Approach to trauma (pediatrics) Quiz: Ace Your Exams
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A 6-year-old boy is brought to the emergency department by ambulance after being struck by a car while crossing the street. Upon arrival, the child is awake, anxious, and pale, speaking in short phrases with a hoarse but intelligible voice. The child has a history of mild intermittent asthma and was hospitalized for bronchiolitis at age 2. Immunizations are up to date, and there are no known drug allergies or history of bleeding disorders. Temperature is 36.5°C (97.7°F), heart rate is 145/min, respiratory rate is 30/min, blood pressure is 88/56 mmHg, and oxygen saturation is 96% on room air. There is moderate nasal bleeding but no obvious facial deformity. A large, bleeding laceration is present over the left thigh with brisk arterial bleeding. Capillary refill is 5 seconds. Peripheral pulses are weak but palpable. Which of the following is the best next step in the management of this patient?
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