Page 728 - ACCCN's Critical Care Nursing

Paediatric Considerations in Critical Care 705

Learning activities
Learning activities are all based on the case study. 4. What is an appropriate ventilation strategy for Lisa, keeping in
1. Consider the information provided in the first paragraph of the mind her lung and head injuries and associated treatment?
case study. What injuries can you predict in children travelling 5. Will permissive hypercapnoea be considered for Lisa? Provide
in a rear car seat? a rationale for your answer.
2. On arrival in the ED, Lisa has a GCS score of 4 and requires 6. The specialist retrieval teams were unable to retrieve Lisa for
immediate intubation. Calculate the ETT size for Lisa. Should some hours due to inclement weather. Consider where Lisa
the ETT be placed orally or nasally? Should a cuffed or uncuffed would be best managed within your own facility, should this
ETT be placed? Justify your answers. situation arise. Imagine your facility is located a minimum of
3. Lisa’s mean blood pressure was initially low, and she required 6-hour drive from a major paediatric trauma centre. Consider
initial fluid resuscitation. What fluids could have been consid- the availability of resources (human and technological) that
ered for Lisa to restore her circulating blood volume while con- would be available in various clinical areas to manage Lisa for
sidering her lung and brain injuries? 12 hours until retrieval could be accomplished.

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