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Flight Paramedic Certification > Pediatrics > Flashcards

Pediatrics Flashcards

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1
Q

When does the Anterior Fontanelle close?

A

12-18 months

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2
Q

When does the Posterior Fontanelle close?

A

2 months

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3
Q

Anatomic specifics

A

Bones of the skull are softer and separated by cartilage until age 5.

Blunt force trauma and broken bones indicate significant MOI and potential of bleeding.

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4
Q

Children will not demonstrate hypotension until acute blood loss totals?

A

25% of circulating volume

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5
Q

What influences heat loss?

A

Larger ratio of body surface area to volume

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6
Q

Pediatric assessment triangle

A

Appearance
work of Breathing
Circulation

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7
Q

Respiratory/Airway differences?

A

Larger tongue
<10 years, narrowest portion of airway is cricoid
O2 consumption in infants is double of an adult.

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8
Q

ETT sizing formula over 1 year

A

(Age + 16) / 4

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9
Q

ETT sizing norms <1 year

A

Premature Neonate = 2.5-3.0
Term Neonate = 3.0-3.5
3 mo - 1 year = 3.5-4.0

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10
Q

Estimated Blood Volume (EBV)

A

Premature Neonate = 90-100 ml/kg
Term Neonate = 80-90 ml/kg
3 mo - 1 year = 70-80 ml/kg
>1 year = 70 ml/kg

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11
Q

Maximum Allowable Blood Loss (MABL)

A

EBV x (current Hct - minimum acceptable Hct) / Current Hct

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12
Q

Emergency Fluid Resuscitation

A

Infant / neonate = 10 ml/kg
Child = 20 ml/kg

3:1 ratio of crystalloids to blood. Use blood early in trauma

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13
Q

Iv Maintenance Infusion Rates

A

4 ml/kg for 1st 10kg
2 ml/kg for 11th -20th kg
1 ml/kg for every kg >20

(Example: 25kg =65 ml/hr)

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14
Q

Hypoglycemia in pediatrics

A 
Neonates = <40 mg/dl 
Child = <60 mg/dl
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15
Q

Hypoglycemia treatment

A

1-2 mg/kg
Neonates use D10
Child use D25

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16
Q

How to make D10 and D25

A 
D25% = Discard 25ml of D50, replace with 25ml of NS
D10% = Discard 40 ml of D50, replace with 40ml of NS
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17
Q

Cardioversion Joules?

A

0.5-1.0 J/kg (on sync)

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18
Q

Defibrillation Joules?

A

2 J/kg, then 4 J/kg

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19
Q

Resuscitation drug doses?

Adenosine, Atropine, Epi 1:10, Epi 1:10

A

Adenosine = 0.1-0.2 mg/kg
Atropine = 0.02 mg/kg (min 0.1, max 0.5)
Epi 1:10 = 0.01mg/kg
Epi 1:1 = 0.1 mg/kg

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20
Q

1 cause of pediatric traumatic deaths?

A

Motor vehicle accidents

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21
Q

Child abuse injuries

A

Most common injuries are skin
Most common fatal injuries are head
Skeletal injuries best to determine long term abuse.

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22
Q

Comminuted Fracture

A

Bone broken into fragments

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23
Q

Compound Fracture

A

Bone is broken and piercing skin

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24
Q

Compressed Fracture

A

One bone is forced against the other

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25
Q

Displaced Fracture

A

End of bones are not aligned

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26
Q

Greenstick Fracture

A

Periosteum divided on only one side

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27
Q

Pathological Fracture

A

Occurs because of bone deficit

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28
Q

Simple Fracture

A

Straight and in good alignment

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29
Q

Spiral Fracture

A

Results from twisting motion

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30
Q

Isolette use

A

<10 lbs or 30 days
Thermoregulation issues
Sound / light /stimulus discipline

Stay out of it!

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31
Q

Status changes with temperature

A

Hot = fussy, tachycardic.

Cold = Bradycardic, hypotension, obtunded.

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32
Q

Define and Treat Diaphragmatic Hernia

A

Bowels causing lung compression
Intubation / PPV for resp distress.
OG tube with suction
NPO

33
Q

Define and Treat Choanal Atresia

A

Bony structure occluding nasopharyngeal airway. Oral airway access using OPA or ETT if needed.

34
Q

Treatment of Aspiration Pneumonia

A

If brisk, monitor only.
If lethargic, intubate

ET suctioning acceptable but discouraged unless necessary.
Consider risk of Tracheal-Esophageal fistula.

35
Q

What is the most common Congenital Heart Defect?

A

Ventricular Septal Defect

36
Q

What drug maintains patency of the PDA?

A

Prostaglandin

37
Q

What drug closes the PDA?

A

Oxygen and Indomethacin

38
Q

What is the PDA?

A

Patent Ductus Arteriosus : Vessel connecting the Pulmonary Artery to Aorta.

Functionally closes at birth, anatomically at 21 days.

39
Q

What are Cyanotic lesions?

A

Any condition with mixing of unoxygenated and oxygenated blood.
Commonly causing a cyanotic appearance.

40
Q

What are Acyanotic lesions?

