Reference no: EM133607593

Question: Sebastian (he/him) is a five-year-old child who was transported by ambulance to the Emergency Department (ED) after falling through the screen of a second-floor window to a concrete sidewalk. There was no initial loss of consciousness reported by his older sister who ran downstairs after she saw him fall. On your initial exam Sebastian is noted to be drowsy, but responsive to voice and is moving all extremities on command. His initial vital signs on arrival: Oxygen saturations 98% on face mask RR 24 HR 76 BP 114/60 Pain on FLACC scale 7/10 Glasgow Coma Score 14 (E3/V5/M6). A PIV was placed, and labs were obtained. A CT scan was ordered, as well as plain films to rule out other breaks/injuries. As the you are getting ready to transport the him to the CT scanner, Sebastian becomes unresponsive with sluggish pupils. Intubation was accomplished quickly and you and the team rush him to the CT scanner. CT reveals a skull fracture and blood noted in the subdural and epidural spaces. A procedure was performed in the OR to remove his bone (craniectomy) and the evacuate the blood. The patient was admitted to the PICU for management of a traumatic brain injury. What are some characteristics of pediatric patients that put them at risk for traumatic brain injuries? How do you calculate a GCS score? How often would you be checking this child's neurological exam after he is admitted to the PICU? Why do you think this patient initially showed no signs of neurologic injury? What nursing interventions can you anticipate in the care of this child? What medications do you anticipate seeing ordered for this child (name 3) and discuss the side effects?