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ER 1 > Peds Emergencies > Flashcards

Peds Emergencies Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Define a pediatric patient by age

A

<18 yo

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2
Q

What are the three overarching etiologies that constitute ped emergencies?

A
  • Respiratory
  • Shock
  • Cardiac
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3
Q

4 types of respiratory emergencies

A
  1. Upper airway obstruction
  2. Lower airway obstruction
  3. Lung parenchyma diseases
  4. Disordered control of breathing
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4
Q

Respiratory Distress

- sx

A
  • 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
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5
Q

Respiratory Failure

- sx

A
  • 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)
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6
Q

General management respiratory distress

A
  • Airway (head tilt, chin lift)
  • Oxygen
  • pulse oximetry
  • IV/IO access
  • ECG monitor
  • BLS if needed
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7
Q

Three examples of upper airway obstruction

A
  • Croup/RSV
  • Anaphylaxis
  • Aspiration of foreign body
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8
Q

Tx for croup/RSV

A
  • nebulizer epinephrine (racemic epi)
  • Dexamethasone
  • Humidified air
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9
Q

Tx for anaphylaxis

A
  • IM epi
  • Albuterol
  • Antihistamines (diphenhydramine and ranitidine)
  • Methypredisolone
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10
Q

Where is an aspirated foreign body most likely to lodge in a kid

A

right main bronchi

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11
Q

Upper airway obstruction s/sx

A
  • 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
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12
Q

Two common causes of lower airway obstruction

A
  1. bronchiolotis/RSV

2. Asthma

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13
Q

Bronchiolitis/RSV

- tx

A
  • Nasal suctioning

- bronchodilator

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14
Q

Asthma

- tx

A
  • Albuterol w/ or w/o ipratropium (duoneb)
  • Corticosteroids
  • SQ epi
  • Mag sulfate
  • Terbutaline
  • Humidified air
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15
Q

Lower airway obstruction s/sx

A
  • 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
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16
Q

Two common causes of lung parenchymal disease

A
  1. Pneumonia/pneumonitis

2. Pulmonary edema

17
Q

Pneumonia/pneumonitis

- types

A
  • infectious
  • chemical
  • aspiration
18
Q

Pneumonia/pneumonitis

- tx

A
  • albuterol

- abx as needed

19
Q

Pulmonary edema

- two types

A
  • cardiac (CHF dt CHD)

- Non-cardiac (ARDS)

20
Q

Non-cardiac pulmonary edema treatment

A
  • noninvasive/invasive ventilator support with PEEP
  • vasoactive support
  • diuretic
21
Q

Lung parenchymal dz s/sx

A
  • 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
22
Q

Disordered control of breathing

- three common causes

A
  1. ICP
  2. Poisoning/OD
  3. Neuromuscular disease
23
Q

4 causes of ICP that cause disordered control of breathing

A
  1. trauma/abuse
  2. Meningitis/encephalitis
  3. tumor
  4. brain bleed
24
Q

Common causes of poisoning/OD that cause disordered control of breathing

A 
Opioids
CCB
BB
crack
TCA
25
Q

Three neuromuscular diseases that cause disordered control of breathing

A
  • epilepsy
  • Cerebral palsy
  • brain injury
26
Q

4 Types of shock

A
  1. Hypovolemic
  2. Distributive
  3. Cardiogenic
  4. Obstructive
27
Q

Two kinds of hypovolemic shock

A
  • non-hemorrhagic

- hemorrhagic

28
Q

Three kinds of distributive shock

A
  • septic
  • anaphylactic
  • neurogenic
29
Q

5 conditions that can cause cardiogenic shock

A
  • Bradyarrythmia or tachyarrhythmia
  • CHD
  • myocarditis
  • cardiomyopathy
  • poisoning
30
Q

4 types of obstructive shock

A
  • ductal-dependent
  • tension pneumothorax
  • cardiac tamponade
  • PE
31
Q

Shock resuscitation

A
  • O2, maintain sat 94-99%
  • ECG monitor
  • IV/IO access
  • BLS as needed
  • Bedside glucose if needed
  • Specific therapies based on cause of shock
32
Q

Medications to admin during shock

A
  • 20 ml/kg NS or LR iV bolus (5-20 min)
  • if cardiomyopathy: 10 ml/kg
  • if CCB/BB OD 5 ml/kg
33
Q

Types of cardiac emergencies (rhythms)

A
  • v-fib
  • v-tach
  • bradycardia
  • supra ventricular tachycardia
  • pulseless electrical activity
  • asystole
34
Q

Peds Glascow coma scale

A

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

ER 1 (18 decks)

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