Paediatric haemorrhagic shock fluids — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesPaediatric haemorrhagic shock fluidsDIPIMC DipIMC

A 3-year-old weighing about 14 kg is in haemorrhagic shock after a road traffic collision, with a heart rate of 160, capillary refill of 4 seconds, cool peripheries and only a partial response to initial measures.

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Reveal the answer and explanation

Correct answer: C — 140 mL crystalloid (10 mL/kg), then reassess and move early to blood

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · E = shown as D · A = shown as E

In paediatric trauma, fluid is given in smaller 10 mL/kg aliquots with reassessment and early escalation to blood, so a 14 kg child receives about 140 mL initially. A 20 mL/kg bolus (A) is more typical of septic shock, and large crystalloid volumes worsen dilution and clot disruption in trauma. Resuscitate the bleeding child with cautious crystalloid and early blood, not large fixed volumes.

Reference: APLS; NICE NG39; JRCALC