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Nelson - Emergencies > Pedia Emergencies and Resuscitation > Flashcards

Pedia Emergencies and Resuscitation Flashcards

1
Q

2nd leading cause of accidental death in children <5

A

Drowning

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2
Q

3rd major cause of death in adolescents

A

Drowning

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3
Q

Associated with survival rates as high as 70% with good neurologic outcome

A

Rapid, effective bystander CPR for children

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4
Q

Upon arrival at the scene of a compromised child, a caregiver’s first task is

A

A quick survey of the scene itself

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5
Q

Any child with these conditions requires immediate CPR

A

1) Without a pulse 2) HR <60

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6
Q

Normal HR is roughly ___x normal RR for age

A

2-3x

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7
Q

Lower limit of SBP in neonates should be

A

<60

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8
Q

Lower limit of SBP in infants should be

A

<70

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9
Q

Lower limit of SBP in 1-10 yr olds should be

A

< Age x 2 + 70

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10
Q

Lower limit of SBP in any child older than 10 y/o should be

A

<90

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11
Q

MC precipitating event for cardiac instability in infants and children

A

Respiratory insufficiency

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12
Q

First priority in resuscitation of a child

A

Rapid assessment of respiratory failure and immediate restoration of adequate ventilation

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13
Q

Earliest and most reliable sign of shock

A

Tachycardia

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14
Q

In the setting of a pediatric emergency, ___ refers to a child’s neurologic function in terms of the level of consciousness and cortical function

A

Disability

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15
Q

A GCS score of ___ requires aggressive management

A

≤8

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16
Q

Components of a secondary assessment in pediatric emergencies

A

Focused history and PE using SAMPLE

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17
Q

Children of this age group are particularly susceptible to foreign body aspiration and choking

A

<5

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18
Q

MCC of choking in infants

A

Liquids

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19
Q

MCC of choking in toddlers and older children

A

Small objects and food

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20
Q

Management of airway obstruction in an infant

A

5 back blows and 5 chest thrusts

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21
Q

Management of airway obstruction in a child >1 y/o

A

5 abdominal thrusts (Heimlich maneuver) with the child sitting or standing

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22
Q

Upper airway narrowing is most often caused by

A

Airway edema

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23
Q

Lower airway narrowing is most commonly caused by

A

Bronchiolitis and acute asthma exacerbations

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24
Q

As effective as ET intubation and safer when provider is inexperienced with intubation

A

Bag-valve-mask ventilation

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25
Q

A child requires intubation when at least 1 of these conditions exist

A

1) Unable to maintain airway patency or protect the airway against aspiration 2) Failing to maintain adequate oxygenation 3) Failing to control CO2 levels and maintain safe acid-base balance 4) Sedation and/or paralysis is required 5) Care providers anticipate a deteriorating course that will eventually lead to the first 4 conditions

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26
Q

Most important phase of intubation procedure

A

Preprocedure preparation

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27
Q

Goals of rapid sequence intubation (RSI)

A

1) Induce anesthesia and paralysis 2) Complete intubation quickly minimizing elevations of ICP and BP

28
Q

T/F Chest radiography is necessary to confirm appropriate tube position

A

T

29
Q

Shock occurs when

A

O2 and nutrient delivery to tissues is inadequate to meet metabolic demands

30
Q

MC type of shock among children worldwide

A

Hypovolemic shock

31
Q

MCC of distributive shock

A

Sepsis and burns

32
Q

Type of shock associated with closure of ductus arteriosus in a child with ductus-dependent systemic blood flow

A

Obstructive shock

33
Q

Type of shock associated with massive pulmonary embolism

A

Obstructive shock

34
Q

Type of shock associated with tension pneumothorax

A

Obstructive shock

35
Q

Type of shock associated with pericardial tamponade

A

Obstructive shock

36
Q

MC pre-arrest rhythms in young children

A

Bradyarrhythmias

37
Q

HR that is an indication to begin chest compression

A

<60bpm

38
Q

Factors known to cause bradycardia

A

6 Hs and 4 Ts: Hypoxia, hypovolemia, hydrogen ions, hypo- or hyperkalemia, hypoglycemia, hypothermia, toxins, tamponade, tension pneumothorax, trauma

39
Q

Narrow QRS complex is objectively how many sec

A

≤0.08 sec

40
Q

Wide QRS complex is objectively how many sec

A

> 0.08 sec

41
Q

Narrow complex tachycardia may either be

A

Sinus tachycardia and SVT

42
Q

Sinus tachycardia vs SVT: History and onset are consistent with a known cause of tachycardia

A

Sinus tachycardia

43
Q

Sinus tachycardia vs SVT: Onset is often abrupt without a prodrome

A

SVT

44
Q

Sinus tachycardia vs SVT: P waves are consistently present, of normal morphology, and occur at a rate that varies somewhat

A

Sinus tachycardia

45
Q

Sinus tachycardia vs SVT: P waves are absent or polymorphic, and when present is often fairly steady at or above 220/min

A

SVT

46
Q

Management for SVT

A

Adenosine rapid push and flush; if without line or adenosine failed, do synchronized cardioversion using 0.5-1 J/kg

47
Q

Management for wide complex tachycardia

A

Immediate cardioversion: 1J/kg then 2J/kg if 1J/kg is ineffective

48
Q

Most important treatment of cardiac arrest

A

Anticipation and prevention

49
Q

Unwitnessed pediatric cardiac arrest in an outpatient setting should be treated as ___ in nature

A

Asphyxial

50
Q

Witnessed pediatric cardiac arrest in an outpatient setting should be treated as

A

Primary arrythmia

51
Q

Management for asphyxial cardiac arrest

A

Initiate CPR immediately

52
Q

Management for cardiac arrest from an arrythmia

A

Activate EMS immediately and obtain AED

53
Q

When a LONE rescuer provides CPR, the universal ratio of ___ is used

A

30 compressions: 2 ventilations

54
Q

When a second care provider arrives at the scene, ratio of ___ is used in children ≤8 years old

A

15:2

55
Q

Emergency defibrillation is indicated for

A

Vfib or pulses Vtach

56
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Inamrinone

A

Inodilator

57
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Dobu

A

Inodilator

58
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Dopa

A

Inotrope, chronotrope, renal and splanchnic vasodilator

59
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Epi

A

Intrope, chronotrope, vasodilator at low doses, vasopressor at high doses

60
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Mil

A

Inodilator

61
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Norepi

A

Inotrope, vasopressor

62
Q

Meds to maintain cardiac output and for post-resuscitation stabilization: Na nitrprusside

A

Vasodilator

63
Q

Often the largest and easiest vein to access for cannulation in the upper extremities

A

Median antecubital vein

64
Q

T/F IO is recommended for patients for whom IV access proves difficult or unattainable, even in older children

A

T

65
Q

If venous access is not attainable within ___ with CP arrest, an IO needle should be placed in the anterior tibia

A

1 min

66
Q

T/F Any and all medications and fluids may be administered via IO

A

T

67
Q

Most common cannulated artery

A

Radial artery

Nelson - Emergencies (6 decks)

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