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Pediatrics > Ped Accidents and Injuries - Exam 2 > Flashcards

Ped Accidents and Injuries - Exam 2 Flashcards

1
Q

trauma is ___ times more likely in males than females. ______ is the most common preventable cause of mortality in trauma

A

2 times greater in males

Hemorrhage

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2
Q

What are the top 6 accidents/injuries for infants? _____ is specifically for kids less than 1

A

bedding if less than one

sleep positioning

feeding safety

car seat

crib

co-sleeping

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3
Q

What are the top 7 accidents/injuries for toddlers?

A

Crib Safety
Choking Foods & Toys
Cords and Cribs
Electrical Sockets
Stairs / Windows
Burns
Poisoning

aka the kiddo is 1-3 years old and learning to walk

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4
Q

What are the top 6 accidents/injuries for preschoolers?

A

Drowning - 1 - 4 years
Toy Safety
Traffic Safety / Pedestrian Injury
Bicycle / Tricycle Safety
Gun Safety
Stranger Safety

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5
Q

What are the top 5 accidents/injuries for school aged children?

A

Bike and ATV safety
Pool safety
Sports
Gun safety
Stranger Safety

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6
Q

What are the top ones for early teen/adolescent? **Which one is the starred one?

A

Vehicle Safety / Seat Belt - 5 - 19 years

Helmets and Protective Gear

Sports

Drug & Alcohol Abuse

Bike & ATV Safety

Gun Safety

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7
Q

______ is the #1 cause of death due to accidents in children 5-19 years old. 60% are due to _______. _______ are the MC among severe injuries due to improper use of safety belts

A

motor vehicle crash

unrestrained child

head injuries

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8
Q

What are some important questions to ask if a child has been in a MVC?

A
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9
Q

What are some trauma mechanisms that are associated with a high risk of injury?

A
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10
Q

What is the car seat recommendation for infants and toddlers? What is the law in WV?

A

Rear-facing Car Seat until 2 years old or highest weight or height allowed by car seat manufacturer

2 years of age AND up to 35 lbs.

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11
Q

What is the car seat rule for toddlers and preschoolers?

A

Forward facing with 5-point harness for as long as possible and at least to 4 years of age AND 40 lbs

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12
Q

What is the car seat recommendation for school aged children? How should the seat belt sit?

A

Belt positioning booster seats until reaching 4 feet 9 inches in height AND at least 8 years old

Seat belts with shoulder and lap belt

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13
Q

How old should the child be until they can sit in the front seat?

A

Backseat only until 13 years of age

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14
Q

**What is the infant seat belt recommendation? Once a car seat has been involved in a MVC, what should you do?

A

rear facing until 2 AND 35 lbs

needs to be discarded

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15
Q

_______ is a serious cervical and lumbar spinal cord injuries as well as intra-abdominal injuries in children in MVC resulting from poorly fitting seat belts

A

seat belt syndrome

aka their seat belt was NOT fitted properly and it caused serious injuries

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16
Q

How should a properly fitted seat belt sit on a child?

A

Shoulder belt across mid chest not neck

Lap belt low across hips and pelvis, not the abdomen

Tall enough to sit in backseat with knees bent without slouching

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17
Q

60% of pedestrian injuries are ______ at highest risk, happen in own driveway when family backs over them

A

under age 5, toddlers

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18
Q

_____ is the second most common childhood injury due to a consumer product, next to _____

A

bicycle injuries - #2

MVC - #1

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19
Q

_____ is the single most effective measure for prevention of significant injury in bicycle accidents. When do bike accidents have the highest mortality?

A

helmet

Highest morbidity and mortality occur from collision of a cycle and an automobile

60-90% reduction in head injury with use of helmet -

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20
Q

What are the risk factors that increase bike accidents?

A

Non-daylight hours
Exposure time
Riding on sidewalk
Using for play
Male gender
under 3 years old
risky bicyclist behavior

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21
Q

Why are kids less than 3 at the highest risk for bike accidents?

A

<3 years old: no cognitive ability to both pedal and steer: bicycle with training wheels under age 3 with foot brakes. No bike hand brakes until at least 6 years old

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22
Q

What are the 3 reasons to discard a bike helmet?

