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Peds II > Emergencies > Flashcards

Emergencies Flashcards

1
Q

What are the two primary components of the PE post-head injury?

A
  • ABC (airway, breathing, circulation)

- GCS (Glasgow Coma Scale)

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2
Q

What is Cushing’s Triad, and what type of injury might it be seen with?

A

Head injury

  • Wide pulse pressure
  • Bradycardia
  • Abnormal respirations
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3
Q

What are two possible PE findings seen with a basilar skull fracture?

A
  • Battle’s sign

- Raccoon eyes

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4
Q

What diagnostic criteria is used when determining the need for CT post-head injury?

A

PECARN/CATCH/CHALICE

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5
Q

Realistically, what NINE (ugh) criteria would warrant the need for CT post-head injury?

A
  • GCS <15
  • Acute AMS/”not acting right”
  • Signs of skull fracture
  • Vomiting 3+ times
  • Seizure
  • <2 years old
  • Non-frontal scalp hematoma
  • LOC for 5+ seconds
  • Severe mechanism
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6
Q

Of the three types of head bleeds, which has the poorest prognosis?

A

Subdural hematoma

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7
Q

Of the three types of head bleeds, which is most common?

A

Subarachnoid hemorrhage (SAH)

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8
Q

What type of head bleed has CT shows crescent-shaped hematoma that crosses suture lines (usually parietal area)?

A

Subdural hematoma

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9
Q

What type of head bleed often presents with brief LOC → lucid period (normal) → deterioration?

A

Epidural hematoma

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10
Q

What type of head bleed has CT shows elliptical shape that does NOT cross suture lines?

A

Epidural hematoma

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11
Q

How can you differentiate Subdural hematoma from Epidural hematoma on CT?

A
  • Subdural: crosses suture lines

- Epidural: does NOT cross suture lines

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12
Q

What type of head bleed has CT shows small, dense “slivers”?

A

Subarachnoid hemorrhage (SAH)

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13
Q

Under what two conditions could you send a child home with head injury precautions as disposition for head injury?

A
  • No ICH

- No skull fracture

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14
Q

Under what condition would you admit a patient + neuro consult as disposition for head injury?

A
  • ICH +/- skull fracture
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15
Q

What condition involves appears normal but amnesia/repetitive speech, confusion, delayed response?

A

Concussion

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16
Q

For concussion, when might a patient expect HA, mental fogginess to resolve?

A

Within 7-10 days

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17
Q

What tool is used to evaluate concussions?

A

ACE (Acute Concussion Evaluation)

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18
Q

What two conditions MUST be relayed to the patient with diagnosis of concussion?

A
  • NO same-day return to play regardless of sxs (must be completely sxs-free to return)
  • SLOW advancement of activity with sxs resolution
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19
Q

What is post-concussive syndrome?

A

3+ months of sxs

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20
Q

What is second impact syndrome?

A

2nd impact within weeks of 1st

- Increases risk of brain swelling, death

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21
Q

What is Chronic Traumatic Encephalopathy?

A

Permanent changes (long-term sequela) after multiple impacts

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22
Q

What type of injury is rare in peds and often due to if <8 years = falls, if 8+ years = MVA? What should you still consider?

A

Cervical Spine Injuries

- Consider SCIWORA (Spinal Cord Injuries w/o Radiographic Abnormality)

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23
Q

What is the gold standard test to evaluate for Cervical Spine Injuries?

A

MRI

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24
Q

What exam (three components) should ALWAYS be checked and documented before/after splinting?

A

Neuro exam

  • ROM
  • Pulses
  • Capillary refill
25
Q

What three treatments are recommended for an open compound fracture?

A
  • Splint
  • Start abx
  • Ortho consult
26
Q

What two treatments are recommended for a grossly deformed/displaced fracture?

A
  • Closed/open reduction +/- fixation

- Ortho consult

27
Q

What four treatments are recommended for a non-displaced compound fracture?

A
  • Start abx
  • Repair laceration
  • Splint
  • Ortho follow up
28
Q

For what two types of fractures is ortho consult recommended?

