Acutely Ill Child Flashcards
Initial Observation for Triage
#1 Respiratory rate and effort (rapid, shallow, accessory ) #2 Skin color (pale, mottled, cyanotic) #3 Response to Environment (cries, sleepy, limp, play, eye contact)
Primary Assessment in Pediatric emergency
#1 Airway #2 Breathing assessment (fast, slow, absent) #3 Cardiovascular assessment (skin color, cap refill, temp) #4 Neurological (alert, voice, pain, unresponsive) #5 Exposure (hidden injuries, risk for hypothermia)
Secondary Assessment
VS Hx Head to toe Dx tests Weight Parent- child relationship
Focused Hx of the secondary assessment
SAMPLE S/S at onset of illness Allergies Medications Past medical Hx Last liquid or food intake Events leading up to illness/injury
Causes of Hypovolemic shock
Fluid loss: diarrhea hemorrhage vomiting decreased fluid intake DKA third spacing burns
S/S of Hypovolemic shock
Dry mucous membrane Depressed fontanel Cold/clammy skin Oliguria Poor skin turgor Decreased cap refill
S/S of Neonatal sepsis
O Hypothermia O Temperature instability O Changes in feeding, color, activity O Nurse’s instincts O Tachypnea O Tachycardia O Hypotension O Hypo/ Hyperglycemia O Advanced infection: jaundice, hemorrhage, enlarged liver or spleen, shock, respiratory failure, seizures
Lower SBP in Infants/children
Infant (0-1months) 60mmHg
Infant (1-12 months) 70mmHg
Children (1yr and up) 70 + 2x the child’s age
Early S/S of septic shock in Children
Early signs: Vasodilation, extremities warm to touch, Tachypnea, Tachycardia
Late S/S of septic shock in Children
Rapid, thready pulse Cyanosis Cold, clammy Purpuric skin lesion Narrow pulse pressure Oliguria or anuria
Explain the pediatric trauma score
The higher the score the better the outcome (12 best; -6 worst)
Anyone scoring less or equal to 8 send to pediatric trauma center
Early signs of shock in trauma children
Increased HR
Decreased cap refill
Pale, cool extremities
Weak peripheral pulses
Shock interventions for trauma
O2 Spinal stabilization Preserve body temp Hemorrhage control Fluids
What is the best intervention for Children with brain injury
Give high flow oxygen
Hyperventilation only if they deteriorate
