Pediatric Injuries and Emergencies

Question 1

what age range has the highest rates of accidental injury?

Answer 1

infants 1-2 years old.

Question 2

What is the most common cause of death younger than a year

Answer 2

suffocation

Question 3

what is the most common cause of death in pre-schoolers and school-aged kids?

Answer 3

MVAs

Question 4

Posoining under 5 and poisoning in teens:

Answer 4

under 5 is accidental

teens do it mostly intentionally

Question 5

What are the most common agents ingested by young kids?

Answer 5

cosmetics, hair products, cleaning solutions, analgesics

Question 6

What three meds lead to hospitalizations?

Answer 6

tyleonol, lead antidepressants

Question 7

What poisons cause death?

Answer 7

carbon monoxide, hydrocarbons, illicit drugs, caustic ingestions.

Question 8

What are the five routes for accidental poisonings?

Answer 8

1. ingestion
2. dermal
3. ophthalmic
4. inhalation
5. envenomation

Question 9

what odors match what substances?

Answer 9

bitter almond = cyanide
garlic = arsenic
sweet= chloroform, acetone, ether
violet - turpentine

Question 10

Why is alkaline ingestion so bad?

Answer 10

because it is tasteless so kids continue to drink. It liquefies mucosal surfaces, heals with strictures, increases risk of esophageal carcinoma.

Question 11

Is acidic ingestion worse or alkaline?

Answer 11

alkaline. acidic is sour tasting so kids stop drinking.

Question 12

Metabolic acidosis is caused by agents such as:

Answer 12

methanol or ethylene glycol

Question 13

If a kid ingests triclyclic antidpressatns, what can you look for on the EKG?

Answer 13

wide QRS complex.

Question 14

What are several ways to do GI decontamination?

Answer 14

1. activated charcoal is treatment of choice
2. emesis may occur spontaneously : induced emesis is NO LONGER RECOMMENDED!
3. Gastric lavage

Question 15

What should tap water be kept under (temperature wise)

Answer 15

130F or 54.4 C

Question 16

What burn appearance should rasise suspicion of child abuse?

Answer 16

stocking and glove

Question 17

What is the most frequent pathogen associated with burn infection?

Answer 17

pseudomonas aeruginosa…they most often come from own flora. others come from gram negative

Question 18

What burns are ALWAYS an emergency?

Answer 18

burns to the eyes

Question 19

Who does the rule of nines apply to?

Answer 19

> 15 years old
9% = head, each up extremity
18% = each side of torso, each lower extremity
1% = genitalia.

Question 20

How is TBSA calculated in infants?

Answer 20

1% = hand and fingers

Question 21

What is SIDS?

Answer 21

Sudden death of an infant <1 year that remains unexplained after complete postmortem exam. Leading cause of death in infants 1 mo to 1 year.

Question 22

Risk factors for IDS?

Answer 22

Low SES
Non-white
Mother who smokes
preterm or SGA
siblings of prior SIDS victims
Infants recovering from mild URIs
Sleep position

Question 23

What are the theories for SIDS?

Answer 23

Apnea: central apnea; obstructional apnea or combo of both.

obstruction, hypoxia, etc

Question 24

What is near drowning?

Answer 24

survival for at least 24 hours after asphyxia because of submersion. Problem = neurologic sequalae.

Question 25

What are the pros and cons of cold water submersion?

Answer 25

cons= cold heart is more likely to have arrhythias, tissue 02 is impaired by cold

pros= protective effect by reducing brain metabolism and 02 consumption.

surivial rates are better in cold water than in warm.

Question 26

What are some unfavorable factors for near drowning?

Answer 26

> 3 or more…

over 3 years old
submersion for 5 minutes
greater than 10 min delay is resuscitation
coma on admit to ER
pH less than 7.10

Question 27

What will the PE show you for near drowning?

Answer 27

PE

1. dialted pupils
2. increased muscle tone
3. bradycardia
4. slow, shallow respirations
5. CNS depression
6. if large amounts of water swallowed— then electrolyte abnormalities. (dilution hypnatremia/hypokalemia).