Paediatric Trauma in 2-Year-Old with Supracondylar Fracture

You are the on-call anaesthetist at a general regional hospital. You are called to the emergency department to attend a trauma involving a 2-year-old girl. On entering the resuscitation room in the emergency department, you see a crying and slightly drowsy child with an obvious arm deformity. You establish this was an unwitnessed accident. The mother explains she last saw her daughter riding her scooter in the driveway. A short time later, she found her crying and distressed under a parked car and called emergency services. The child has just arrived by ambulance. She has received fentanyl 1 mcg/kg, and crystalloid 10ml/kg intravenously en route. Observations HR 180 bpm BP 82/40 mmHg RR 35 breaths per minute SpO2 96% on room air