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Peds > Emergency > Flashcards

Emergency Flashcards

1
Q

what is the leading cause of death in US children

A

Accidental injuries

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2
Q

What predisposes infants and toddlers to head injuries

A

Large head compared to body size
Weak neck muscles
Thin skulls
Physically uncoordinated

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3
Q

What should you consider for accidents in ch

A

Falls

Abuse

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4
Q

Head injury Hx

A 
Witnessed fall
What height 
Immediate cry
Consolability
vomiting 
time since happening
arousability
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5
Q

Head injury exam

A
  • ABC

* Neurostatus exam: Glasgow

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6
Q

Head injury diagnostics

A

Bed side US
Radiography
CT

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7
Q

Signs of basilar skull fracture

A

Battle’s sign
Periorbital ecchymosis (raccoon eyes)
Hemotympanum
otorrhea/rhinorrhea

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8
Q

How to decide whether or not to do the CT

A

PECARN
CHART
CHALICE

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9
Q

pathophys of subdural hematoma

A

Acceleration-deceleration injury

Blood pools between dura and arachnoid due to tearing of bridging veins

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10
Q

Sxs of subdural hematoma

A

irritability
lethargy
buldging fontanelle
vomiting

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11
Q

Subdural hematoma diagnostics

A

CT-cresecent shape across suture lines (REFER)

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12
Q

Pathophys of epidural hematoma

A

Blow to the head

Rapture of middle meningeal artery

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13
Q

Sxs of epidural hematoma

A

blow to the head

brief period of unconsciousness feeling great then dramatic change (btr prognosis)

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14
Q

epidural hematoma

A

non-contrast CT-elliptical/lentiform shape (REFER)

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15
Q

Subarachnoid hemorrhage pathophys

A

Blood pooling in cisterns, sulci, fissures, CSF

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16
Q

SAH diagnostics

A

Non-contrast CT-small dense slivers followed w/ angiography

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17
Q

Tx SAH

A

No ICH/skull fracture = can go home w/ head injury precautions
ICH +/- skull fracture = REFER

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18
Q

Mild TBI/concussion pathophys

A

Direct blunt force trauma- force stretches and shears axons

Altered mental status +/- unconsciousness

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19
Q

Sxs of concussion

A

Amnesia
Confusion
Delayed response
Repetitive speech

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20
Q

Hx qn for concussion

A
  • Did they have seizure at the time
  • Has it happened before
  • Alcohol or drugs involved (indication for CT)
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21
Q

post concussion syndrome

A

symptoms lasting 3mos or longer

22
Q

2nd impact syndrome

A

second concussion within weeks leading to brain swelling and herniation

23
Q

What do people with a concussion need to be able to return to sports

A

Neurologist clearance

24
Q

What do you need to always do with a fracture

A

Document neuromuscular status before and after splinting/reducton

25
Q

Fracture mgt

A

Open: Cpd-splint/dress, IV abs, ortho
non-displaced w/ laceration-PO abs, repair laceration, splint, ortho FU
Grossly displaced/deformed: Ortho - may compromise neurovascular structures
Other: splint, pain control, ORTHO

26
Q

Osteomyelitis pathophys

A

Hematogenous spread of infection to bone

27
Q

Dx osteomyelitis

A

MRI (best)
Xray: lytic lesions (10-14days)
Labs: CBC, CRP, ESR

28
Q

Most common location for osteomyelitis

A

Long bones (femur, tibia, humerus)

29
Q

Causative agents of osteomyelitis

A

S. aureus (MRSA)
S. pneumonia
S. pyogenes

30
Q

pathophys acute septic arthritis

A

hematogenic spread of bacteria to joint

31
Q

Etiology of septic arthritis

A

S. aureus (chn.)

Neisseria (adolescents/young adults)

32
Q

Deadly in a dose

A

Aspirin, beta blockers, Ca channel blockers, camphor, chloroquine, clonidine, iron, lindane, methyl salicylate, methadone, nicotine, oils, theophylline

33
Q

Hx for poisons

A 
Substance
Qty
Route
How long since they took sthng 
Progression of sxs.
Home treatments
34
Q

Toxidromes

A

Group of responses seen in classes of meds

35
Q

Anticholinergic

A

Hot as a hare, dry as a bone, red as a beet, blind as a bat
Vitals: Tachycardia, Hyperthermia, HTN
Meds: Atropine, Jimsonweed

36
Q

Cholinergic

A

Sweating, salivation, urination, lacrimation, miosis, seizures
Vitals: Bradychardia, hypothermia, tachypnea

37
Q

Concerns for foreign body

A

Sharp

long

38
Q

Vegetable matter foreign body

A

Causes pneumonitis

39
Q

Danger of ingesting magnets

A

Attraction to other things can cause entrapment of tissues

40
Q

risk with button battery ingestion

A

Burns wishing 4hrs

41
Q

Dry drowingin

A

Laryngospasm leading to hypoxia. No fluid in the lungs

42
Q

Wet drowning

A

Aspiration of water into lungs leading to dilution of surfactant and impaired gas transfer = atelectasis = VQ mismatch

43
Q

Age range to consider child abuse in drowning situation

A
44
Q

Secondary drowing

A

Death that occurs 72hrs after near drowning incident. depends on aunt of water ingested

45
Q

neonate

A
46
Q

infant/young child

A

> 2mos to 3yrs

47
Q

Fever w/ out a source

A

Rectal temp >38˚C(100.4)

48
Q

Who gets cathetarized for urine sample for fever w/out a source

A

All males

49
Q

Work up for non-toxic appearing fever w/out a source

A

UA (cath) & culture
Rapid viral test
Stool for WBC w/ Guiac

50
Q

Work up for toxic appearing fever w/out a source

A 
UA (cath) & culture
Rapid viral test
Stool for WBC w/ Guiac
CBC w/ diff
CXR
CSF analysis
51
Q

Mgt non-toxic fever w/out source

A 
go home must come back in 24hr for follow up
no sig risk factors
fully immunized
healthy prior to fever
cargiver
52
Q

Mgt toxic fever w/out a source

A

Admit

Empiric abx

Peds (11 decks)

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