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Passmed revision > Paeds - accidents > Flashcards

Paeds - accidents Flashcards

1
Q

If a pt after head injury and had been in a high speed RTA, how would you manage them?

A

1) ABC - resus
2) If they have no other issues (vomit X3/impaired consciousness/amnesia/seizure/NAI)
the observe for 4 hours

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2
Q

If you decide to observe a head injury patient for 4 hours due to only 1 minor sign of potentially serious injury: what are you observing for?

A
  • Regularly monitor GCS
  • Focal neuro signs
  • Seizures
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3
Q

If a patent with head injury, suffered a seizure after the injury, how would you manage them? They have no significant PMH

A

Post traumatic seizure in the absence of a history of epilepsy –> CT within 1 hour!!

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4
Q

Define concussion

A

Transient + reversible LOC

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5
Q

How does an infant with haematoma present differently to an older child and why

A

Sutures haven’t yet fused

Thus ICP doesn’t increase initially w haematoma

May present with shock first

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6
Q

What signs would make you worry about a potentially serious head injury and immediately refer for urgent CT?

A
  • Post-traumatic seizure w/o epilepsy hx
  • Basilar skull fracture (panda eye, blood from ear, mastoid bruising)
  • ?NAI
  • Open fracture
  • Deteriorating GCS
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7
Q

What one piece of advice MUST be given to parents on discharge following a head injury

A

MONITOR FOR 24 HOURS - if deterioration –> come back (extradural haematoma)

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8
Q

Advice to parents on discharge after head injury

A

Monitor 24 hours!!!

  • Can give paracetamol + ice pack
  • Return to school once feeling better
  • Avoid contact sports for 3 weeks
  • Avoid NSAIDs
  • Avoid sleeping pills/etoh/drugs
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9
Q

1% Surface area

A

palms + adducted fingers

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10
Q

Difference btw partial and full thickness skin burn

A 
Partial = painful + pink
full = painless, white
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11
Q

When to involve a burn specialist

A

10% surface area partial thickness
5% surface area full thickness

  • Face/mouth/perineum/hands
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12
Q

Mx of paediatric burns - 4 points

A

1) Rehydrate
2) wound care
3) Analgesia - consider IV opioids
4) ?tetanus boost

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13
Q

Which household product can cause constricted pupils if OD

A

Organophosphates (eg in insecticides)

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14
Q

2 poisons which can increase RR

A

aspirin

carbon monoxide

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15
Q

4 drugs which cause hypotension

A

Beta blockers
Iron
TCA
Opiates

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16
Q

Initial management of suspected poisoning

A

Stabilise patient + TOXBASE

= check for toxicity severity + recommended duration of monitoring

17
Q

how is activated charcoal given

A

Orally or NGT

If oral, can disguise taste in cola

18
Q

useful Ix for alcohol poisoning

A

Plasma EtOH level + glucose

19
Q

useful 4 Ix for paracetamol poisoning

A

Plasma paracetamol level

Cr
LFTs
PTT

20
Q

Tx of iron poisoning

A

Desferrioxamine

21
Q

2 useful Ix for iron poisoning

A

Serum iron level

X-Ray = # of tablets

22
Q

which drug, if OD’d, is plasma level monitoring useless

A

TCAs (eg imipramine)

23
Q

useful ix for battery ingestion

A

Chest and abdo x-ray

24
Q

what is TOXBASE?

A

Database w drug toxicities and recommended duration of monitoring

25
Q

3 causes of lead poisoning

A

Surma
Exhaust fumes
Chewing paint

26
Q

2 potential Ddx for pica?

A

IDA

lead poisoning

27
Q

in any suspected non-accidental head injury, what ix must be done

A

CT + MRI head
skeletal survey
coagulation screen
Ophthalmology review

28
Q

Important documentation in ?NAI

A
  • Interaction between child + carers
  • Body map
  • Plot growth chart
29
Q

how may a child’s behaviour manifest in abuse?

A 
Infant: FTT or developmental delay
Social withdrawal/apathy
ASB
bed-wetting
faecal incontinence
depression, anxiety,
30
Q

how may a child’s behaviour manifest in abuse?

A 
Infant: FTT or developmental delay
Social withdrawal/apathy
ASB
bed-wetting
faecal incontinence
Older child: depression, anxiety,

Passmed revision (15 decks)

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