Emergencies in Children Flashcards
What is a fever treated with?
acetaminophen or ibuprofen
fever threshold for neonates & infants < 3 months
38 C (100.4 F)
fever threshold for infants 3-36 months
39 C (102.2 F)
fever threshold for children > 36 months old
not defined because concern for serious bacterial illness in this age group should be directed by other S/S of underlying cause
may not produce symptoms other than fever
UTI
Ideally, how do we want to get a urine sample from kids?
urine cath or suprapubic aspiration
What’s wrong with bagged specimens for collecting urine in children?
high rate of false positives
How is the diagnosis of meningitis made?
CSF by lumbar puncture
frequently associated with or following upper respiratory tract symptoms
pneumonia
What remains the gold standard for diagnosing pneumonia?
plain chest radiographs
due to group A Streptococcus
becomes more common in children > 36 months old
pharyngitis
Tx for pharyngitis
amoxicillin or Pen G
what is the most common cause of vomiting & diarrhea in children?
acute viral gastroenteritis
what remains the gold standard measurement of dehydration in children?
(but is infrequently available in the ED)
precentage of body weight lost
what are the 3 clinical signs that have significant positive likelihood ratios for 5% dehydration?
- prolonged capillary refill time
- abnormal skin turgor
- abnormal respiratory pattern
management of mild to moderate dehydration
oral or nasogastric dehydration
(nasogastric tx is more cost effective than IV treatment)
management of moderate dehydration
no advantage of rapid or ultra rapid hydration over standard hydration
management of moderate to severe dehydration
requires prompt fluid resuscitation with large volumes of fluid over a short period of time
use isotonic solution or lactated Ringer’s during resuscitation phase
what is the most common cause of neonatal cardiorespiratory distress
neonatal sepsis
S/S of neonatal sepsis
temp instability
CNS dysfunction (lethargy, irritability, seizures)
respiratory distress
feeding disturbance
jaundice
rashes
what should be suspected in a well-developed neonate who presents w/ unexplained cardiorespiratory collapse, cyanosis, and/or tachypnea, especially without retractions
congenital heart disease
when does congenital heart disease usually become symptomatic?
in the first week of life or after the second week of life
what is the most common site of infection in neonates?
lungs → pneumonia
S/S of bronchilitis
nasal discharge
sneezing
decreased appetite
feeding difficulty
cough, dyspnea
irritability
occasional periods of apnea
up to 4% of febrile infants with bronchiolitis have concomitant _____
UTI
may manifest as lethargy or respiratory and/or cardiovascular collapse in the neonate
inborn erros of metabolism
what is one of the few acute life-threatening endocrine emergencies that present in the neonatal period
congenital adrenal hyperplasia
what are some risk factors for intracranial hemorrhage in a neonate?
can result from birth trauma or non-accidental trauma
home delivery without administration of Vit K
traumatic vaginal delivery
bilious vomiting
distending rigid abdomen
sepsis
circulatory collapse
abdominal catastrophe-
congeital malrotation can lead to midgut volvulus & intestinal infarction
necrotizing enterocolitis is typically a disease affecting what population?
premature infants