A
  • Open compound

- Grossly deformed/displaced

29
Q

What condition is most common if <5 years and male; more common in long bones?

A

Osteomyelitis

30
Q

What is the most common etiology of Osteomyelitis?

A

Staph aureus

31
Q

What two diagnostic tests are recommended for Osteomyelitis?

A
  • MRI

- Cultures

32
Q

What is the recommended treatment for Osteomyelitis?

A

Vancomycin (IV)

33
Q

What is unique about the following drugs and their toxicity: ASA, beta-blockers, CCBs, Camphor, Chloroquine, Clonidine, Iron, Lindane, Methyl Salicylate, Methadone, Nicotine, oils, Theophylline, Tricyclic Antidepressants

A

LETHAL IN ONE DOSE

34
Q

What is the recommended treatment for toxic ingestion?

A

ABC-DDD

  • ABC: airway, breathing, circulation
  • DDD: disability, drugs, decontamination
35
Q

What is the antidote for Acetaminophen toxicity?

A

Acetylcysteine

36
Q

What is the antidote for Benzos toxicity?

A

Flumazenil

37
Q

What is the antidote for Opioids/Narcotics toxicity?

A

Narcan (Naloxone)

38
Q

If a FB has past the pylorus, what does this mean?

A

SHOULD pass in stool on its own (no intervention)

39
Q

What can aspirated vegetables cause?

A

Pneumonitis

40
Q

What test should be used to remove FB from the esophagus?

A

Endoscopy

41
Q

What test should be used to remove FB from the trachea?

A

Bronchoscopy

42
Q

Symptoms of feeding refusal, vomiting, choking/coughing, neck/throat pain, dysphagia, increased salivation are indicative of what?

A

Esophageal FB

43
Q

Where should a patient be referred if the FB is above the cricopharyngeus?

A

ENT

44
Q

Where should a patient be referred if the FB is below the cricopharyngeus?

A

GI

45
Q

What type of FB is an emergency?

A

Button battery in Esophagus

46
Q

When is removal of a button battery in Esophagus considered emergent?

When is it NOT necessary, unless…?

A

Lodged in esophagus = emergent removal

- Past esophagus, no need to remove UNLESS not past pylorus after 24-48 hours

47
Q

In what two age groups is drowning most common?

A
  • Children <4 years

- Young adults 15-24 years

48
Q

What does impaired ventilation in drowning lead to (2)?

A
  • Hypoxemia

- Acidosis

49
Q

What is the most common type of drowning?

A

Wet drowning

50
Q

What condition involves aspiration of water into lungs?

A

Wet drowning

51
Q

What condition involves occurs when laryngospasm → hypoxia → LOC?

A

Dry drowning

52
Q

What two findings can indicate very poor prognosis for near-drowning?

A
  • CPR

- Fixed/dilated pupils

53
Q

What is the most critical factor in determining prognosis for drowning? What are three other factors?

A

Duration of submersion

  • Time to effective BLS (worse if 10+ minutes)
  • Resuscitation duration (worse if 25+ minutes)
  • Young respond better
54
Q

What is the goal for identifying Fever Without Source?

A

Identify occult systemic bacterial infection

  • PNA
  • UTI
  • Bacteremia
  • HSV-6
  • Meningitis
55
Q

For what condition should you work up infants regardless of appearance?

A

Fever Without Source

56
Q

For Fever Without Source, if Group B Strep is present, what condition should always be checked for?

A

Meningitis

57
Q

For infantile fever and ill-appearing, what two diagnostic tests are recommended?

A
  • UA (cath)

- Urine C&S

58
Q

For infantile fever and well-appearing/NOT fully vaccinated, what diagnostic test is recommended, and for what three specific groups?

A

UA (cath)

  • Female <2 years
  • Uncircumcised boy <1 year
  • Circumcised boy <6 months
59
Q

For infantile fever and well-appearing/fully vaccinated, what two diagnostic tests are recommended, and for what three specific groups?

A

UA (cath)
UA C&S

  • Female <2 years
  • Uncircumcised boy <1 year
  • Circumcised boy <6 months

Peds II (12 decks)

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