ER Flashcards
primary survey
A airway B breathing C circulation with hemorrhage control D disability (neurologic deficit) E exposure (maintain warm environment, expose patient)
secondary survey
head to toe assessment to prioritize care
most common ped surgical emergency
appendicitis
most common cause of shock in children
hypovolemia (NOT cardiac)
kids who show up in cardiopulmonary arrest usually have what
primary respiratory arrest
Pulmonary system is unable to maintain adequate gas exchange to meet metabolic demands
respiratory failure
reversible small airway obstruction that is refractory to sympathomimetic and inti-inflammatory agents and that may progress to respiratory failure without prompt and aggressive intervention
status asthmaticus
ARDS four features of dx
Underlying disease that predisposes to ARDS
Bilateral infiltrates on CXR
Absence of evidence of heart failure ( esp LVF)
Severe hypoxemic respiratory failure
most common precipitant ARDS
infection
increased anion gap
metabolic acidosis-accumulation of acid
- lactic acidosis
- ketoacidosis
- exogenous acids
normal anion gap
metabolic acidosis- loss of base
renal bicarb loss
loss of bicarb from gut
decreased renal hydrogen ion secretion
metabolic alkalosis
Hydrogen ion loss: vomiting, renal loss, diuretics, hypokalemia, low Cl states
Bicarb gain: sodium bicarb administration, citrate administration
respiratory acidosis
Airway obstruction, pneumonia, ARDS, PE
Respiratory muscle weakness
Trauma
Respiratory depression
respiratory alkalosis
High levels of anxiety or pain Altitude Excessive mechanical ventilation Respiratory stimulants/salicylate overdose Pulmonary embolism, asthma, edema
1 week old in ER with shock
sepsis
cardiac
IEM
Failure of cardiovascular system to deliver oxygenated blood and substrates to tissues, and to remove toxic metabolites. –> anaerobic metabolism in cells –> cell damage
shock
hypovolemic shock
dehydration, burn, hemorrhage
distributive shock
septic, anaphylaxis, spinal
cardiogenic shock
myocarditis, dysrhythmia
obstructive shock
tamponade, pneumothorax
compensated shock
organ perfusion maintained
uncompensated shock
circ failure with end organ dysfunction
irreversible shock
irreparable loss of essential organs
Weakness, fatigue, headache, pallor, disorientation,thirst, N/V, occ muscle cramps
heat exhaustion
life threatening failure of thermoregulation. Rectal temp over 40.6. Sxs of CNS dysfunction
heat stroke
heat stroke effects
Cellular hypoxia, enzyme dysfunction, disrupted cell membranes -> global end organ derangements
rhabdomylosis, ATN, renal failure, ARDS, DIC
most common cause of burns in children
scalding
dry, red, hypersensitive (sunburn)
Heal 5-7 days, no scarring
superficial, first degree
deep- white and dry, skin blanches, decreased pain, can blister
partial thickness, superficial or deep 2nd degree burn
all epidermal and dermal elements
full thickness
most common poisoning
tylenol
antidote tylenol poisoning
acetylcysteine
should you suture a wound
no
bugs for human bites
Strep, staph, anaerobes, and Eikenella Corrodens
bugs for dog and cat bites
Pasteurella multocida, strep , staph and anaerobes
