Pregnant patients can lose 30% blood volume without change in vitals. So, if pregnant patient comes in tachy, with normal rest of vitals, likely in shock

All pregnant women should have supplemental oxygen in trauma bay.

Best indicatory of shock in children → tachycardia

Even better is HR/SBP

Toddler = 1-3 years

ETT size in pediatric – age/4 +4

Use cuffed ETT in children of all ages

Don’t do sniffing position in infants, obstructs airway

Never do a cricothyroidotomy if <12 years old → do NEEDLE cricrothyroidotomy instead

12 open cricothyroidotomy is preferred

Percutaneous transtracheal jet insufflation – good temporizing measure, can clear airway too

14 gauge needle? 4 Fr angio cath

Splenic Trauma

• Operative indications
  • Persistent derangements in vitals despite adequate resuscitation
  • Blood transfusions (packed RBCs > 20 cc/kg)

When to do CT

• O2 92% + 4L NC and normal CXR → CT chest
• AST >200 → CT abd
• AMS, GCS ≤14, basilar skull fx → CT head