Chapter 160; General Approach to Pediatric Patient

Question 1

What are four anatomical differences between adult and pediatric airways?

Answer 1

1. Anterior and cephalad airway
2. Larger Tongue to mouth ratio
3. Cartilage is more flexible = floppy
4. Larger occiput forces children in slight flexion while lying

Question 2

What are the 5th percentile values for BP in children?

Answer 2

<1 month = 60 systolic
1mon-12mon = 70 systolic
>1year . = 70 +2xAGE

Question 3

Parents of a 6 month old child state that the child is not rolling over yet. Is this normal ?

Answer 3

This is an abnormal development sign. Typically children should be sitting without supports at that age.
Most children achieve rolling over by age 4 months

Question 4

What are the components of the Rapid Pediatric Assessment Triad?

Answer 4

WOB
Appearance
Perfusion

Question 5

What does the TICLS pneumonic stand for and what is it used for?

Answer 5

Tone
Interactions
Consolibility
Looking
Speech/Cry

Another tool used for quick visual assessment of a pediatric patient - Appearance

Question 6

What is the name of the medical act that allows physicians to treat minors in life threatening situations without parental consent?

Answer 6

The Emergency Medical Treatment and Active Labour Act

Question 7

Name two very concerning work of breathing signs for impending respiratory demise in pediatrics

Answer 7

Head Bobbing and SeaSaw (Paradoxical belly breathing)

Question 8

What is “Cold Shock”

Answer 8

Pediatrics cannot significantly increase CO by increasing contractile efficiency so they increase rate and vasoconstrict. When this vasoconstriction is prolonged they begin to have minimal perfusion to extremities.

This is why levophed is not a first line pressor in kids but epinephrine is.