Pediatric Emergencies Flashcards
Pediatric Assessment Triangle
Appearance
Work of breathing
Circulation to the skin
Begin your assessment with the ___ and move toward the ___ in children under 6.
feet, head
Respiratory rate, HR, BP, and temperature of neonate
30 to 60
90 to 160
67/35 to 84/53
98 to 100
Respiratory rate, HR, BP, and temperature of infant
30 to 53
90 to 150
72/37 to 104/56
96.8 to 99.6
Respiratory rate, HR, BP, and temperature of toddler
22 to 37
80 to 120
86/42 to 106/63
96.8 to 99.6
Respiratory rate, HR, and BP of preschool age
20 to 28
65 to 100
89/46 to 112/72
Respiratory rate, HR, and BP of school age
18 to 25
58 to 90
97/57 to 120/80
Respiratory rate, HR, and BP of adolescent
12 to 20
50 to 90
110/64 to 131/83
Even though the tidal volume in children is similar to adults, children have smaller oxygen reserves due to “
Metabolic oxygen demand is doubled
Functional residual capacity is smaller
Keep the nares clear in infants younger than ____.
6 months
Signs of vasoconstriction
Weak peripheral pulses in extremities
Delayed capillary refill
Pale, cold extremities
Pediatric differences in skin -thinner more elasticity, increased surface area, and decrease subcutaneous tissue - contributes to an increase in :
Hypothermia
Severity of burns
Injury following temperature extremes
TICLS
Tone Interactiveness Consolability Look or gaze Speech or cry
What does the appearance aspect of PAT reflects?
Adequacy of ventilation Oxygenation Brain perfusion Body homeostasis CNS function
Signs of work of breathing
Tachypnea Abnormal airway noises Retractions of intercostal muscles or sternum Abnormal posturing Head bobbing Nasal flaring
Three characteristics when assessing circulation :
Pallor
Mottling
Cyanosis
What is mottling caused by?
Constriction of peripheral blood vessels
What are the components of assessing breathing?
RR
Auscultate breath sounds
Pule ox
What are the components of assessing circulation?
Control active bleeding HR and quality Skin Capillary refill BP
In infants, palpate the _____ pulse or _____ pulse.
Brachial
Femoral
In children older than 1 year, palpate the _____ pulse.
Carotid
Weak or absent peripheral pulses are indications of?
Decreased perfusion
Weak central pulses indicate?
Significant hypotension
Decompensated shock
Absence of central pulse indicates?
Immediate need for CPR
Indications of rapid transport
Significant MOI Hx compatible w/ serious illness Physical abnormality Potentially serious anatomic abnormality Significant pain AMS s/s shock
When should a pediatric patient be placed in a cart seat during transport?
Weighing less than 40 lbs and do not require spinal immobilization
Capillary refill should be noted in children younger than ___ years.
6
To obtain an accurate reading of a pediatric patient’s BP, use a cuff that covers _____ of the upper arm.
two-thirds
Formula for calculating BP in children aged 1 to 10.
(Age [in years] x 2) / 70
Albuterol dosage
<20 kg : 1.25 mg
>20 kg : 2.5 mg
Over 20 minutes. May repeat once within 20 minutes.
D25
> 1 y/o : 0/5-1 g/kg via slow IV/IO push.
Repeat as necessary.
Neonates and infants : 200 - 500 mg/kg slow IV push. Repeated as necessary. Mx concentration of 12.5%
Dextrose 10%
2.5 - 5.9 mL/kg
Administrated w/ infusion.
Epinephrine
Anaphylaxis and asthma : 0.01 mg/kg of 1 mg/mL solution SQ/IM.
Max dose of 0.3 mg.
Can repeat every 5 minutes.
Glucagon
<20 kg or 5 y/o : 0.5 mg IM/IN
>20 kg : 1 mg IM/IN
Narcan
< 20 kg or 5 y/o : 0.1 mg/kg IV/IO/IM
>20 kg or 5 y/o : 2.0 mg
Repeat every 2 minutes PRN.
Max dose of 2 mg.
Activated charcoal
0.5-1 g/kg PO
Signs of respiratory distress
Pallor or mottled color Irritability, anxiety, restlessness Increased respiratory rate Retractions Abdominal breathing Nasal flaring Inspiratory stridor Grunting Mild tachycardia
Signs of impending respiratory failure
AMS Central cyanosis, pallor Tachypnea to bradypnea to apnea Severe retractions Accessory muscle use Nasal flaring Grunting Paradoxical Abdominal motion Tripod position Tachycardia to bradycardia
3 causes of airqay obstruction in children
Foreign object
Infections
Disease
When should you consider an infection as a possible cause of airway obstruction?
Patient has congestion, fever, drooling, and cold sxs.
Signs of severe airway obstruction
Ineffective cough Inability to speak or cry Increasing respiratory difficulty w/ stridor Cyanosis LOC
If an infant is conscious with a complete airway obstruction, perform:
5 back blows followed by 5 chest thrusts
If a child older than 1 year is conscious with a complete airway obstruction, perform :
Abdominal thrusts
