Pediatric Emergency Medicine Flashcards
When evaluating a patient, what is the first question you should ask yourself every time?
How does the patient look–sick or not sick?
In well-appearing pediatric patients, where should you consider examining the child? What part(s) of the exam should you do first? Last?
In parent’s lap
Least invasive first
Ears and throat last
What are the 5 key interventions in a sick child?
O2 Pulse Ox Cardiorespiratory monitor IV access CXR/EKG
In a sick child, what should you treat first regardless of complaint/diagnosis?
Treat the greatest threat to life every time, usually airway!
Remember the primary survey? What does it consist of?
ABCDE
If a child is posturing and leaning forward, what could this indicate?
Issues with the airway (epiglottitis!)
What is the quickest and easiest way to assess a patient’s airway?
Ask them their name
What are characteristics of a pediatric airway that make it unique? Size, location, length, shape; what does this mean for the child?
Smaller (more prone to obstruction) More anterior and cephalad (higher up) in location Shorter (more prone to right main stem intubation) Funnel shaped (narrowest at sub glottis in kids < 8 yrs)
To help align the airway in an infant, how might one position the patient’s head?
Towel roll under the shoulders
To help align the airway in an older child, how might one position the patient’s head?
Towel roll under neck, in conjunction with jaw thrust
To ensure proper bag mask ventilation, you should observe what movement in the patient?
Chest rise with each breath
Do you need to remove the c collar to ventilate?
yes, a second provider will provide stabilization of the c spine during ventilation/intubation
If you do not not BMV at an appropriate rate, what does this increase the risk of?
Gastric air, regurgitation, and aspiration
May also result in barotrauma (PTX)
If you BMV at a rate that is too fast, this may increase intrathoracic pressure and impair venous return, which will in turn decreases what three things?
Cardiac output, cerebral blood flow, and coronary perfusion
What can grunting be indicative of?
Auto PEEP (positive end expiratory pressure) where too much air over inflates alveoli causing progressive air trapping
What can you administer to a patient with croup to reduce swelling of the airway around the vocal cords ?
Racemic Epinephrine (Neb)
T/F Pediatric arrest is rarely a sudden event
T
What are the two most common causes of pediatric arrest?
Respiratory failure and Shock
How often is pediatric arrest a primary cardiac event?
Rarely
