoulders to keep the spine in
a neutral position
SCIWORA Spinal Cord Injury Without Radiographic Abnormality
Neurologic deficit cw spinal injury but no abnormality seen with radiographic studies
Can have a delayed presentation
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Heat Loss
Children are much more susceptible to hypothermia than adults
Be very aggressive in preventing and managing hypothermia
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Burns
Airway management is the biggest concern Remember the rule of nines is different for
a child A relatively mild burn in an adult can very
serious in a child Take no chanceshellipplan on evacuating all
burns
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Rule of 9rsquos
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Questions or comments at this point
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Pediatric Resuscitation Equipment Problem
This equipment can be found in the WHOHumanitarian Augmentation Set
We currently donrsquot have an allocation for pediatric trauma equipment in the standard SKO
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Pediatric Resuscitation Equipment What can we use that is light appropriate
for the mission and easy to use The BroselowHinkle System
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
Small portable kit based on the Broselow tape
Has been used successfully on the battlefield
Will require traditional re-supply utilizing NSNs
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
Eliminates Memorization 1048707
Eliminates Mathematics1048707
Promotes Standardization
Provides Redundancy and Universality
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
Place on flat surface next to supine childhellip
Hand running along the length of the tape from head to patientrsquos heel
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Hand on tape adjacent to patientrsquos
heel identifying patients weight and heel identifying patients weight and color zone
BroselowHinkle System
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
Measure Child and Assign Color Zone Child measures in Broselow ldquoredrdquo I need the ldquoredrdquo Ambu mask
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
BroselowHinkle System
We are currently working on developing a tactical prototype The future plan is to have 2 complete tactical
systems added to the standard SKO
Until then we recommend 2 per BAS at unit cost of $160000ea
Questions
Questions