Pediatric Injury Prevention Flashcards
skull expands until age?
2 years of age
why more injury to c1-c2 level in infants
less muscle strength, more neck mobility
Child restraint laws in Ohio
- 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)
Rear facing restraint?
from birth to 1 year and 20 lbs
Toddlers should be restrained ?
upright and forward facing until 40-65 lbs (depending on model)
Booster seat
with lap and shoulder belt is needed for child weighing more than 40 lb
Children under age ? greatest risk for foreign body ingestion
under the age of 4
Prevention of choking
- 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
The fifth leading cause of death in children younger than 5 years
Poisins
Overdose in infants are often the result of ?
therapeutic overdosing
Cleaning substances, analgesics, topical agents, cough and cold preparations
*greatest risk for children under?
children under the age of 6
Poisining in adolescents
Adolescents drug experimentation and suicide attempts
Prent teaching for child poisining
- 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
Goals of poisin treatment: SIRES
initial intervention for management of poisining?
- Terminate Exposure!
- Empty mouth of pills, plants
- Flush eyes or skin
- Remove contaminated clothes
Gastric decontamination to eliminate poisin and prevent absorption?
- Syrup of Ipecac: no longer used in the home setting. Can be used in the healthcare system
- Gastric Lavage
- Activated Charcoal
- Induces emesis
- Contraindicated in some poisons
- Electrolyte disturbances
- No longer recommended to have at home
Syrup of ipecac
- Used in 1st 1-2 hours
- 50 - 100 ml of saline flushed into NG tube, aspirated until clear
- Save first specimen for toxicology analysis
gastric lavage
- Odorless, tasteless, fine, black powder
- Used if poisoning is > 2 hrs
- Absorbs many compounds
- “slurry” (black mud)
Activated charcoal
Signs & Symptoms
- Anorexia, nausea, vomiting
- Liver tenderness
- Liver toxicity: usually occurs after 24 hr
- Assess liver function: Elevated AST, ALT
acetaminophen poisining
management of acetaminophen poisining
- Gastric Lavage if within the 1st hr of ingestion
- Then Activated charcoal
- Mucomyst is antidote
In all types of poisining, when child is stable?
- assess for contributing factors
- institute anticipatory
- education
- 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
lead poisining
clinical manifestations of lead poisining
- Often, no symptoms
- Irritability
- Headaches
- Fatigue
- Abdominal pain
- Cognitive and motor delays
*Screening is essential
Complications of lead poisining as well as difference between low lead and high lead poisining?
- 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
elevated blood level of lead?
5 micrograms per deciliter
Chelation Therapy
> or = 45 micrograms per deciliter
Removes lead from soft tissue and bones
PO chelation for moderate to high levels
- succimer (Chemet)
- d-penicillamine (Cuprimine)
IM/IV chelation for severely high levels
- edetate calcium disodium (EDTA) (Versenate)
- dimercaprol (BAL in Oil)
Lead poisining dietary management
- Sufficient caloric intake
- Calcium
- Zinc
- Iron
- Vitamin D
- Vitamin C
Nursing management in reducing blood lead levels?
- 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
