Pediatrics and OB Emergencies Flashcards
1
Q
5 stages of development
A
Infancy, toddler, preschool, school age, adolescence
2
Q
What age is infancy
A
0-1 year
3
Q
what age are toddlers
A
1-3
4
Q
What age are preschoolers
A
3-6
5
Q
school age
A
6-12
6
Q
adolescence
A
12-18 year
7
Q
How do you do a physical assessment for kids under 6 years old?
A
Toe to head
8
Q
How do you do a physical assessment for kids older than 6 years old?
A
Head to toe
9
Q
Pediatric Assessment Triangle
A
Appearance (awake, aware, upright), Work of breathing (retraction, noises), Skin Circulation
10
Q
What is the trend with kids vitals under 6?
A
Higher pulse, low blood pressure, higher respirations. Kids rely on cardiac output
11
Q
Signs of respiratory distress in kids (5)
A
retraction of intercostal muscles (Ribs showing), Nasal Flaring, Grunting at end of breath, Tripod, Use of accessory muscles
12
Q
Stages of decompensation (5)
A
Respiratory distress, hypoxia, bradycardia, cardiac arrest, cyanosis (late sign)
13
Q
When do you begin CPR in Pediatrics?
A
HR <60bpm and signs of poor perfusion
14
Q
What are signs of poor perfusion?
A
Poor cap refill, respiratory distress, cyanosis, ALOC
15
Q
How fast should Cap refill occur?
A
<2 seconds
16
Q
CPR rates 1 rescuer Pediatrics?
A
Neutral Sniffing Position, 30:2, BMV 1 Breath every 2-3 seconds. 1.5” or 1/3 depth of chest
17
Q
CPR Rates 2 rescuer Pediatrics?
A
Neutral Sniffing Position, 15:2, BMV 1 Breath every 2-3 seconds. 1.5” or 1/3 depth of chest
18
Q
What is Pediatric age for AED
A
1-8 years old
19
Q
What is Pediatric age for CPR?
A
1-puberty
20
Q
Modified CPR?
A
Visualize airway before ventilate
21
Q
How to treat a baby choking?
A
5-5- visual. 5 back blows, 5 compressions, visualize airway
22
Q
How to use an OPA on ped.
A
Measure, drop straight in
23
Q
Contraindication for NPA in kids
A
infants (<1 year old)
24
Q
Status Asthmaticus
A
Asthma unresolved by Albuterol
25
Key information for dehydration in kids
How often changing diapers (6-10 is normal), Fluid intake, Weight, Activity level, Check turgor on belly. ALS needed
26
Mild Symptoms of Dehydration (3)
Dry lips/gums, decreased saliva output, decrease diaper changes
27
Moderate Symptoms Dehydration (5) think “s”
Same as mild but include sunken eyes, sleepiness, irritability, loose skin, sunken fontanelle
28
Dehydration Severe Symptoms (3)
Signs of metabolic hypovolemic shock, Delayed cap refill, tachypnea (fast breathing)
29
What kind of seizure to kids experience with seizure?
Febrile
30
Meningitis symptoms in kids (5)
Nuchal Rigidity, photophobia, increase irritability, bulging fontanelle without crying (ALOC), rash (Serious sign)
31
Signs of poison
Vomiting with no signs of infection, unsupervised for any time
32
Tx of poison
Activated charcoal 12.5-25g
33
Contraindication for charcoal
No patent airway. Ingestion of alkali, acid, or petrol
34
What to worry about in cases of drowing?
C Spine injuries
35
Contraindication for C collar in Pediatrics?
Infancy
36
When immobilizing spine in infants, what is important?
Allowing arms and legs to move. Kids will move whole body if they can't move arms and legs
37
Triage "Jump Start" (Kids) labels
Green, yellow, red, black
38
Green tag (Triage)
Ambulatory, no life threats. Give command for anyone that can hear you to go to a designated spot
39
Yellow Tag (Triage) Delayed Treatment
Breathing on own 15-45 bpm, Palpable peripheral pulse (infants brachial, others radial), Appropriate response to verbal/painful stimuli
40
Red (Triage) Immediate treatment
Respirations less than 15 or more than 45, apneic (BMV 5 breaths and reassess
40
Red Tag (Triage) Immediate treatment
Respirations less than 15 or more than 45, apneic (BMV 5 breaths and reassess, black tag if no breath), breathing without pulse, ALOC or inappropriate pain response
41
Black Tag (Triage) Dead
Apneaic without pulse or unresponsive to rescue breathing
42
Key information to identify if injuries are abuse
Is the injury appropriate?
Is it consistent with story?
Is the caregiver acting appropriately?
Is the child acting appropriately?
Is there evidence of drug/alcohol abuse?
Was there a delay in seeking care?
Are their multiple injuries of different healing stages?
Is there a glove burn? (dipped in hot liquid)
Unexplained LOC, No MOI/NOI, Shaken Baby syndrome
Are weight and hygiene appropriate?
