The final part of the primary survey serves to identify any important wounds and to detect or prevent hypothermia. Actively bleeding wounds or penetrating wounds will direct the priority of actions taken during the resuscitation and secondary survey. Bleeding is controlled by direct pressure, using air splints on the extremities if needed. A rectal temperature should be obtained for all pediatric trauma patients, but especially if the temperature outside is cool. Children become hypothermic much easier than adults due to their high body surface area. Hypothermia can develop in the emergency department despite a seemingly comfortable ambient temperature. Whenever possible, keep the child covered. Warm fluids to 40°C if large amounts of IV fluids or blood products are used.
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