A

head hits hard surface

fall results in marks on shell

greater than 5 years old

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23
Q

______ is the second leading cause of accidental trauma in children next to MVC, especially under age 5

A

drowning/submersion injuries

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24
Q

______ is the leading cause of death between ages 1 - 4 - even greater than birth defects. Which gender is more likely?

A

drowning/submersion injuries

Males 6 times more likely

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25
If the kiddo is less than 4, what type of water? older than 4?
<4-year-old - bathtubs or pool (42% home pool) >4-year-old - pools or bodies of water
26
What is the immediate treatment for drowning on site?
CPR started immediately with 100% oxygen administered Protection of C-spine Breaths without Heimlich: don’t delay
27
What is the tx for a cold water drowning at the hospital?
Resuscitation with aggressive attempts made to restore temp - do not abandon until warmed to 30 degrees C / 86 degrees F (but not above 34 degrees - ischemic brain injury) NG tube, catheter - core rewarming, warm O2, lavage at 40 degrees C (104 degrees F) 100% oxygen 15 Liters non-rebreathing mask Intubation and mechanical ventilation if unable to keep oxygen above 80 on 15 L IVF (20 ml/kg) NG tube for water removal Temperature management Outcome
28
What is the tx for a warm water drowning at the hospital?
100% oxygen 15 Liters non-rebreathing mask Intubation and mechanical ventilation if unable to keep oxygen above 80 on 15 L IVF (20 ml/kg) NG tube for water removal
29
What is the temp cutoff for a cold vs warm water drowning? Which one has WORSE outcomes?
cold: <20 degrees Celsius warm: water temp >20 degrees C warm has the WORSE outcomes
30
What are some prevention strategies to avoid drowning?
swim lessons lifejackets fencing for pool "touch supervision"
31
What age does the AAP recommend swim lessons? Does the kid normally scream or splash?
AAP recommends formal swimming lessons after the 4th birthday Most children who drown in pools are found silently floating with NO screaming or splashing being noted, were last seen in their home, were missing at least 5 minutes, and in care of one or both parents at time of drowning
32
What are the 3 different types of burns?
First degree - superficial Only epidermis Second degree – partial thickness Epidermis and dermis – blisters Third degree – full thickness Destroys epidermis and dermis
33
_____ are the leading cause of injury-related death in the home. What are some younger children more likely to be burned from? older kids?
burns Scald burns - hot liquids - most common Hot water from faucet, microwave oven and toaster, cooking and pulling items off stove, oven doors Open flame
34
What type of burn. What is the tx?
first degree Cool compresses, analgesics
35
What type of burn? What is the tx?
second degree Silvadene and analgesics with sterile non-adhesive dressings
36
What type of burn? What is the tx?
third degree Referrals Immediate: IVF, monitor airway, Foley and transfer
37
according to the burn chart, what is considered a minor burn?
Minor burns are <10% of the body surface area for first/second degree burns and <2% for third degree burns
38
**Draw the burn chart for children
39
What is the tx for an electrocution?
Watch for entrance and exit wounds ECG for arrhythmias, CK for muscle injury, UA for myoglobinuria, BMP to monitor kidney function and check for rhabdomyolysis
40
What is the pt education for burns?
keep water temps less than 120 degrees sun protection: protective clothing, hats, sunscreen if over 6 months old and needs to be at greater than 15 spf outlet covers smoke detectors and fire extinguishers
41
What is the tx for a dog/cat bite? **What is the MC canine microbe? What abx?
All require high pressure, high volume irrigation with saline, scrubbing and debridement tetanus prophylaxis +/- rabies vaccine +/- closure of wound only if on the face or large wound **Pasteurella multocida Augmentin
42
**What type of sutures are preferred for bite injuries? What should you NOT use?
**Interrupted sutures with frequent wound checks **Never Dermabond!!!
43
_____ is the leading cause of non-fatal injury in children 0 - 19 years of age. What is considered a "serious" fall?
fall injuries Trauma centers generally use “fall >10 - 15 feet” as serious as most less than 10 feet not life-threatening. (or 2-3 times the patient height)
44
What are some prevention strategies for falls in kiddos?
45
What age range has the highest risk of choking? What is the tx if the kiddo is under 1? Over 1?
Children 6 months - 4 years - highest risk Under age 1 - Hard back blows Over age 1 - Abdominal thrusts / Heimlich maneuver)
46
What are the top 10 MC cause of choking?
47
What organ is the coin in?
esophagus
48
toy related injuries: Risk ages 4 and under for ______. _____ for children 14 and under
choking on toys Riding toys
49
