Author: Fiona Mendes, Fleur Cantle / Editor: Yasmin Sultan / Reviewer: Fiona Mendes / Codes: / Published: 07/09/2022
Hello ALARA, Goodbye frying scans!
A 6-year-old child presents to your major trauma centre Emergency Department (ED) by ambulance after falling off her bicycle. It was observed by her 8-year-old cousin. They were riding on concrete pavement outside their home and she went over the handlebars and then fell onto her left side. Her mother heard a scream and came to find her daughter lying on the side of the road with a small superficial bleeding wound to her elbow and grazes to her left arm. She was able to get up with her mothers assistance and could walk afterwards. Her helmet was intact.
She has graze to the left forearm and the elbow wound has stopped bleeding after gauze and a bandage was applied. She complains of left elbow pain, which is worse on movement.
From the primary survey, of note, she has abdominal bruising to the left upper quadrant and there is an overlying superficial graze, which appears to be in the imprint from the handlebars. There is tenderness localised over the bruising and graze.
Observations on arrival: oxygen saturations 96% on room air, respiratory rate 25 breaths per minute, heart rate 90 beats per minute, blood pressure 95/45 mmHg, blood glucose level 5.3. GCS 15. Pupils are both +3mm, equal and reactive.
As part of the trauma team you assess this paediatric patient.
