Peds - Emergencies

Question 1

after-drop

Answer 1

initial drop in ped temp when rewarming from hypothemia

Question 2

core temp goal when resusitating hypothermic?

Answer 2

32-35C

Question 3

kid comes in after near-drowning but asymptomatic - how long to keep inpt?

Answer 3

8h (3-5 min hypox = CNS injury)

Question 4

labs for tox

Answer 4

BG
electrolytes w/ anion gap
ABG/WBG
UA
Utox, serum acetminophen/salycilate
EKG
Xray

Question 5

tox-induced sz tx

Answer 5

benzo, then barbituate

Question 6

tox-induced bradycardia

Answer 6

atropine

Question 7

tox-induced HTN

Answer 7

benzo, then nitroprusside

Question 8

antidote for TCA

Answer 8

Na bircarb

Question 9

antidote for insecticide

Answer 9

atropine

Question 10

manage magnet ingestion

Answer 10

serial X rays, endoscopy is possible

Question 11

organism for human bites

Answer 11

eikenella

Question 12

organism for animal bites

Answer 12

pasteurella

Question 13

concerned about infxn for bite - how to proceed?

Answer 13

gram stain, culture before antibx

Question 14

when to close a bite wound

Answer 14

facial/cosmetically impt
uninfected (appearing)
<12h old (<24h face)

Question 15

when NOT to close a bite wound

Answer 15

crush/puncture
hand/foot location
cat/human bite (exception:facial)
immunocomp

Question 16

when to give tetanus post-bite

Answer 16

if >5yo

Question 17

rabies ppx

Answer 17

IM HDVC or PCEC x 4 (d0,3,7,14)
and
RIG IM around bite

Question 18

2kg wt loss = how much fluid loss

Answer 18

2L

severe dehydration >10%, mild 3-5%

Question 19

labs indicative of dehydration

Answer 19

• serum bicarb <17

^BUN

Question 20

fluid replenishment goals

Answer 20

5mL/2min (oral)

10 mL/kg per emesis/diarrhea (oral)

Question 21

IV fluid to give dehydrated kids

Answer 21

crystalloid ISOtonic 0.9% saline (dextrose shows no benefit)

colloid if low intravascular oncotic P

Question 22

moderate dehydration IV rate

Answer 22

60ml/kg/hour

Question 23

initial dehydration bolus

Answer 23

20ml/kg in 10-30min

Question 24

SIDS peak age

Answer 24

2-4 mo (90% before 6mo)

Question 25

where not to use lidocaine+epi for analgesia

Answer 25

fingers, nose, penis, toes

Question 26

apply lidocaine __ min before procedure

Answer 26

30

Question 27

route for midazolam sedation

Answer 27

IN (mild sedation)

Question 28

moderate sedation indications

Answer 28

ortho reduction tongue lac, extensive lac MRI/CT

Question 29

ketamine SE

Answer 29

N/V, HR+BP^, agitation/hallucination, respiratory supp.

Question 30

boys w/ abd pain and vomiting

Answer 30

testicular exam

Question 31

preferred fluid for irrigation of wound

Answer 31

NL saline

Question 32

amt fluid to irrigate wound w/

Answer 32

50-100mL/length in cm