Peds - Presentation Flashcards
What is the age range for a neonate?
0-28 days
Neonates are particularly susceptible to various health issues due to their immature physiology.
What are the vital sign ranges for infants (1 month - 1 year) in terms of breaths per minute?
30-53
Infants have the highest respiratory rates among the pediatric age groups.
List the age groups in pediatrics according to Stollery Children’s Hospital.
- Neonate (0-28 days)
- Infant (1 month - 1 year)
- Toddler (1-2 years)
- Preschooler (3-5 years)
- School Aged (6-10 years)
- Adolescent (11-18 years)
Each age group has distinct developmental characteristics.
What is a key characteristic of toddlers (1-2 years)?
Assert independence, resist logic
They learn by trial and error and imitation.
What is the primary focus of the Pediatric Assessment Triangle?
To quickly establish type of physiological problem and urgency for treatment
This assessment is done within the first few seconds of encountering the child.
Fill in the blank: The first sign of distress in a child is often _______.
tachypnea
What are signs of increased respiratory effort in children?
- Nasal Flaring
- Head Bobbing
- Seesaw Respirations
- Retractions
These signs indicate respiratory distress and varying levels of obstruction.
What is the breathing rate for school-aged children (6-10 years)?
18-25
School-aged children have a lower respiratory rate compared to infants and toddlers.
What is the significance of the ‘good tone’ in babies?
Indicates normal muscle tone and interaction with surroundings
Babies should demonstrate good tone and be responsive to stimuli.
What does grunting in infants signify?
A sign of lung tissue disease or respiratory distress
Grunting occurs during expiration and indicates the infant is trying to maintain positive pressure in the alveoli.
What is the breathing rate for adolescents (11-18 years)?
12-20
Adolescents have the lowest respiratory rate among the pediatric age groups.
What are the signs of deterioration in neuro function?
- Confusion
- Irritability
- Lethargy
- Agitation
- Loss of tone
- Seizures
- Pupil dilation
These signs indicate a need for immediate medical attention.
What is a common characteristic of school-aged children (6-10 years)?
Development of deductive reasoning
They start to understand complex concepts and have a better ability to articulate their thoughts.
What are common airway sounds associated with respiratory distress?
- Stridor
- Snoring
- Grunting
- Wheezing
- Crackles
These sounds can indicate the location and severity of the airway obstruction.
Pediatric Assessment Triangle
Apperance
Perfusion/Circulation to Skin
WOB
This method focuses on appearance, breathing, and circulation.
What should be done for a child with a suspected foreign body airway obstruction?
Relief Techniques
Techniques vary based on the age and size of the child.
What are signs of probable respiratory failure?
1.Very rapid or inadequate respiratory rate
2.significant inadequate or absent respiratory effort
3. absent distal air movement,
4.bradycardia
5. hypoxemia despite O2
6. decreased LOC
7.cyanosis
Signs indicate critical respiratory distress and require immediate medical attention.
What is the heart rate range for a neonate?
100-205 beats per minute
This range is crucial for assessing cardiac health in neonates.
What is the normal systolic blood pressure formula for children?
Normal Systolic BP = 90 + (age of pt x 2)
This formula helps to estimate normal blood pressure based on age.
What are the central pulses to assess in children?
Carotid, Brachial, Femoral
Central pulses are used to evaluate circulation status.
What is the pediatric compression-ventilation ratio without an advanced airway?
15:2
This ratio is important for performing CPR on children.
What are common causes of upper airway obstruction in children?
- Infection/swelling of the airway
- Foreign body airway obstruction
- Mass
- Congenital airway abnormalities
- Hospital acquired (ex: subglottic stenosis from previous intubation)
These causes can significantly impact a child’s breathing and require prompt intervention.
What are the symptoms of croup?
- Barking cough
- Stridor
- Hoarseness
- Increased work of breathing
- Fever (often)
Croup is typically viral and affects children aged 6 months to 3 years.
What are the three severity levels of croup?
- Mild: occasional barking cough, absent/mild retractions
- Moderate: frequent barking cough, audible stridor at rest
- Severe: frequent barking cough, marked retractions, agitation
Severity affects treatment approach and urgency.
What is the first-line treatment for pediatric anaphylaxis?
Immediate and concurrent IM Epinephrine
Epinephrine should be administered without delay in cases of anaphylaxis.
What is the typical response to a child with a foreign body airway obstruction who cannot make sounds?
Perform back slaps and chest thrusts for <1 year; Heimlich maneuver for >1 year
Correct intervention is critical to preventing respiratory failure.
What is the significance of assessing skin color and temperature in pediatric patients?
It helps evaluate peripheral versus central perfusion
Skin assessments can provide insights into circulatory status.
Fill in the blank: The heart rate for infants ranges from _______ beats per minute.
100-180
This range is critical for assessing infant cardiac health.
What are the signs of lower airway obstruction?
- Wheezing
- Cough
- Prolonged expiratory phase
- Tachypnea
- Possible decreased air entry on auscultation
Lower airway obstruction is often associated with conditions such as bronchiolitis and asthma.
What is bronchiolitis?
A viral infection causing inflammation of bronchioles, mucosal edema, increased mucous secretion, and impaired mucous clearance
Most commonly appears in infants <2 years old; symptoms last 5-7 days.
What is the pre-hospital management for bronchiolitis?
