Question

A 3-year-old boy presents with multiple-system trauma. The child was an unrestrained passenger in a high-speed MVC. On primary assessment, he is unresponsive to voice or painful stimulation. His RR is 5 bpm, HR and pulses are 170 bpm, SBP is 60 mmHg, capillary refill is 5 secs, and SpO₂ is 75% on room air. What action should you take first?

a) Provide 100% oxygen by simple face mask
b) Perform immediate endotracheal intubation
c) Establish immediate access
d) While a colleague provides spinal motion restriction, open the airway with a jaw thrust and provide bag-mask ventilation

Answer 1

To address the multiple-system trauma in a 3-year-old boy, the first action you should take is to establish immediate access to evaluate and stabilize his condition. Providing 100% oxygen and performing bag-mask ventilation are also necessary to improve oxygenation and ventilation.

Step-by-step explanation:

The first action you should take is to establish immediate access in order to evaluate and stabilize the child's condition. This involves obtaining intravenous access for fluid resuscitation and administration of medications.

Providing 100% oxygen by simple face mask is the next step, as the child has a low oxygen saturation level (SpO₂ is 75% on room air). Oxygen administration will help improve oxygenation and tissue perfusion.

While a colleague provides spinal motion restriction, you should open the airway with a jaw thrust and provide bag-mask ventilation. This will assist with oxygenation and ventilation until the child's breathing and respiratory rate improve.