_____ leading risk of death for toy related injuries, especially if ______ or _____ are involved. Most deaths are from ______
Non-powered scooters child falls from toy or struck by vehicle asphyxiation
50
How old should your kiddo be to ride a skateboard?
Children <5 years old should not ride skateboards
51
What age range is at the highest risk for ATV injury? What area of the spine for younger children? older children?
11 - 15 years of age most at risk Younger children: lumbar fractures Older children: thoracic fractures
52
When are ATV injuries worse?
the a child was involved in an accident and were driving an ADULT sized ATV
53
According to the AAP, how old should you be to drive an ATV? **What are the 3 pt education points?
must be 16!! Off road use only on non-paved surfaces HELMET!! do NOT ride double, no passengers
54
______ is the MC sports injury
Inversion ankle injuries
55
**_____ is the most dangerous athletic activity. What 3 additional ones?
football then rugby, hockey then soccer
56
**_____ is the MC neck injury
cervical spine
57
Children through high school age take _____ to recover from a concussion and should be managed conservatively. What makes the recover process take longer?
longer hx of previous concussion
58
**If you suspect a concussion, what are the recommendations?
Remove from play immediately and do not return to game with a suspected concussion
59
**Draw the SCAT5 recommendations chart
60
Where do the majority of poisonings take place? What age group?
at home under 5 years old and the child exposes themself to the poison
61
What is the tx for a chemical ingestion?
0.5 - 1 g/kg (max 50 g) per dose Repeated every 2-6 hours until passed through rectum
62
**What is the absolute CI for activated charcoal?
Presence of intestinal obstruction
63
What are the 5 CI for activated charcoal?
Depressed mental status Late presentation Increased risk and severity of aspiration with AC use (Hydrocarbon ingestion) need for endoscopy heavy metals (do not absorb AC) alcohols
64
Read the list for specific things to not use AC on
65
**What is the medication for an acetaminophen overdose?
N-Acetylcysteine (Acetadote) PO or IV
66
What is the chart called for when or when not to treat an tylenol overdose?
Rumack Matthew Nomogram
67
**What is the medication dosage for a Tylenol overdose? What do you need to monitor? When are liver abnormalities going to peak?
150 mg/kg loading dose over 15 - 60 minutes Second infusion 50 mg/kg over 4 hours Third infusion 100 mg/kg over 16 hours Daily AST, ALT, serum bilirubin, PT Liver abnormalities may not peak until 72 - 96 hours
68
What dose of iron will cause iron overdose symptoms? ______ is likely to occur
Dose >20 mg/kg will cause symptoms Hemorrhagic gastroenteritis 30 - 60 minutes after ingestion
69
What is the timing of an iron overdose?
Hemorrhagic gastroenteritis 30 - 60 minutes after ingestion Shock, acidosis, coagulation defects and coma lasting 4 - 6 hours Phase of improvement 2 - 12 hours Delayed shock 12 - 48 hours, liver damage and hepatic failure Metabolic acidosis, fever, leukocytosis, liver damage with hepatic failure, or coma
70
What is the tx of shock associated with iron overdose?
Gastric lavage and whole bowel irrigation;
71
What will lead poisoning present like?
Symptoms of weakness, irritability, weight loss, vomiting, ataxia, headache, colicky abdominal pain, developmental delays
72
What is a big offended for a source of lead in a kiddos life? When do you screen for lead?
Lead paint, specifically homes built before 1960 CBC and Lead in every child around 12-month WCC
73
What is considered a positive lead level? What should you do next?
Positive levels: ≥ 5 - 9 mcg/dl should be confirmed within 1 - 3 months and repeated after 3 months, then 6 - 9 months after environmental changes are initiated
74
When is chelation therapy recommended in high lead levels? What is the name of the rx?
Chelation therapy - blood lead level ≥ 45 mcg/dL Succimer - 10 mg/kg every 8 hours for 5 days; then every 12 hours for 4 days
75
How long does it take a disk-shaped battery to pass through GI tract? When should you repeat the xray?
Over 80% pass through GI tract in 48 - 72 hours Repeat x-rays if doesn’t pass within 7 days
76
When is a disk-shaped battery an emergency?
remove button battery if it is the esophagus If in esophagus more than 24 hours, greater risk for erosion
77
What are the pt education points for poison prevention
Poison Control Storage of pills and household cleaning supplies Avoid taking medications in child’s presence Never refer to pills as candy Child-proof pill bottles and locks on cabinets Recognition of risk at grandparent or relative home Lead screening
78
What is the prevention for firearm injury?
Removal from home unloaded in safe with ammunition in SEPARATE location gun locks
79
Kids and adolescents are at an increased risk for _____ when there is a gun in the home too
suicide
80

Pediatrics (24 decks)

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