- ABC’s
- O2
- Do not let them eat/drink
- Oral/Nasal suctioning as needed
- Ventolin (if wheeze present)
Pre-hospital management is crucial to stabilize the patient before reaching the hospital.
What is pediatric asthma?
A chronic inflammatory disease characterized by recurrent episodes of expiratory airflow obstruction due to airway swelling, bronchospasm, and increased mucous production
Triggers include allergens, air pollution, and viral respiratory infections.
What are the focused asthma history questions?
- Previous ICU admission?
- Previous intubation?
- Any hospitalizations or ED visits for asthma in the last year?
- Using >1 canister of Ventolin per month?
These questions help identify triggers for exacerbation severity and risk factors for ICU admissions.
What are the indicators of asthma severity?
- SpO2
- Use of accessory muscles
- Air entry to both lungs
- Presence of wheezing
- Nasal flaring
- Reduced level of activity
- Decreased level of alertness
These indicators help assess the functional severity of airway obstruction.
What characterizes mild asthma severity?
- Can lie down flat
- Speak in full sentences
- May have tachypnea
- WOB mild
- Wheeze moderate
- SpO2 >95%
Mild asthma can often be managed with minimal intervention.
What characterizes severe asthma severity?
- Breathless at rest
- Hunched forward/tripoding
- Speak in single words
- Agitated
- Tachypnic
- WOB severe
- Wheezing loud
- SpO2 <90%
Severe asthma requires immediate medical intervention.
What is the pre-hospital management for asthma?
- ABC’s
- O2
- Administration of bronchodilators (Ventolin and Atrovent)
Essential for stabilizing the patient before hospital management.
What are common causes of pediatric seizures?
- CNS infection (meningitis, encephalitis)
- Ischemia
- Metabolic issues (hypo/hyperglycemia)
- Traumatic injury
- Drug related issues
- Prolonged febrile seizure
Identifying the cause is crucial for effective management.
What are pediatric febrile seizures?
Seizures that commonly occur in children 1-5 years of age, often outgrown by age 5
Increased likelihood exists if there is a family history or prior febrile seizures.
What is Waddell’s Triad?
- Femur fracture
- Intra-thoracic or intra-abdominal injury
- Head injury
This triad is commonly seen in pediatric pedestrian patients after blunt force trauma.
What are the most common mechanisms of burn injury for ages 5 years and older?
- Fire/Flames
- Scald injuries
- Contact with hot objects
Scalds are the most common mechanism in young children.
What is the pediatric management for traumatic brain injury (TBI)?
- ABC’s
- IV access
- Detailed Neuro Assessment
- Hypertonic Saline/Mannitol
- Imaging
- Neurosurgery
Avoid hypotension, hypoxia, and other factors that may worsen the injury.
What are the vital signs for a 4-year-old male after a seizure?
- HR: 72
- BP: 100/64
- RR: 12
- SpO2: 88% RA
- Temp: 38.6
- Wt: 15kg
These vitals are critical for assessing the child’s immediate health status.
What is Non-Accidental Trauma?
Recognition of child maltreatment that requires careful assessment.
Which age group is most vulnerable to Non-Accidental Trauma?
Younger children, but it applies to all age groups, genders, and demographics.
List some signs of Traumatic Brain Injury.
- History of poor feeding
- Vomiting
- Lethargy
- Irritability
- Respiratory depression/apnea
- Altered LOC/coma
- Seizures
- Abnormal posturing
- Hypotonia
- Full fontanelles
What type of fractures indicate Non-Accidental Trauma?
- Bruising or fractures of upper extremities and ribs
- Skull fractures
- Rib/scapula fractures
- Bilateral, symmetrical fractures
What are characteristics of accidental burns?
- Asymmetrical
- Splash marks
- If contact burn, not uniform
What is BRUE?
Brief Resolved Unexplained Event with changes in color, breathing, tone, or altered LOC.
What are the signs of BRUE?
- Change of color
- Change of breathing
- Change of tone
- Altered LOC/responsiveness
What are some risk factors for SIDS?
- Unsafe sleep environments
- Exposure to tobacco smoke
- Bed sharing
- Overheating
- Sleeping on side or stomach
What is Pediatric Diabetic Ketoacidosis (DKA)?
A condition often seen in Type 1 Diabetes characterized by insulin deficiency.
What are common symptoms of Pediatric DKA?
- Generalized abdominal pain
- Vomiting
- Polyuria
- Fatigue
- Headaches
- Excessive thirst
What are signs of shock in a child?
- Tachycardia
- Decreased capillary refill
- Hypotension (late finding)
How do you treat DKA in pediatrics?
- Manage IV fluids judiciously
- Avoid insulin bolus
- Bicarbonate not indicated outside of arrest situations
Typical growth rate within first year of child?
Double by 6 months
Triple by 1 year
Name the 5 areas of the chest that could shows signs of repiratory distress in peds?
- Supraclavicular
- Suprasternal
- Intercostal
- Substernal
- Subcostal
What are compressions with peds with an advanced airway in place?
Continuous compressions at rate 100-120/min
1 breath every 6 seconds (10 breaths/min)
Depth of compressions peds?
- Adolescents/Adults - 2 hands, 5cm/2in
-Children - 1 or 2 hands, ⅓ chest diameter or 5cm/2in
-Infants - 2 fingers or hands encircling chest, 4cm/1.5in
