Pediatrics Flashcards
Caregiver
- Listen to, and support, the caregivers
- Calm caregivers = calm child
- Agitated caregivers = agitated child
- Keep caregiver informed
- Remain calm, caregivers are watching you for support
Development stages
- Neonate (birth- 1m)
- Infant (1m -1y)
- Toddlers (1-2y)
- Preschoolers (3-5 y)
- School age and pre-adolescent (6-12 y)
- Adolescent (12-18y)
Neonate
- Birth to one month
- Completely dependent on caregivers
Infant
- One month to one year
- Less than 6 months: can you recognize caregivers face and voice
- Over 6 months: do not like to be taken from caregivers (Let caregivers hold child during assessment)
Toddler
- 1-2 years
- Do not like
- To be touched
- To be taken from caregiver
- Having clothing removed
- Fear of pain
Preschoolers
- 3-5 years
- Believe illness or injury is their fault
- Have caregiver hold child on their lap
School age and pre-adolescents
- 6-12 years
- Modest
- Fear permanent injuries and disfigurement
Adolescents
- 12-18 years
- Preoccupied by their bodies and are modest
- Capable of hysterical reactions to event
PAT
Pediatric Assessment Triangle
- Appearance
- Work of breathing
- Circulation
Appearance
- Tone: assess muscle tone
- Interactivity and irritability: Alert or disinterested in event?
- Consolability: Can child be consoled by caregiver
- Look or gaze: Is there a “nobody home” look on the child’s face?
- Speech or cry: Good strong cry or speech pattern?
Work of Breathing
- Abnormal sounds
- Abnormal posture or position
- Retractions
- Nasal flaring
- Head bobbing
Circulation
- Pallor
- Mottling
- Cyanosis
PAT findings
- Respiratory distress
- Respiratory failure
- Compensated shock
- Decompensated shock
- Brain Injury
- Cardiopulmonary failure
Respiratory DISTRESS
Appearance: Normal
Work of breathing: Abnormal
Circulation: Normal
Respiratory FAILURE
Appearance: Abnormal
Work of breathing: Abnormal
Circulation: Normal or Abnormal
Compensated shock
Appearance: Normal
Work of Breathing: Normal
Circulation: Abnormal
Decompensated shock
Appearance: Abnormal
Work of breathing: Normal or abnormal
Circulation: Abnormal
Brain Injury
Appearance: Abnormal
Work of breathing: Abnormal
Circulation: Abnormal
Cardiopulmonary Failure
Appearance: Abnormal
Work of breathing: Abnormal or Absent
Circulation: Abnormal
Croup
Common infection of the upper airway
- usually viral
- 6 months to 4 years
- Swelling of the glottis
SXSX Croup
- Stridor in inhalation
- Seal bark cough
Epiglottitis
Swelling of the epiglottis
- Bacterial
- 2 to 7 years
- Life threatening emergency
SXSX Epiglottitis
- Painful swallowing
- High fever
- Drooling
- Stridor
Asthma
Narrowing of airway due to edema and mucus production
- Reversible
- Has definite cause and is REPEATABLE
- Patient is little older and has a repeatable cause of wheezing
SXSX Asthma
- Shortness of breath
- Wheezing
Bronchiolitis
Narrowing of airway due to swelling/ viral infection/ RSV (Respiratory Syncytial virus)
- Usually happens to the very young/ less than 2 years of age
SXSX Bronchiolitis
- Similar s/s to asthma
- Patient is very young and has a viral infection
Seizures
Fever is most common cause of seizures in children
Treatment Seizures
- Strip child down to diaper
- Give sponge bath with a cloth soaked with tepid (Luke warm) water
- Watch for shivering!
BRUE/ ALTE
Brief Resolved Unexplained Event/ Apparent Life Threatening Event
- Children is less than one year
BRUE/ ALTE Examples
- Cyanosis or Pallor
- Absent, decreased, or irregular breathing
- Changes in muscle tone
- ALOC
Sudden Infant Death Syndrome
- Children less than one year of age
- Most common in 2-4 months
- Crib death
- Death of a child with no cause found on autopsy
Child Abuse
Indicators:
- Multiple bruises in various stages of healing
- Multiple injuries/ unusual wound patterns
- Fearful child
- Injuries don’t match MOI
- if suspected, alert law enforcement at scene and hospital staff
- Contact child protective services (CPS)
-Immediately by phone- Written report send in to CPS in 36 hours
