Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics 2 > pediatric ER > Flashcards

pediatric ER Flashcards

1
Q

in a child with suspected acute abdomen, what are some clues to help you characterize what is going on?

A
  1. pain pattern
  2. localization
  3. colour of emesis
  4. appearance of stool
  5. physical exam

can divide causes into common vs life threatening vs anatomical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what causes for acute abdomen may interest a surgeon?

A
  1. acute appendicitis
  2. intussusception
  3. bowel obstruction
  4. volvulus
  5. malrotation
  6. hernia, incarcerated
  7. perforation
  8. trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what causes for acute abdomen would be unlikely to interest a surgeon?

A
  1. esopagus
  2. stomach
  3. liver
  4. gall bladder
  5. ducts
  6. pancreas
  7. small bowel
  8. large bowel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes for acute abdomen would definitely not interest the surgeon?

A
  1. DKA/sugar abnormalities
  2. electrolytes
  3. pneumonia
  4. UTI/pyelo and other kidney disease
  5. GU problems
  6. inflammatory–HSP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do you manage acute abdomen generally?

A
  1. stabilize (ABCs)
  2. NPO!!
  3. IV access and fluids
  4. appropriate investigations
  5. manage/call for help (surgery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a helpful mnemonic for remembering the important parts of an ER paeds history?

A

SAMPLE

symptoms
allergy
meds
past medical history
last meal
events
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the goal systolic BP in kids? (lower limit of acceptable normal)

A

higher than:

(2 x age in years) + 70

low BP is a worrisome finding

characterize cold vs. warm shock if BP is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the four classes of causes of shock

A

hypovolemic
cardiogenic
obstructive
distributive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

example of hypovolemic shock

A

severe gastroenteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

example of cardiogenic shock

A

CHD, hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

example of obstructive shock

A

inflow into heart or outflow from heart obstruction (RV or LV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

example of distributive shock

A

sepsis or anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do you manage shock in kids?

A

fluid management

  1. IV or IO access x 2
  2. normal saline 20mL/kg
  3. reassess and repeat
  4. consider inotropes, blood
  5. consider corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the priorities in the ER for managing meningococcemia?

A
  1. early recognition
  2. stabilize ABCs
  3. IV fluids
  4. antibiotics
  5. avoid delays
  6. transport to tertiary hospital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the priorities for the admitted child for meningococcemia management

A
  1. abx
  2. adequate BP
  3. adequate ventilation
  4. transfusions
  5. find/correct derangements
  6. treat contacts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what should you ask on hx in the ER for a child presenting with a burn?

A
  1. demographics
  2. SAMPLE hx
  3. mechanism of injury
  4. extent/severity of wound
  5. concerns–> non accidental?
17
Q

how do you assess severity of burns?

A
  1. depth of injury
  2. total body surface area
  3. type of injury
  4. risk factors
18
Q

how deep are first degree burns? what is the extent of the injury?

A

superficial

epidermis is injured but the dermis is intact

19
Q

how deep are second degree burns? what is the extent of the injury?

A

partial

dermis is partially injured but the skin is still viable

20
Q

how deep are third degree burns? what is the extent of the injury?

A

full

dermis is completely injured and the skin is not viable

21
Q

how do you estimate total body surface area?

A

Lund and Browder chart

rule of 9s…
front and backs of legs–9% of TBSA each
upper back 9%
lower back 9%
abdomen 9%
one arm is 9% (front is 4.5 and back is 4.5)
head is 9% (face is 4.5, back of head is 4.5)
palms are each 1% and genitalia is 1%

22
Q

how do you manage burn patients overall initially?

A
  1. ABCDE
  2. stabilize and review ABCs
  3. burn assessment (depth and TBSA)
  4. contact the burn centre if moderate to severe
23
Q

how do you manage the burn itself initially?

A
  1. analgesia
  2. debridement
  3. burn dressing
  4. if mild (less than 5%)–treat as outpatient
  5. if moderate to severe (more than 5%) or other risks, admit to hospital
24
Q

potential complications from burns?

A

pain

pruritis

infection

SIRS picture

dehydration/volume loss

scarring

psychological trauma

25
Q

what is the parkland formula?

A

fluid resuscitation beyond maintenance for burn victims

volume of ringers lactate equal to 4mL x %BSA x weight (kg)

give half in the first 8 hours

half in the next 16 hours

Pediatrics 2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions