Which of the following statement(s) is/are true concerning trauma involving children?

a. The greater head/body ratio in children compared to adults leads to a higher frequency of head injuries in children

c. A greater propensity to hypothermia is seen in children

The smaller size of pediatric patients results in an increased likelihood of multiple system trauma because of the force of impact is dissipated over a relatively small area. A higher frequency of head injuries in children is partially explained by the proportionately greater head/body ratio, the thin skull, and the weaker supporting cervical musculature. In infants with unfused cranial sutures and open fontanels, intracranial hemorrhage can be perfuse and result in shock. The protuberant abdomen of the child obtains little protection from either the thoracic cage or pelvis, accounting for a higher incidence of intraabdominal injuries.

The physiologic response to hypovolemia after pediatric trauma is characterized by the immediate constriction of small and medium-sized arteries, thus maintaining normal blood pressure. Decompensation generally occurs with a blood volume deficit of 20% to 25%. Tachycardia, tachypnea, diminished peripheral perfusion, and change in the level of consciousness are better potential indicators of early shock than blood pressure. The thin skin, lack of subcutaneous fat, and large surface area/body weight ratio all contribute to the propensity of the young child for hypothermia.