Pediatric EM

Question 1

bag at the appropriate rate if too fast what are 4 main risks…

Answer 1

Risk of gastric air, regurgitation, aspiration,

barotrauma aka pneumothorax

impair venous return due to high intrathoracic pressure

= low CO, cerebral and coronary perfusion

Question 2

what is considered an ominous sign when assessing breathing?

Answer 2

grunting

Question 3

what are 2 unique factors of pediatric arrest?

Answer 3

rarely a sudden event, and rarely just a cardiac event

Question 4

what are 3 main causes of pediatric respiratory failure?

Answer 4

intrinsic lung disease, airway is obstructed, inadequate effort

Question 5

T/F for respiratory failure monitoring cant always ___

Answer 5

rely on blood gases

its a clinical diagnosis

Question 6

def respiratory failure

Answer 6

inadequate oxygenation/ ventilation

Question 7

how to assess peds circulation

Answer 7

HR, BP 
Central pulse 
Distal pulses 
Skin mottled? 
cap refill?

Question 8

central pulse to check for infants is ___ artery

Answer 8

brachial

Question 9

central pulse to check for older kids is ___artery

Answer 9

femoral

Question 10

Peds mean systolic BP equation is

Answer 10

90 mmHg + (age in yrs times 2)

Question 11

what is unique about PEds BP?

Answer 11

they can maintain a normal bp until they lose over 30% of CO volume

Question 12

lower limit of normal SBP in kids

Answer 12

70mmHg + (2 times age in years)

Question 13

asthma attack I would expect a ___ stridor

Answer 13

expiratory tx: racemic albuterol

Question 14

viral illness with swollen vocal cords

Answer 14

racemic mixture of epinephrine

Question 15

what fluids to give if peds goes into shock..

Answer 15

20ml/kg boluses until tachycardia goes away and you see improved perfusion

Question 16

what if peds has shock due to hemorrhage?

Answer 16

after 2 boluses (of 20ml/kg) give PRBC 10 ml/kg

Question 17

PRBC stands for..

Answer 17

packed red blood cells

Question 18

for quick diability exam ask what 4 questions

Answer 18

1. how is patient mentating?
2. pupils?
3. are they moving all 4 extremities
4. symmetric strength and sensation

Question 19

AMPLE stands for…

Answer 19

allergies, medications, past medical history (pregnancy), last meal, events surrounding visiti

Question 20

___ is the most common cause of death and disability in childhood

Answer 20

injury

Question 21

___ is most common cause of death in children

Answer 21

MVC

Question 22

what should you expect with a peds trauma pt

Answer 22

multisystem injury due to ..
smaller body mass
less fat and CT
organs closer together

Question 23

3 main head anatomical differences in kids

Answer 23

large head relative to body, less myelin, soft cranium

Question 24

if there is evidence if increased ICP with herniation what 3 steps should you do?

Answer 24

elevate head 30 degrees
hypertonic saline (3%) 5ml/kg
mannitol 0.5-1mg/kg

Question 25

what are sunset eyes

Answer 25

when eyes stuck looking down - sign of increased ICP

Question 26

___injury is a marker for other injuries

Answer 26

chest injury

higher risk for pneumothorax

Question 27

why are kids with abdominal trauma at a higher risk for liver and spleen injury?

Answer 27

theirs is lower - less protected by rib cage

Question 28

____sign warrants an abdominal CT on a kid

Answer 28

seatbelt sign

Question 29

when do pediatric fontanels close?

Answer 29

not until 12-18 months

Question 30

SCIWORA stands for..

Answer 30

spinal cord injury without radiologic evidence

Question 31

childs normal blood volume is about

Answer 31

70 ml per kg

Question 32

peds trauma pts at high risk for…

Answer 32

trauma

Question 33

if peds pt is sick think of the big 5…

Answer 33

oxygen / ventilation 
pulse ox 
cardiorespiratory monitor 
IV access 
CXR/ EKG