Final review Flashcards
3 types of shock
hypovolemic
distributive
cardiogenic
if someone is stroking out and has a broken leg what do you treat first
stroke
chest pain non cardiac causes (more common)
trauma pneumothorax PE asthma sickel sell
early signs of shock
increased HR poor cap refill weak pulses decreased urine dry no tears
late signs of shock
mental status
cyanosis
apnea
low BP
bradyarrhythmias are secondary to…
hypoxia
types of tach HR in kids
narrow and wide
narrow tach
SVT
wack/absent P waves
wide tach
VT
APGAR
appearance pulse grimace activity respirations
min score 0
max score 10
peds vs adult
bigger head to body ratio
head is 2/3 size it will be as an adult
cover it to prevent heat loss
where does towel go to get sniffing position?
under the shoulders
kids necks are…
short and stubby
finding a carotid pulse may be difficult
t/f kids in shock lose their BP faster than adults?
false!
more blood loss before hypotension
kids brains are __% of their body weight
10
kids abdomen
wall is thinner so less protection
multiple organ injuries are common
liver and spleen are larger
kids skin
thinner
stretchier
less fat
thermal burns can be deeper
lose more fluids/heat
t/f newborns can shiver
F!
KEEP THEM BABIES WARM
neonate age
0 - 1 month
infant age
1 month - 1 year
toddler age
1 - 3 years
preschooler age
3 - 6 years
school age
6 - 12 years
adolescent
12 - 18 years
what age can infants hold their head up?
4 months
average neonate weight
6 - 8 lbs / 3 - 3.5 kg
situational crisis phases
protest
despair
withdrawal
SIDS
sudden infant death syndrome
more common in boys, formula fed, premature babies between the ages of 2-4 months
T/F sids is diagnosis of exclusion?
T!
How to prevent SIDS
breast feed
let baby sleep on its back
no blankets for BABY
infant distress signs
retractions (chest movements)
grunting (keeps air in the lungs)
apnea (paused breathing)
jaundice
something in the blood
can cause brain damage if left untreated
croup
upper airway infection
most common!
larynx/trachea/bronchioles are infected
more common in boys
croup findings
stridor
barking cough
hoarse voice
increased breathing
larynx parts
supraglottis
glottis
subglottis
peds larnyx
funnel shaped sub glottis most narrow hyoid/cartilage overlap crics not possible usually sits higher
cardiovascular emergency categories
anatomic
acquired
electrical
peds assessment triangle
appearance
work of breathing
circulation
wolf parkinson white
short PR interval
slurred up stroke on QRS
(delta wave)
prolongation of the QRS interval
an accessory pathway that pre excites the ventricles
T/F cardiac arrest is more common in kids then adults
F! its more common in adults
when it happens its usually connected to a respiratory issue
hypovolemic shock
most common type of shock
loss of volume
distributive shock
leakage of plasma out of vessels into surrounding tissues
vasodilation
caused by anaphylaxis, sepsis, spinal cord injury
obstructive shock
impaired filling of the heart
reduced cardiac output
PE/pneumo/cardiac tamponade
cardiogenic shock
pump failure
uncommon in kids
heart failure
fever rectal temp
> 38.3C
fever benefits
inhibit growth/replication of microorganisms
increase WBC function
activate lymphocytes/antibodies
most common age to contract meningitis
1 - 5 y/o
more common in males
meningitis s/s
flu like symptoms fever photophobia kernigs/brudzinskis signs headache
VERY FAST ONSET
encephalitis is usually a ________ infection
viral
how to tell if a infant has encephalitis
bulging of the fontanels N/V stiffness crying poor feeding irritability
AEIOUSTIPPS
alcohol epilepsy opiates uremia trauma infection psych poison stroke
increased ICP cushings triad
increased systolic
brad HR/RR
rapid transport
febrile seizure cause
I don’t fucking know
types of febrile seizures
simple/complex
epilepsy seizures can be…
over 20 minutes
2+ seizures without a return to baseline
whos more likely to purposely expose themselves to toxins…
adolescents
if a toxic substance has been applied to the skin
a glass of milk or water may help no syrups!
activated charcoal may help
or dialysis
forms of abuse
physical
sexual
emotional
neglect
most common form of child abuse
physical
young or older children are more at risk for abuse
younger
nature vs nurture reasons for abuse
nature - its the abusers nature
nurture - based off of childhood experiences
___% of abusers claimed they didn’t mean to hurt the child
70
suspicions of child abuse
scene assessment
family history
multiple contusions in weird spots and in different healing stages
child doesn’t look to parent for reassurance
what to do if you suspect abuse
document in PCRs
call law enforcement
death rate with shaken baby syndrome
70% 1/4 die
most shakers are fathers or baby sitter if female is involved
what type of disorder is autism
pervasive developmental disorder
causes difficulty understanding/communicating
autism symptoms relate to…
communication social interaction sensation of discomfort ability to play ability to purposely shift attention
autism is genetic t/f
T!
frontal lobe function
speech/movement
occipital lobe function
vision
temporal lobe function
hearing/facial recognition
parietal lobe function
touch/pressure
taste
body awareness
how long are infants nose breathers for?
6 months
child oxygen consumption vs adult
6-8ml/kg
3-4ml/kg
best maneuver to overcome upper airway obstruction in children
jaw thrust
neonate breaths per minute when ventilating
30
infant breaths per minute when ventilating
10-20
children breaths per minute when ventilating
8-10
why is ventilating to fast a bad thing?
decreases CPP
decreases rate of ROSC
decreases rate of survival
a young child falling from a height is most likely to fall on their…
head
narrowest part of the child airway
cricoid cartilage compare to vocal cords for adults
is it easier to hear heart and lung sounds in a child or an adult?
child because their skin is thinner / flexible
pneumos are hard to diagnose
top causes of serious trauma in children
head trauma then abdominal trauma
more vulnerable to blunt trauma because their organs are so big
organs caught in handle bar injuires
pancreas
SI
whats more common sprains or fractures in kids
fractures due to weak growth plates
t/f the fulcrum gets higher with age
F! it gets lower
around C5 - C7 in adults
how does the baby use the maternal cardiovascular system
uses the foramen ovale
a hole in the septum
how do babies receive antibodies
through breast feeding
muscles in infants account for __% of their body weight
25
tips when approaching toddlers
general appearance head to toe smile use distractors show what you'll do on a toy save unpleasant things for last
tips when approaching pre schoolers
gaining trust is important
tell them what you are going to do
find comfort in toys and having a parent nearby
when does stranger anxiety start
toddler phase
poorly developed sense of cause and effect
toddler phase
school age children
6-12
increased sense of independence/self esteem
don’t want to be different
allow them to make minor choices
understand cause and affect
VS gradually come close to adults
what can cause acne
hormone changes
adolescent issues
conflict
identity
privacy
t/f higher proportion of blunt trauma involves the head
T!
when are lungs full developed
at age 8
what abdominal organs are most vulnerable to injury in kids
liver/spleen
what weaker in kids bones or ligaments
bones
whats longer inspiration or expiration?
inspiration!
stridor is usually heard on…
inspiration
most common cause of bradycardia in kids
hypoxia
normal cap refill time…
under 2 seconds
longer means low CO
causes for long cap refill
dehydration, shock and hypothermia
