EPC Flashcards
Pts 1-3 years old are called…
Toddlers
Kids between 3-6 are called…
Preschoolers
At what age can you stop doing toe-to-heads and just do head to toe assessments.
Preschoolers
Kids between 6-12 are called
School aged
Kid has poor appearance but normal work of breathing and circulation. What’s wrong?
CNS dysfunction
Toddlers and preschoolers (some infants) are susceptible to what disease?
Croup
Croup treatment
Nebulized epi (for strider)
Corticosteroids
Kid has dyspnea, gradual onset that worsens at night. Seal-bark cough. What is it?
Croup
What does croup do to the body?
Viral
Infection of upper and partial lower airway
What are common bacterial upper airway infections in kids?
Epiglottis, tracheitis, retropharyngeal abscess, peritonsilar abscess
Kid (4-6) with hx recent sickness and sudden onset stridor with drooling. What’s wrong?
Epiglotitis
Kid (4-6) with hx long sickness, high fever, lots of thick mucous, barking cough. What’s wrong?
Tracheitis
Kid (up to 6) has hx of penetrating trauma or upper infection, slowly starts drooling with stridor. What’s wrong?
Retropharyngeal abscess
Best way to manage an airway in odds with upper airway infections?
BVM. They will have difficult intubations
Bronchiolotis vs asthma?
Bronchiolotis = 0 to 2years with wheezing
Asthma = older than 2
Kid has fever vomiting cough, abnormal a lungs… what’s wrong?
Pneumonia
Treatment for pneumonia in kids?
Supportive
Three main drugs for anaphylaxis
ABCs
Adrenaline
Benadryl
Corticosteroids
Albuterol vs ipratropium effects
Albuterol = B2 - relax bronchial smooth muscle
Ipratropium = anticholinergic = same plus decrease secretions
Infant vs child ventilation rate
Infant 30/min
Child 20/min
compared to adults, how do kids’ hearts compensate for shock?
increase HR more than stroke volume
kid has pale and mottled skin. what does this mean?
shock
a weak central pulse in kids is compensated or decompensated shock?
decompensated
quick way to tell BP for kids >1
70 + 2xage
3 types of shock
cardiogenic, hypovolemic, distributive (pipe issue)
most common type of shock in peds? give examples
hypovolemic from bleed or dehydration
a kid in shock, assume its … until proven otherwise
hypovolemia
ways to recognize hypovolemia in kids?
no tears/urine
dry mucous membranes
sunken fontanelles / eyes
poor skin turgor
hx
examples of cardiogenic shock
PE, tension pneumo, tamponade (obstructive)
dysrhythmia, trauma, myocarditis
number one drug choice for cardiogenic kid shock
epi
what SS triad to assess cardiac tamponade?
becks triad
JVD
Hypotension
muffled heart tones
how would a PE show on the monitor?
decreased end tidal
what are the types of distributive shock
neurogenic
anaphylactic
septic
fluid dose for neurogenic shock vs cardiogenic shock?
neuro = 20ml/kg
cardio = 10ml/kg
max dose of fluids in peds for neuro and septic shock?
60ml/kg (20ml/kg x3 doses)
what height fall is fatal to a kid
twice their height
would bicarb help with respiratory acidosis?
NO. will make it worse.
how can hypothermia worsen a trauma kid?
SPO2, Glucose, anaerobic metabolism
is BP a good indicator of shock in kids?
not at all. can be normotensive but still in shock due to strong vasoconstriction in peds
good questions to ask a pregnant mom
prenatal care
complications?
med hx
drug use / high risk behaviors?
pregnancy problems?
newborn suddenly tanks after you start bagging. whats wrong?
pneumothorax
main cause of CNS dysfunction in newborns
hypoglycemia
bag rate for a neonate
40/min (every 1.5sec)
when to start CPR on a newborn?
<60bpm or >30s of bagging with no improvement
when to stop CPR on a newborn?
they can keep >60HR on their own
compression to vent ratio for newborns
3:1
how often to reassess pt during newborn CPR
every 30s
newborn fluid dose
10ml/kg bolus over LONGER times (10-20min)
what counts as fever
> 100.4 F
can fevers cause braindamage in kids?
no
are febrile seizures fatal?
no
kid with a CSF shunt is seizing. what could this mean?
possible clog or block
how to tell if a neonatal is seizing
chewing, eye twitch, horizontal fixed gaze, lip smaking, bicycle legs
a new born is kicking its legs, smacking its lips, and has a fixed gaze with eye twitching. whats wrong?
its seizing
whats status epilepticus?
5+ min
no return to baseline LOC
when is a seizure a serious issue?
after trauma
<12mo
first ever seizure
prolonged posticaal or status
treatment for DKA
fluids (20ml/kg x3 ) over 30-60min if not in shock
what temp = heat stroke?
> 104 F
heat stroke rx?
cooling, fluids, monitor cardiac
most common arrhythmias in kids
sinus brady, sinus tach, or SVT
brady rate for kids, infants, newborns?
kids <60
infants <80
newborns <100
brady rx
underlying cause (hypoxia, hypoglycemia)
Epi every 3-5min
atropine (if indicated)
pace
SVT rate for kids vs infants?
kid >180
infant >220
rosc fluids for kids
20ml/kg
how to assess ICP
brady
hypertension
agonal respirations