Six hours after a car crash, a restrained child presents with nausea and hypotension. Which condition should you suspect?

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Multiple Choice

Six hours after a car crash, a restrained child presents with nausea and hypotension. Which condition should you suspect?

In blunt trauma to a child, internal bleeding into the abdomen can develop and become evident hours after the injury. Nausea paired with hypotension six hours post-crash points to ongoing intra-abdominal hemorrhage, such as splenic or hepatic injury or a mesenteric tear. The abdomen is a common source of delayed shock in kids because they can compensate for a while before blood loss becomes evident. Head injuries usually present with altered mental status or vomiting related to brain injury, not primarily with hypotension from blood loss. A fractured femur or spinal injury would present with limb findings or neurological deficits, rather than a progressive, systemic shock picture from abdominal bleeding.

In blunt trauma to a child, internal bleeding into the abdomen can develop and become evident hours after the injury. Nausea paired with hypotension six hours post-crash points to ongoing intra-abdominal hemorrhage, such as splenic or hepatic injury or a mesenteric tear. The abdomen is a common source of delayed shock in kids because they can compensate for a while before blood loss becomes evident.

Head injuries usually present with altered mental status or vomiting related to brain injury, not primarily with hypotension from blood loss. A fractured femur or spinal injury would present with limb findings or neurological deficits, rather than a progressive, systemic shock picture from abdominal bleeding.

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