hyperthermia, hypothermia and fever

Question 1

heat stroke def

Answer 1

core temp is higher than 40 c or 104 f

CNS dysfunction

2 kids nonexertional and exertional

Question 2

nonexertional heat stroke is caused by

Answer 2

underlying conditions - obesity, CVD, neurlogic disorder etc

cant leave hot environment - no access to hydration / cooling

Question 3

exertional heat stroke

Answer 3

exercise in heavily hot humid weather

Question 4

t/f heat stroke will have…

Answer 4

widened pulse pressures

Question 5

t/f immersion therapy can increase mortality?

Answer 5

true - for elderly pts with classic heat stroke

Question 6

hypothermia when core temp is …

Answer 6

below 35 c

Question 7

stages of hypothermia

Answer 7

mild 32-35 or 90-95
moderate 28-32 or 82-90
severe below 28 or 82

Question 8

resuscitative efforts should be..

Answer 8

continued indefinitely until body reaches 32-35 or 90-95 F

Question 9

for hypothermic pts.. with PEA

Answer 9

do NOT do chest compressions

Question 10

FUO

Answer 10

fever of unknown origin
temp greater than 38.3 (101) multiple times
more than 3 wks of illness
failure to reach dx after 1 wk inpatient

Question 11

acute fever with no obvious source

Answer 11

this is commonly worked up in ER

Question 12

fever defined as rectal temp that is over

Answer 12

38 c or 100.4 F

Question 13

nontoxic child with fever workup

Answer 13

URI, AOM, strep
Rapid test for virus
UA/ urine culture

Question 14

cath criteria for males and females

Answer 14

all males less than 6 mo
all uncircumcised males less than 12 mo
all females under 2 yrs
if older female but think uti do cath

Question 15

another thing to think when have nontoxic kid with fever and strep test comes back negative

Answer 15

look for occipital nodes ..mono!

Question 16

toxic fever workup for kids

Answer 16

rapid test for virus 
CBC 
blood culture 
CXR 
stool for WBC/ guaiac if D is also present  
UA/ urine culture 
CSF - LP (abx before)

Question 17

when admit kids with fever?

Answer 17

if toxic and…
pending culture results, give IV parenteral abx

Ceftraixone, cefotaxime or ampicillin / sulbactam