Pediatric Injury Prevention

Question 1

skull expands until age?

Answer 1

2 years of age

Question 2

why more injury to c1-c2 level in infants

Answer 2

less muscle strength, more neck mobility

Question 3

Child restraint laws in Ohio

Answer 3

• Includes day-care or pre-school vehicle
• Excludes taxi, bus, , public safety vehicles, emergency vehicles
• Drivers who operate a vehicle with an unrestrained or improperly restrained child under age 16 can be fined and possible jail time

-Child Restraint: Children who are in either or both categories:

less than 4 years of age

less than 40 pounds
Booster Seat
Children less than 8 years of age, unless they have reached 4′ 9′′ in height
Seat Belt
Children who are 8 - 15 years of age (or younger children who are at least 4′ 9′′ tall)

Question 4

Rear facing restraint?

Answer 4

from birth to 1 year and 20 lbs

Question 5

Toddlers should be restrained ?

Answer 5

upright and forward facing until 40-65 lbs (depending on model)

Question 6

Booster seat

Answer 6

with lap and shoulder belt is needed for child weighing more than 40 lb

Question 7

Children under age ? greatest risk for foreign body ingestion

Answer 7

under the age of 4

Question 8

Prevention of choking

Answer 8

• Avoid hard food: hard candy, nuts, popcorn, raw fruits and vegetables, seeds
• Avoid soft foods: hot dogs, grapes, cheese cubes, caramel, chewing gum
• Supervise child when eating
• Do not give children food in car
• Never let children run or play with lollipops in mouth
• Check floors, rugs for hazards
• Keep latex balloons out of reach
• Keep small objects away from reach

Question 9

The fifth leading cause of death in children younger than 5 years

Answer 9

Poisins

Question 10

Overdose in infants are often the result of ?

Answer 10

therapeutic overdosing

Question 11

Cleaning substances, analgesics, topical agents, cough and cold preparations

*greatest risk for children under?

Answer 11

children under the age of 6

Question 12

Poisining in adolescents

Answer 12

Adolescents drug experimentation and suicide attempts

Question 13

Prent teaching for child poisining

Answer 13

• Post the universal phone number for poison control center near the telephone
• 1-800-222-1222
• Call 911 in the case of convulsions, cessation of breathing or unconsciousness
• Do not make your child vomit
• Ask parent to bring in container or sample of substance swallowed and/or emesis

Question 14

Goals of poisin treatment: SIRES

Question 15

initial intervention for management of poisining?

Answer 15

• Terminate Exposure!
• Empty mouth of pills, plants
• Flush eyes or skin
• Remove contaminated clothes

Question 16

Gastric decontamination to eliminate poisin and prevent absorption?

Answer 16

• Syrup of Ipecac: no longer used in the home setting. Can be used in the healthcare system
• Gastric Lavage
• Activated Charcoal

Question 17

• Induces emesis
• Contraindicated in some poisons
• Electrolyte disturbances
• No longer recommended to have at home

Answer 17

Syrup of ipecac

Question 18

• Used in 1st 1-2 hours
• 50 - 100 ml of saline flushed into NG tube, aspirated until clear
• Save first specimen for toxicology analysis

Answer 18

gastric lavage

Question 19

• Odorless, tasteless, fine, black powder
• Used if poisoning is > 2 hrs
• Absorbs many compounds
• “slurry” (black mud)

Answer 19

Activated charcoal

Question 20

Signs & Symptoms

• Anorexia, nausea, vomiting
• Liver tenderness
• Liver toxicity: usually occurs after 24 hr
• Assess liver function: Elevated AST, ALT

Answer 20

acetaminophen poisining

Question 21

management of acetaminophen poisining

Answer 21

• Gastric Lavage if within the 1st hr of ingestion
• Then Activated charcoal
• Mucomyst is antidote

Question 22

In all types of poisining, when child is stable?

Answer 22

• assess for contributing factors
• institute anticipatory
• education

Question 23

• paint chips from window sill, crib, furniture
• lead dust from home remodeling
• folk remedies
• ceramics (unglazed pottery)
• cigarette butts and ashes
• lead in soil and water from old lead pipes

Answer 23

lead poisining

Question 24

clinical manifestations of lead poisining

Answer 24

• Often, no symptoms
• Irritability
• Headaches
• Fatigue
• Abdominal pain
• Cognitive and motor delays

*Screening is essential

Question 25

Complications of lead poisining as well as difference between low lead and high lead poisining?

Answer 25

• Anemia
• Kidney damage
• Neurologic changes
• Low lead level: hyperactivity, hearing impairment, distractibility, mild intellectual deficits
• _High lead leve_l: cognitive impairment, paralysis, blindness, seizures, coma, death

Question 26

elevated blood level of lead?

Answer 26

5 micrograms per deciliter

Question 27

Chelation Therapy

Answer 27

> or = 45 micrograms per deciliter

Removes lead from soft tissue and bones

Question 28

PO chelation for moderate to high levels

Answer 28

• succimer (Chemet)
• d-penicillamine (Cuprimine)

Question 29

IM/IV chelation for severely high levels

Answer 29

• edetate calcium disodium (EDTA) (Versenate)
• dimercaprol (BAL in Oil)

Question 30

Lead poisining dietary management

Answer 30

• Sufficient caloric intake
• Calcium
• Zinc
• Iron
• Vitamin D
• Vitamin C

Question 31

Nursing management in reducing blood lead levels?

Answer 31

• Wash & dry child’s hands & face frequently, especially before meals
• Wash toys & pacifiers
• During remodeling keep children out of house
• Make sure child eats regular meals, lead is absorbed easier on an empty stomach
• Don’t use pottery for eating
• Don’t store foods in open containers, especially imported