Pediatric Emergencies Flashcards

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1
Q

Birth to 2 months

A

Controls gaze

Turns head

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2
Q

2-6 months

A

Eye contact
Uses both hands
Rolls over
Sleep through night

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3
Q

6-12 months

A

Sits without support
Crawls
Puts things in mouth
Teething begins

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4
Q

Toddler

A

1 to 3 years

Use parent to do things to child

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5
Q

Toddler Development

A
-Crawls/walks
Sensory developments
-Runs climbs
Balance
-Fine motor Skills
Toiler training
Draw a circle
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6
Q

Preschool Age

A

3 to 5 years
Can understand directions
4 years old develops 20/20 vision and has normal running or walking

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7
Q

School Age

A

6-12 years

Can communicate well

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8
Q

Adolescence

A

13-17 years

Issues of independence and sexuality

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9
Q

Neck and Airway

A
Short necks
Airway smaller
Epiglottis is LONG and floppy
Keep nares clear <6 months old
Neck very soft and collapsible, don't hyperextended neck
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10
Q

Narrowest portion of child’s airways is____

A

Occurs at cricoid cartilage rather than vocal cords in adults

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11
Q

Respiratory System

A

Metabolic oxygen demand of child is doubled to adult

Children inhale toxins faster than adults and become symptomatic sooner

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12
Q

Ventilating

A

Only enough air to see rise of the chest

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13
Q

Pediatric Resp Rates

A
Neonate-1month: 30-60
Infant: 25-50
Toddler: 20-30
Preschool: 20-25
School: 15-20
Adolescent: 12-20
Adult: 12-20
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14
Q

Pediatric Pulse Rates

A
Neonate-1month: 100-180
Infant: 100-160
Toddler: 90-150
Preschool: 80-140
School: 70-120
Adolescent: 60-100
Adult: 60-100
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15
Q

Cardiovascular System

A

Pulse can be 200 or more for compensation

Peds rely on heart rate for cardiac output rather than vasoconstriction

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16
Q

Blood Volume in Ped

A

Appx. 70ml/kg

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17
Q

Hypovolemia in Ped

A

May lose a lot of blood before hypotension show

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18
Q

Delayed Capillary Refill

A

Shunting of the vessels causing peripheral vasoconstriction

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19
Q

Nervous System

A

Brain and spinal cord not very well protected
Less subarachnoid space causing less cushion for the brain
Easier to damage head and spine

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20
Q

Suspect Shock in Ped

A

Tachycardia

Brady for hypoxia

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21
Q

Spinal column

A

Fulcrum of spine is closer to C1-C2 because head is heavier

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22
Q

Abdomen and Pelvis

A

Head 1st cause of injury, abdominal injuries second

Not as much protection with ribs and abdominal organs

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23
Q

Musculoskeletal

A

Fractures are easier due to lack of ossification centers

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24
Q

Chest and Lungs

A

Very thin chest wall
Ribs are more pliable and flexible
Easier to hear heart and lung sounds

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25
Q

Skin

A

Thinner more elastic skin
More BSA ratio
Temperature isn’t regulated as well
Increased risk of hypothermia and severe burns

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26
Q

Metabolic

A

Not much glycogen stores in liver of pediatrics

Cover head to manage heat loss

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27
Q

Pediatric Assessment Triangle

A

Work of breathing
Circulation of skin
Appearance

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28
Q

TICLS

A

Most important feature of child’s appearance
Tone: muscle tone, ridged or limp?
Interact: alert? How easily distracted? Grasp or reach?
Consolability: can be calmed by caregiver?
Look: fixed gaze or glass stare
Speech: strong cry? Age appropriate speech

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29
Q

Work of Breathing

A

Abnormal Airway Sounds: snoring, hoarse speech, strider, wheezing or grunting
Abnormal Positioning: sniffing positions, tripod, refusing to lie down
Retractions: superclavicular, intercostal, substernal retractions, head bobbing
Flaring: flaring of nares on inspiration

30
Q

Grunting

A

Indicative of partially closed epiglottis and moderate to severe hypoxia
Seen with pnuemonia

31
Q

Mottling

A

Reflects vasomotor instability in capillary beds seen by patchy areas of vasoconstriction and vasodilation

32
Q

Acrocyanosis

A

Blue hands or feet in younger than two months

33
Q

Pallor

A

Whit or pale skin of mucous membranes

34
Q

Length Tape

A

Measures up to 75lbs or 34kg

35
Q

Blood Pressure

A
80+age(2)
Minimal:
Infant- >70
Toddler- >80
Preschool and School- >80
36
Q

Respiratory Emergencies

A

90% cause of cardiac arrest in Peds

37
Q

Foreign Body Airways in Infant

A

Responsive: deliver 5 back blows and five chest thrusts
Unresponsive: look in mouth, start CPR start with 30 or 15:2 if another person available

