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Peds > Peds week 8 > Flashcards

Peds week 8 Flashcards

1
Q

__ are leading

cause of death and disability in the pediatric population of the United States.

A

Injuries

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2
Q

__ is the most common cause of death from injury for victims of all ages

A

traumatic brain injury

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3
Q

Care of a child with TBI is focused on __

A

optimizing cerebral perfusion

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4
Q

Why avoid overzealous fluid resuscitation in the trauma patient?

A

may worsen bleeding
hemodilution
worsen cerebral edema
worsen pulmonary edema

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5
Q

epi dose for hypotension and cardiac arrest

A

1 mcg/kg for hypotension
10 mcg/kg for arrest

Hypotension is 1/10th of the problem compared to arrest

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6
Q

atropine dose for symptomatic bradycardia and max doses for children and adolescents

A

20 mcg/kg
max 1 mg for child
max 2 mg for adolescent

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7
Q

bicarb dose

A

1-2 meq/kg

Bicarb will raise your pH 1-2 points

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8
Q

calcium chloride via central line

A

10-20 mg/kg

1/3 of the gluconate dose

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9
Q

calcium gluconate via peripheral IV

A

30-60 mg/kg

3x the CaCl dose

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10
Q

adenosine dose

A

100mcg/kg first dose max 6 mg
200 mcg/kg second dose max 12 mg

For SVT going 100 bpm or 200 bpm

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11
Q

amiodarone for vfib and vtach

A

5 mg/kg , max 300 mg

We shocked the vfib 5x before it converted

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12
Q

magnesium for torsades

A

25-50 mg/kg max 2 gm

The amplitude of torsades varies from 25-50 millivolts

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13
Q

dopamine and dobutamine rates

A

1-20 mcg/kg/min

Same as usual

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14
Q

epi, isoproterenol, norepi, and phenylephrine rates

A

0.1-1 mcg/kg/min

They all have one “i” which looks like a “1” - max rate

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15
Q

milrinone

A

50-100 mcg/kg load
0.5-1 mcg/kg/min rate

You’re more bad ass than me if you actually remember this.

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16
Q

nipride and ntg rates

A

1-10 mcg/kg/min

Both nipride and nitro start where epi leaves off

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17
Q

prostaglandin e1 rate

A

0.05 mcg/kg/min

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18
Q

vasopressin rate

A
  1. 0001 - 0.0005 units/kg/min

1. 2345 move the 1 to the 5 spot

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19
Q

platelets should be

A

30,000 - 50,000 / mm3

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20
Q

refrigerate platelets??

A

NO NO NO

21
Q

rapid administration of FFP can cause

A

citrate toxicity

22
Q

what is in cryo?

A

factors 8 and 13, vWF, and fibrinogen

23
Q

PRBC’s dose

A

10-15 ml/kg increases hemoglobin 2-3 g/dl

If your hematocrit gets down around 10-15 you should probably give 2-3 units

24
Q

platelets dose

A

5-10 ml/kg increases platelet count 50k - 100k

Platelet count increases 10,000 per mil per kg

25
Q

FFP dose

A

10-15 ml/kg

Similar to PRBCs

26
Q

cryoprecipitate dose

A

1-2 units/kg

Consider giving some cryo every 1-2 units of blood

27
Q

EBV preterm

A

100

28
Q

EBV full term

A

90

29
Q

EBV under 1 year

A

80

30
Q

EBV 1 year to adult

A

70

31
Q

EBV obese

A

65

32
Q

calculate maximal allowable blood loss

A

hct - minimum allowed hct
times EBV
divided by hct

40-21= 19 x EBV 1000 ml = 19000 / 40 = 475 ml allowable blood loss

33
Q

calculate PRBC transfusion

A

desired HCT minus actual HCT
times EBV
divided by 60

35-23 = 12
x 800 = 9600
/ 60 = 160 mls of PRBC

34
Q

children with severe pulmonary dz, cyanotic heart dz, and preterm infants require a __ hct

A

greater

35
Q

what HCT is acceptable in healthy infants up to 3 mo of age if little potential for postop bleeding?

A

20-25%

20% for over 3 months

36
Q

if you have nada type O negative blood, could you transfuse type O positive into a male or postmenopausal female?

A

yes

37
Q

what two processes can occur as a result of disruption of the BBB due to trauma or hypoxia?

A

cerebral edema and neuronal hypoxia

38
Q

verbal modified GCS

A 
5 - coos, babbles
4 - crying
3 - screaming
2- grunt or moans to pain
1 - no response
39
Q

eye opening GCS

A

4 - spontaneous
3 - to shout
2 - to pain
1 - no response

40
Q

motor response GCS

A 
6 - spontaneous
5 - localizes to pain
4 - withdraws to pain
3 - decerebrate
2 - decorticate
1 - no response
41
Q

two stages of pediatric head trauma

A

primary insult - from mechanical forces at the time of impact
secondary insult - parenchymal damage caused by pathologic sequelae

42
Q

PaCO2 for head trauma

A

35-40, avoid hyperventilation

43
Q

good idea to do a nasal intubation or place an NG on someone with a skull fracture?

A

not unless you want to intubate their brain through their sphenoid bone

44
Q

what is the usual pathogenesis of a subdural hematoma?

A

rupture of veins between brain and dura, dura still attached to skull

45
Q

what is the usual pathogenesis of a epidural hematoma?

A

rupture of artery between skull and dura, the dura is peeled off the skull

46
Q

what are signs of an epidural hematoma, and what is the treatment

A

signs: LOC, hemiparesis, blown pupil
treatment: surgical evacuation

47
Q

what type of bleed results from shaken baby syndrome?

A

acute subdural that tears the veins

48
Q

bilateral retinal hemorrhage =

A

90% incidence of shaken baby syndrome

49
Q

children under __ are highest risk for abuse

A

3

Peds (8 decks)

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