43
Signs of baby shaken syndrome
Bulging fontanelle, no illness/trauma, unconscious
44
SUID
Sudden unexplained infant death
45
signs of SUID
2-4 months old, Health with no home hazards such as poor sleeping arrangements that could cause suffocation
46
Contraindication for CPR in infants
Blood tinged fluid from nose/mouth, petechial rash, rigor mortis, dependent lividity
47
ALTE
Apparent life threatening event
48
Signs of ALTE
cyanosis, apnea, choking, responds to physical stimuli.
49
Treatment of ALTE
Load and go to hospital, airway management
50
Umbilical vein function
Carries oxygen and nutrient rich blood to fetus
51
Umbilical Artery function
Carries oxygen poor blood to placenta
52
What vital changes happen during pregnancy
HR and Respiratory rate increase
53
Pre-Eclampsia
HTN induced by pregnancy. Headache, vision disturbance, anxiety, edema (30th week)
54
Eclampsia
Seizures induced by HTN
55
Compression of inferior vena cava in pregnant women while in supine position
Supine Hypotension syndrome.
56
Treatment of Supine Hypotension syndrome
left lateral position
57
Gestational diabetes and complications
Diabetes induced by pregnancy, causes baby to be large due to excess glucose
58
Patient has history of PID, unilateral pain in Lower quadrants
Ectopic pregnancy
59
Placenta abrupto signs and causes
Premature tearing of placenta from uterus. lots of pain but little bleeding. Usually due to trauma
60
Placenta Provia signs and cause
placenta develops over cervix. Lots of bleeding but little to no pain
61
Patient is experiencing regular contractions. What stage?
stage 1. Until full dialation
62
Patient is at full dilation to birth. What stage?
Stage 2
63
Patient has delivered baby. What Stage?
Stage 3
64
Imminent signs of delivery (4)
Urge to push, crowning, bulging at perineum, contractions 2-3 minutes apart
65
Key questions for patient delivering baby.
1. Expected due date/last menstrual period 2. Gravida (How many times pregnant) 3. Para (How many births and type) 4. Rupture of amniotic fluid, color/smell 5. Pre natal care/important information 6. complications such as diabetes or pre-eclampsia 7. drug/alcohol use 8. multiple births
66
Para
How many births and the type of birth (Natural, C section, miscarriage/abortion)
67
Gravida
How many pregnancies?
68
Meconium
Fecal matter from baby in womb due to fetal distress
69
What kind of clean must OB kit be?
Sterile
70
When using the OB kit what kind of clean should it be?
Medically clean
71
Medically Clean
Sterile equipment with non sterile BSI
72
What to look for while delivering a baby?
Nuchal Cord, meconium
73
How to treat nuchal chord
finger under cord and over babies head or Clamp, clamp, cut (check for pulse before cut)
74
How level to keep baby at after birth
level with mothers pelvis left lateral trendenberg
75
APGAR
Appearance, pulse, grimace/irritability, Activity, respirations
76
Appearance Score and observations (APGAR)
2 all pink 1 peripheral cyanosis 0 cyanosis all over
77
Pulse Score and observations (APGAR)
2 >100 1<100 0 no pulse
78
Grimace/Irritability Score and Observation (APGAR)
2. Cries/tries to move away from stimuli 1. weak cry doesn't pull away from stimuli 0. no response
79
Activity (APGAR)
2. Resists gentle leg straightening 1 weak response 0 no response/limp
80
Respirations (APGAR)
2. 40-60 1. <40 0. none
81
DOT umbilical cord clamping regulations
1-2" from baby second clamp 2" past that
82
LA umbilical cord clamping regulations
4-6" from baby second clamp 2" past that
83
When should placenta be delivered?
Within 30 minutes after delivery. Code 3 if not delivered
84
signs of placenta delivery (3)
1. urge to push 2. lengthening of umbilical cord 3. Gush of blood
85
What massage after delivery of placenta?
Fundal Massage
86
Breech delivery
Legs first, we can deliver this type. Make V with hand to make airway for baby if head gets stuck
87
Limb Presentation
one foot out. We cannot deliver. Transport immediately. Cover foot with warm sterile dressing
88
Prolapse Cord
Cord comes out before baby.
89
How can we intervene during a prolapse cord?
Use fingers to move baby's head anterior or posterior to relief pressure on cord
90
NeoNatal has a heart rate <100, central cyanosis, but adequate respirations. How do you treat?
Blow by o2 using an NRB
91
NeoNatal has gasping or inadequate breath. How do you treat?
BMV with room air for 30 seconds. Reassess
91
NeoNatal has gasping or inadequate breath. How do you treat?
BMV room air 1 breath per second
92
NeoNatal has an heart rate 60-100 and central cyanosis. How do you treat?
BMV room air 90 seconds
93
CPR ratio for Neonate
3:1
94
Compression depth for neonate
1/2"-3/4"
95
