Childhood Injuries Flashcards
Anatomy of pediatric population that contributes to incidence of head trauma
large heads, thin skulls, poor muscle control
Type of head trauma more common than intracranial hematomas in kids
diffuse edema
When is neuroimaging recommended in children?
LOC >1 min, evidence of skull fx, focal neuro findings
Sx that characterize the Cushing Response which indicated elevated ICP
HTN, bradycardia, apnea
Which way should an infant face in a motor vehicle?
backwards
At what age or weight can a child be in a forward facing carseat?
Children 1-4 and weighing 20-40 pounds
Until what age or weight should a child be in a booster seat in MT?
age of 6 or greater than 60 pounds
Why should an infant not have a walker?
high risk of falls
Greatest period of risk for choking or swallowing foreign bodies
1st year of life
What age group should be given liquid (or chewable) medications?
children < 3yrs
Top three sports/activities with the highest rate of injury in children
Gymnastics, trampoline, baseball
Most common sports injuries in children
sprains, strains, contusions
Differences between pediatric bone and adult bone
Pediatric bone has a higher water content and lower mineral content (ie less brittle, thick periosteum, rich blood supply)
cartilaginous structure that is weaker than bone predisposed to injury
the physis (growth plate)
Osteochondrosis of the heel
age 8-12
Sever’s Disease
Apophysitis of the tibial tubericle (age 11-15)
Osgood-Schlatters
Apophysitis of the inferior pole of the patella (age 10-15)
Sinding-Larsen Johansson
Apophysitis of the medial epicondyle of the elbow (age 10-15)
Little League Elbow
Mechanism of injury is plant and twist of knee. Usually non-contact. Higher incidence in girls. Knee effusion common
ACL injuries
injury in which the FDP tendon is completely ruptured cannot flex the affected digit at the DIP joint.
Jersey finger
extensor tendon injury, is an injury of the extensor digitorum tendon at the (DIP)
mallet finger
Overuse injury secondary to throwing mechanics. Tender directly over the medial aspect of elbow. Will often elicit a history of child pitching “too many” innings or “too many” pitches per week
Little league elbow
Most common type of ankle sprain
lateral
stress fracture or defect of the pars interarticularis in a vertebra. due to repetitive increase in shear forces in the lumbar spine
spondylolysis
movements of extension and rotation leading to slipping of all or part of one vertebra forward on another. occurs as a result of repetitive hyperextension which causes a shear stress at the pars interarticularis
spondylolisthesis
Amount of acetamnophen that suggests toxic exposure
greater than 140mg/kg ingested in single dose or greater than 7.5g is ingested within a 24 hour period
When should you draw a serum acetaminophen level?
draw 4 hours following ingestion in ANYONE suspected of overdose
Treatment of acetaminophen overdose
N-acetylcysteine (Mucomyst)
Why should you avoid Ipecac with acetaminophen overdose?
will delay the administration of N-acetylcysteine
Poisoning presentation that includes: tinnitus, vomiting, hyperpnea, fever, lethargy
aspirin
Treatment for aspirin overdose
activated charcoal, alkalinization w/IV bicarb. Possibly dialysis
Poisoning presentation that includes: vomiting, abdominal pain, GI bleed, diarrhea
Iron
Tx for iron poisoning
Deferoxamine IV (chelating agent)
Poisoning that is insidious and may include vague sx: weakness, irritability, weight loss, ataxia, behavoral disorders, anemia
lead poisoning
Tx of lead poisoning
interrupt ingestion. Chelation therapy with Succimer (in symptomatic children)
Sx that suggest increased ICP
vomiting, HA, changes in mental status
