Paediatric assessment triangle 1. Appearance 2. Work of breathing 3. Circulation

Pediatric Vital Signs Flashcards by Ayah Al

According to PALS 2020, what should HR, RR and BP for an infant?

HR: 100-180
RR: 30-53
BP: 70+ 2x age

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According to PALS 2020, what should HR, RR and BP be for a toddler?

HR 98-140
RR: 22-37
BP: 70+ 2x age

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According to PALS 2020, what should HR, RR and BP be in a preschooler?

HR: 80-120
RR: 20-28
BP: 70+ 2X age

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According to PALS 2020, what should HR, RR, and BP look like inn a school aged child?

HR: 75-118
RR: 18-25
BP: 70+ 2X age

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According to PALS 2020, what should the. HR, RR, and BP be in an adolescent?

HR: 60-100
RR:12-20
BP: >90

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What are 3 upper airway emergencies in paediatrics?

Croup
epiglottitis
Foreign body aspiration

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What are 4 lower airway emergencies in paediatrics?

Asthma
Bronchiolitis
Pneumonia
Foreign body airway obstruction

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What is croup?

Viral infection of the upper airway causing inflammation and edema below the larynx and glottis

Slow onset

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Hallmark sign of croup?

Strider: hoarse bark like cough

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What is epiglottitis?

Bacterial infection causing inflammation of the supraglottic structures
Rapid onset
Drooling
Higher fever

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What are 3 components that lead to poor gas exchange and obstruction?

Bronchospasm
Inflammation
Mucous production

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What is bronchiolitis?

Inflammation of the smaller airways in the respiratory tract
Common in late fall and winter

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What is PAT

Paediatric assessment triangle

Appearance
Work of breathing
Circulation

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Where do you start assessment in an alert child?

Start a the feet and ascend

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Where do you start assessment with an altered child?

At the head like normal and descend

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Late and ominous sign of shock in children?

Hypotension

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Most common form of shock in children?

Hypovolemia due to poor fluid intake and fluid loss

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What is a key finding in distributive septic shock?

Fever

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In Hypothermic paediatrics what changes in the way you administer medications?

Meds should be given with twice the repeat time

Rule of 9s for an infant?

Trunk and abdomen 18% each
Arms 9% each
Legs 14% each
Head 18%

4 Risk factors of SIDS

Male gender
Premature babies
Low birth weight
Young maternal age

What is Leopolds Maneuver?

Palpation of the mothers abdomen to determine the position of the fetus and its descent into the pelvis

8 Signs of imminent delivery?

Bearing down
Passing stool
Has given birth before
Contractions 2 minutes apart
Head can be seen crowning
History of rapid deliveries
Perineum bulging
Sitting on one cheek

What are dizygotic twins?

Fraternal, separate eggs and sacs

What are monozygotic twins?

1 placenta, 2 amniotic sacs

3 Concerns in multiple births?

1. Both need to be in the cephalic position 2. Monoamniotics should be delivered via cesarean section 3. Uterine atony

What are the 9 instruments needed for delivery?

1.sterile bulb or suction 2. Sterile scalpel or scissors 3. Blankets 4. Towels 5. 2 clamps 6.blue pads 7. Abdo pads 8. Plastic apron 9. 2 plastic bags

What 4 things to do when transporting a pregnant patient during delivery?

1. Left lateral/ semi fowlers 2. 2 Large bore Iv 3. Position. Backwards onto the stretcher with the patients legs facing the airway chair 4. Oxygen

When is oxytocin administered during delivery?

Oxytocin 10 units IM administered post delivery of anterior shoulder or as soon as possible after the delivery

If meconium is present, what are your next actions

Do not stimulate the baby to breathe, suction any Meconium that you see for 3-5 seconds Dry and stimulate to breathe and cry

What are the 7 notations at birth?

1. Time 2. Presentation 3. Colour of amniotic fluid 4. Apgar score 5. Sex of baby 6. Time of placenta Delivery 7. Unusual occurrences

What 6 things must you assess on an immediate postpartum mother?

1. Vital signs 2. If appear to be in shock, lay flat and give a fluid bolus 3. Vaginal blood flow 4. Uterine to assess firmness 5. Height of fundus 6. Expression of blood and clots

What are 4 causes of postpartum hemorrhage?

1. Placental tissue remains 2. Uterine atony- uterus fails to contract after delivery 3. Larger babies or multiple births 4. Perineal/ cervical tears

What is the average blood loss postpartum?

500 cc

What is the moderate amount of Blood loss postpartum?

500-1000 cc

What is the severe amount of blood loss postpartum?

1000 cc of blood or greater

What are 7 treatments for postpartum hemorrhage?

1. If 500 ml bolus. To 90 systolic 2. Fundal massage while supporting uterus above the pubis 3. Encourage breastfeeding 4. Encourage urination 5. Lay flat 6. Note amount of Blood Loss/ clots 7. Transport rapidly

What is uterine inversion?

Uterine inversion is when the uterus inverts inside out Ligaments and blood vessels are torn causing life threatening hemmorhage

What is uterine inversion?

Uterine inversion is when the uterus inverts inside out Ligaments and blood vessels are torn causing life threatening hemmorhage

What should you not do to avoid the likelihood of uterine inversion?

Do not pull on the cord while waiting for the placenta to deliver

What are 3 ways of management for uterine inversion?

1. Call OLMC 2. 2 large bore IV’s 3. Cover uterus with moist sterile dressings

Management of nuchal cord?

1. If loose slip over the head 2. If tight, double clamp and cut cord between clamps, unwind from neck 3. Have mother pant while quickly unwinding the cord 4. Prepare for baby to compromised

What are the complications of a prolapsed cord?

1. Increased incidence with premature rupture of membranes, breech or presenting part wont be engaged 2. Cord gets compressed between fetus and pelvis shutting off fetal circulation 3. 50% mortality rate

Which 2 instances cause a higher risk of a prolapsed cord?

1. Premature babies 2. Excessive amniotic fluid

What sign can lead you to suspect a breech delivery?

If the meconium coming from the vagina is greenish black, sticky, thick