A

Blood returning to the right atrium has passed through the lungs like normal.

41
Q

Types of Acyanotic lesions

A 
Atrial Septal Defect
Ventricular Septal Defect
Atrial / Ventricular Septal Defect
Aortic Stenosis
Pulmonary Stenosis
42
Q

Types of Cyanotic lesions

A 
Transposition of Great Vessels
Tetralogy of Fallot
Total Anomalous Pulmonary Venous Return
Truncus Arteriosus
Tricuspid Atresia
Hypoplastic Left Heart Syndrome
43
Q

Endotracheal tube suctioning guidelines

A

Suction 0.5-1cm past ETT depth
80-100 mmHg of pressure
Hyperoxygenate to prevent desaturation
Use new tube each time

44
Q

10, 11, 12 rule

A

Uncuffed tube under 10
Needle cricothyrotomy only under 11
No nasal intubation under 12

45
Q

Rule of 9’s for pediatrics

A 
Arm- 9%
Head and neck- 18%
Leg- 14%
Anterior trunk - 18%
Posterior trunk - 18%
46
Q

Most common predictor of sepsis in a neonate

A

Neutropenia

47
Q

Most common side effect of prostaglandin therapy

A

Hypoventilation or apnea

48
Q

Treatment of esophageal atresia

A

Elevate head of bed

NG/OG

49
Q

Common sign of neonate distress

A

Hiccoughing

50
Q

In transporting an infant with neural defects, which position is optimal?

A

Prone-kneeling position

51
Q

In which position should an infant with gastrointestinal anomalies be transported?

A

Side laying with head slightly elevated

52
Q

Prostaglandin dose

A

0.03 - 0.1 mcg/kg/min

53
Q

Why do children under 10 require uncuffed ETT?

A

Their cricoid cartilage acts as a functional cuff

Cuffs add increased pressure on soft tissues

54
Q

Top 3 killers of neonates in the first 24 hours

A
  1. Sepsis
  2. Respiratory complications
  3. Cardiac problems
55
Q

Neonatal sepsis

A

Occurs in utero often due to Premature Rupture Of Membranes (PROM)

Most commonly caused by Group B Strep

56
Q

S/S of infant seizures

A

Lip smacking
Tounge thrusting
Eye fluttering
Lowered O2 sats

57
Q

Common causes of infant seizures

A

Hypoglycemia
Opiod withdrawal
Interventricular hemorrhage (preterm infant bleeding inside brain)

58
Q

What causes febrile seizures?

A

RATE of temperature increase (not overall temp)

59
Q

Respiratory Distress Syndrome (RDS)

A

1 killer of premature infants

Surfactant deficiency

60
Q

Surfactant ____ surface tension in the alveoli

A

Reduces

61
Q

Omphalocele

A

Protrusion of viscera (arrest development of the abdominal wall)

Worse than Gastroschesis
Treat like an abdominal evisceration

62
Q

Treatment of Omphalocele

A

Treat like abdominal evisceration:

Maintain body temp
Cover with moist, sterile dressings
Keep NPO
Will require surgical repair

63
Q

Gastroschesis

A

Defect with completed development of internal organs.

Abdominal contents are coming out of the body on one side of the umbilical cord

64
Q

Treatment of Gastroschesis

A

Treat like an abdominal evisceration:

Maintain normal body temp
Cover with moist, sterile dressings
Keep NPO
Will require surgical repair

65
Q

Presentation of Ventriculoperitoneal shunt occlusion

A 
Gastric distention 
Mental status change
Decrease LOC
Vomiting 
Seizures
66
Q

Treatment of VP shunt

A

Give Mannitol

Raise head of bed 30*

67
Q

S/S of shaken baby syndrome

A

Bulging fontanelles
Increased ICP
Retinal hemorrhages

68
Q

Tetralogy of Fallot

A

Pulmonary Stenosis
Aortic Coarctation
Transposition of Great Vessels
Ventricular Septal Defect

69
Q

An umbilical cord normally has 2 ____ and 1 ____.

A

Arteries

Vein (the big vessel on the umbilical cord)

70
Q

Presentation of Tet spells

A

Sudden cyanosis and syncope

71
Q

Treatment of Tet spells

A

Knees to chest
Morphine (decrease workload and calming effects)

If unsuccessful, then RSI with 100% O2

72
Q

Normal pediatric systolic BP

A

90 + (2×Age)

73
Q

Hypotensive systolic BP

A

70 + (2xAge)

74
Q

Presentation of Croup (Swelling around vocal cords)

A

Gradual onset with URI, no drooling
Seal like barking cough
Steeple sign on neck x-ray

75
Q

Treatment of Croup

A

Racemic Epinephrine

Decadron

76
Q

Presentation of Epiglottitis (swelling of the epiglottis)

A

Sudden onset , drooling
Tripod position
Thumb sign on neck x-ray
Do not disturb child due to rapid airway loss!

77
Q

Treatment of Epiglottitis

A

Keep child calm
Antibiotics
Humidified O2

78
Q

Waddel’s Triad (child hit by car)

A

Car hits them
They hit the car
They hit the ground

Flight Paramedic Certification (15 decks)

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