Peds Emergencies Flashcards
Define a pediatric patient by age
<18 yo
What are the three overarching etiologies that constitute ped emergencies?
- Respiratory
- Shock
- Cardiac
4 types of respiratory emergencies
- Upper airway obstruction
- Lower airway obstruction
- Lung parenchyma diseases
- Disordered control of breathing
Respiratory Distress
- sx
- Tachypnea
- Increased resp. effort (nasal flaring, retractions)
- Inadequate resp. effort (hypoventilation, bradypnea)
- Abnormal sounds (stridor, wheezing, grunting)
- Tachycardia
- Pale and cool skin
- Changes in LOC
Respiratory Failure
- sx
- Marked tachypnea (early sx)
- Bradypnea/apnea (late)
- Increased/decreased/no respiratory effort
- Poor to absent distal air movement
- Tachycardia (early), bradycardia (late)
- Cyanosis
- Stupor, coma (late)
General management respiratory distress
- Airway (head tilt, chin lift)
- Oxygen
- pulse oximetry
- IV/IO access
- ECG monitor
- BLS if needed
Three examples of upper airway obstruction
- Croup/RSV
- Anaphylaxis
- Aspiration of foreign body
Tx for croup/RSV
- nebulizer epinephrine (racemic epi)
- Dexamethasone
- Humidified air
Tx for anaphylaxis
- IM epi
- Albuterol
- Antihistamines (diphenhydramine and ranitidine)
- Methypredisolone
Where is an aspirated foreign body most likely to lodge in a kid
right main bronchi
Upper airway obstruction s/sx
- Increased respiratory effort
- Stridor (usu inspiratory)
- barking cough
- hoarseness
- tachycardia
- pallor/cool skin early and cyanosis late
- Anxiety/agitation early and lethargy/unresponsiveness late
- temp possible, depending on cause
Two common causes of lower airway obstruction
- bronchiolotis/RSV
2. Asthma
Bronchiolitis/RSV
- tx
- Nasal suctioning
- bronchodilator
Asthma
- tx
- Albuterol w/ or w/o ipratropium (duoneb)
- Corticosteroids
- SQ epi
- Mag sulfate
- Terbutaline
- Humidified air
Lower airway obstruction s/sx
- Increased respiratory effort
- Wheezing (usu expiratory)
- prolonged expiratory phase
- Tachycardia
- pallor/cool skin early and cyanosis late
- Anxiety/agitation early and lethargy/unresponsiveness late
- temp possible, depending on cause
Two common causes of lung parenchymal disease
- Pneumonia/pneumonitis
2. Pulmonary edema
Pneumonia/pneumonitis
- types
- infectious
- chemical
- aspiration
Pneumonia/pneumonitis
- tx
- albuterol
- abx as needed
Pulmonary edema
- two types
- cardiac (CHF dt CHD)
- Non-cardiac (ARDS)
Non-cardiac pulmonary edema treatment
- noninvasive/invasive ventilator support with PEEP
- vasoactive support
- diuretic
Lung parenchymal dz s/sx
- increased resp. effort
- grunting
- crackles
- decreased breath sounds
- Tachycardia
- pallor/cool skin early and cyanosis late
- Anxiety/agitation early and lethargy/unresponsiveness late
- temp possible, depending on cause
Disordered control of breathing
- three common causes
- ICP
- Poisoning/OD
- Neuromuscular disease
4 causes of ICP that cause disordered control of breathing
- trauma/abuse
- Meningitis/encephalitis
- tumor
- brain bleed
Common causes of poisoning/OD that cause disordered control of breathing
Opioids CCB BB crack TCA
Three neuromuscular diseases that cause disordered control of breathing
- epilepsy
- Cerebral palsy
- brain injury
4 Types of shock
- Hypovolemic
- Distributive
- Cardiogenic
- Obstructive
Two kinds of hypovolemic shock
- non-hemorrhagic
- hemorrhagic
Three kinds of distributive shock
- septic
- anaphylactic
- neurogenic
5 conditions that can cause cardiogenic shock
- Bradyarrythmia or tachyarrhythmia
- CHD
- myocarditis
- cardiomyopathy
- poisoning
4 types of obstructive shock
- ductal-dependent
- tension pneumothorax
- cardiac tamponade
- PE
Shock resuscitation
- O2, maintain sat 94-99%
- ECG monitor
- IV/IO access
- BLS as needed
- Bedside glucose if needed
- Specific therapies based on cause of shock
Medications to admin during shock
- 20 ml/kg NS or LR iV bolus (5-20 min)
- if cardiomyopathy: 10 ml/kg
- if CCB/BB OD 5 ml/kg
Types of cardiac emergencies (rhythms)
- v-fib
- v-tach
- bradycardia
- supra ventricular tachycardia
- pulseless electrical activity
- asystole
Peds Glascow coma scale
Eye: same as adult
Verbal:
5: cries and babbles
4: irritable, cries
3: cries to pain
2: moans to pain
1: nothing
Motor:
6: moves spontaneously and purposefully
5: withdraws in response to touch
4-1 same as adult