38
Q

Foreign Body in Children

A

Responsive: abdominal thrusts
Unresponsive: start CPR 30:2 unless another person available then do 15:2.
THEN open airway and look in the mouth. Continue CPR and then laryngoscope

39
Q

Anaphylaxis

A

Respiratory Distress and End Organ failure qualifies as Anaphylaxis
Epinephrine !
.01mg/kg IM 1:1

40
Q

Croup

A
Seal bark cough
Viral infection of upper airway
Treat with racemic Epi
.5ml in 3ml
Racemic- localized
Epi- systemic
41
Q

Epiglottitis

A

Do not work patient up.
Stay calm and keep calm
Don’t look in mouth

42
Q

Asthma

A
Bronchospasm
Mucus production
Inflammation
Albuterol 2.5mg in 3ml
Atrovent <22lbs= 250mcg >22lbs= 500mcg
Corticosteroids
Fluid!
43
Q

Bronchitis

A

Racemic Epi or Albuterol

44
Q

Cystic Fibrosis

A

Fluid lungs and GI tract

45
Q

Bronchopulmonary Dysplasia

A

Spectrum of lung conditions found in premature neonates who required long periods of high oxygen and ventilators support.
May have home ventilators and oxygen
May consider Atrovent

46
Q

Airway Management

A

Use shoulder Roll for head tilt chin lift

47
Q

Long Term ventilation

A

Intubate!

48
Q

OPA

A

Same as adult

49
Q

Bag Mask

A

Capnography saturation

12-20 breaths/min

50
Q

Oxygenation

A

Blow by technique for minimal oxygen needed

51
Q

Intubation

A

Size: age+16 / 4 = size of tube
1month-adolescent = straight blade
Adolescent to adult = straight or curved
2-3cm beyond vocal cords

52
Q

Oro or Nasogastric Insertion

A

Need 30-60ml syringe
Twice the size of ET tube 5mm et is 10FR
Continuous stomach suction at 20-40mmHg

53
Q

Congenital Heart Disease

A

Common heart defects

54
Q

Cyanosis Disease

A
More serious
HLHS hypoplastic Left heart syndrome ( does not distribute oxygen in heart ) - almost no left ventricle at all which mixes oxygenated and deoxygenated blood
DO NOT FLOOD WITH OXYGEN
76-82% oxygen
Tetralogy of Fallot
55
Q

Noncyanotic Disease

A

Atrial Septal Defects

Ventricular Septal Defects

56
Q

Congestive Heart Failure

A

Heart can no longer meet metabolic demands of the body

57
Q

Myocarditis

A

Inflammation of heart muscle
Can lead to heart failure
Symptoms- dyspnea, exercise intolerance, syncope, or murmur

58
Q

Cardiomyopathy

A

DCM- Dialate Cardiomyopathy: heart becomes weakened and enlarged making it less efficient in pumping
HCM- Hypertrophic Cardiomyopathy: thickened heart so heart has to pump harder

59
Q

Seizures

A

Same as adult but most common is a febrile seizure

60
Q

Febrile seizure

A

Occur in 25% of peds

Simple Febrile Seizures: brief generalized seizures, lasting less than 15 minutes

61
Q

Complex Febrile Seizure

A
Longer, lasting more than 15 minutes
FIX the FEVER !!!!!! Tylenol
Acetaminophen is 15mg/kg
Tylenol is 10mg/kg
Fluids! 
BGL!
62
Q

Meningitis

A

Gown up! Very deadly and contagious
Unchallenged Ridgidity
Purpuric and Patecial coloration of the skins. Patecial is small dots
Symptoms- fever,

63
Q

Biliary Atresia

A

Build up of bilirubin

64
Q

Inussusception

A

6months-6years

Telescoping of intestine, small, into itself

65
Q

Meckel Diverticulum

A

Malformation of small intestine

66
Q

Pyloric Stenosis

A

Pylorics become hypertrophied and present with projectile vomiting

67
Q

Hyperglycemia

A

Fluids and insulin

68
Q

CAH Congenital Adrenal Hyperplasia

A

Not enough cortisol

69
Q

Panhypopituitarism

A

Inadequate production of pituitary hormones

70
Q

Toxicological Emergencies

A

Call Posion control

1800-222-1222

71
Q

Antidotes

A
Carbon Monoxide: oxygen
Organophosphate: atropine
Tricyclics AntiDepressants: Bicarbonate
Opiates: Naloxone
Beta Blockers: Glucagon
Ca channel blockers: calcium
Benzodiazepines: Romazicon