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Pediatrics > Lecture 12: Pediatric Accidents & Injuries > Flashcards

Lecture 12: Pediatric Accidents & Injuries Flashcards

1
Q

Which gender dies more?

A

Male 2x more

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2
Q

What is the leading cause of pediatric mortality?

A

Trauma

At the scene or 4 hours post arrival

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3
Q

What is the MC preventable cause of mortality in trauma?

A

Hemorrhage

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4
Q

What is the most common injury factor in infants < 1 yo?

A

Bedding

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5
Q

What is the main risk factor for mortality in preschoolers? (age 1-4)

A

Drowning

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6
Q

What is the primary injury factor for early teens/adolescents?

A

Vehicle safety/Safety belt (5-19y)

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7
Q

What is the MCC of death due to accident in children aged 5-19?

A

Motor vehicle crash

60% due to unrestrained child ):

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8
Q

What MPH is concerning for a high risk injury in a crash?

A

> 20 MPH

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9
Q

When is a rear-facing car seat indicated? (2)

A
  • Until 2 years old OR
  • Highest ht/wt allowed
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10
Q

When is a forward facing carseat indicated until? (2)

A
  • Up to 4 years old AND
  • 40 lbs

Rear until 2, forward until 4 & 40

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11
Q

What are the 2 criteria that make a booster seat needed?

A
  • Shorter than 4’9”
  • 8 years old at minimum

Backseat only until 13 years old

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12
Q

What is seat belt syndrome?

A

Serious cervical and lumbar spinal cord injuries + intra-abdominal injuries

All due to poorly fitted seat belts

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13
Q

Image of proper seat belt fitting

A
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14
Q

What is the 2nd MCC of childhood injury due to consumer product?

A

Bicycles

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15
Q

What is the most effective measure for prevention of significant injury with bicycles?

A

Helmet

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16
Q

When should you discard a helmet?

A
  • Head hit a hard surface
  • Fall resulted in marks on shell
  • Greater than 5 years old
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17
Q

What is the 2nd leading cause of accidental trauma?

A

Drowning, esp under age 5!

From age 1-4, it is the leading cause

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18
Q

Which water temperature tends to have a dismal prognosis?

A

Warm water > 20C

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19
Q

How do most children drown?

A

Silently ):

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20
Q

What is the leading cause of injury-related death at home?

A

Burn injuries

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21
Q

Should you pop burn blisters?

A

No

22
Q

What should you monitor with electrocution injuries? (4)

A
  • EKG
  • CK
  • UA
  • BMP

Rhabdo + EKG

23
Q

How do you treat a second degree burn? (3)

A
  • Silvadene (silver sulfadiazine)
  • Analgesics
  • Sterile non-adhesive dressings
24
Q

Who do dogs bite the most?

A

Boys

25
Q

When do you close a bite wound? (2)

A
  • Only suture if large or facial
  • NEVER DERMABOND
26
Q

Tx of a bite wound (2)

A
  1. Intense, high volume irrigation
  2. Augmentin for 10d
27
Q

What is the MC canine microbe in bite wounds?

A

Pastereulla multocida

28
Q

What is the MCC of non-lethal injuries in children?

A

Falls

29
Q

Where do most falls occur?

A

Home

30
Q

What fall height is concerning?

A

10-15 ft or 2-3x the patient’s height

31
Q

What are the common environments/ways in which children fall?

A
  • Baby walkers
  • Bathtubs
  • Playground equipment
  • Shopping carts
  • Furniture
32
Q

When is choking highest risk in children?

A

6 months - 4 years old

Same for chunks of food

33
Q

How do you tx a choking child under age 1? After age 1?

A
  • Under age 1: Hard back blows
  • After age 1: Abdominal thrusts/Heimlich
34
Q

How does choking present usually? (6)

A

Acute onset of…

  • Coughing
  • Choking
  • Wheezing
  • Cyanosis
  • Drooling
  • Stridor
35
Q

What has the leading risk of death among toys?

A

Non-powered scooters

Injuries common

Most deaths are from asphyxiation overall

36
Q

What age should a child NOT ride a skateboard?

A

Less than age 5

they aint rdy

37
Q

What age range is most at risk for ATV injuries?

A

11-15

38
Q

What is the primary underlying factor for ATV injuries?

A

Riding an ATV bigger than you

39
Q

What is the recommended minimum age to ride an ATV?

A

16 years old per AAP

11-15 is highest risk too

40
Q

When is risk of recurrent concussion highest?

A

Within 10 days of first concussion

41
Q

What are the return to play guidelines?

SCAT5 is the professional criteria

A

General criteria

5 days of no symptoms as you ramp up. Need approval on day 3.

42
Q

When and where do the majority of poisonings occur?

A
  • Under age 5
  • At home

Most are unintentional

43
Q

How do you treat an ingested poison?

A

Activated charcoal

Gastric lavage is rarely used now.

44
Q

When is activated charcoal contraindicated? (6)

A
  • Depressed mental status
  • Late presentation
  • Increased risk and severity of aspiration if used (hydrocarbons)
  • Need for endoscopy (impaired visibility)
  • Toxins that are poorly absorbed by charcoal (metals)
  • Presence of intestinal obstruction (ABSOLUTE CI)
45
Q

How is tylenol poisoning treated? (2)

A
  • Activated Charcoal
  • N-acetylcysteine (Acetadote)
46
Q

How is N-acetylcysteine dosed?

A
  1. Loading dose of 150mg/kg over 15-60m
  2. 2nd infusion of 50mg/kg over 4 hrs
  3. Third infusion of 100mg/kg over 16 hrs

150 1st hour, 50 4th hour, 100 16th hour

Must monitor liver enzymes daily

47
Q

What iron dosage tends to cause symptoms?

A

> 20mg/kg

48
Q

What is the initial condition that occurs from iron OD?

A

Hemorrhagic gastroenteritis

Can lead to shock, coma, hepatic failure

49
Q

How is lead poisoning treated?

> 45 mcg/dl

A

Chelation via Succimer

P sure succimer is oral

50
Q

When is chelation therapy indicated for lead poisoning?

A

Blood lead level >= 45mcg/dl

51
Q

When are blood lead levels checked?

A

12 month WCC

52
Q

Where can you remove disc-shaped batteries?

A

If it is in the esophagus

Otherwise, XR in 7 days

Pediatrics (23 decks)

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