Children with penetrating trauma to the torso require careful evaluation of the chest, abdomen, pelvis, and genital structures for system-specific injuries that may contribute to rapid decompensation and influence the order of emergent resuscitation.
Knowing the weight of the child (or at least having an initial estimate) is critical. Obtain an estimate of the patient’s weight by asking the parent(s) for an estimation of their child’s weight or by using length-based formulas that include general body habitus.
Children can bleed 50% of their blood volume into their chest, and may not show signs of decreased blood pressure until the loss of up to 30% of their blood volume.
Estimations for total-body blood volume are as follows: infants, 80 mL/kg; children aged 1 to 3 years, 75 mL/kg; children aged > 3 years, 70 mL/kg.