Quiz 2: Peds, drowning, OD Flashcards
Abnormal tone, lower interactiveness, no consolability, abnormal look/gaze/speech/cry all describe which aspect of PAT?
Appearance
The PAT focuses on what three aspects of physical assessment?
- Appearance
- WOB
- Circulation to skin
Is PAT for rapid testing or step-wise testing?
Rapid
Younger children have higher ______ and lower _____.
Higher heart rate, lower blood pressure
T/F: Children have the same A&P as adults.
False
T/F: Children have a slow decline.
False, will compensate until they completely crash.
Is appearance associated with sensitivity or specificity?
Sensitivity
WOB and circulation is associated with sensitivity or specificity?
Specificity
What is the single most important factor in pediatric assessment?
Appearance
What reflects overall adequacy of perfusion?
Circulation to skin
What evaluates altered level of consciousness but is not very useful in assessments?
Disability
What reflects mild-moderate severity and is usually more useful in assessments?
Abnormal appearance
Steeple sign signifies:
Croup (LTB)
Thumbs-up sign signifies:
Epiglottitis
Which illness is an immediate emergency, croup or epiglottitis?
Epiglottitis
Is epiglottitis a bacterial or viral infection?
Bacterial
Is croup (LTB) a bacterial or viral infection?
Viral
Epiglottitis has a slow or fast onset?
Fast onset, typically hours
T/F: You should never give a child anything orally or use tongue depressor for any reason on children with epiglottitis.
True
What is the protocol used for pediatric codes?
PALS
Treatment for croup?
Dexamathasone (decadron)
Cool bland aerosol - mild
Racemic epi - moderate
tracheotomy/intubation - rare, severe
Which of the following are true regarding epiglottitis?
- Bacterial
- Fast onset
- No fever
- Quiet and drooling
- Not an emergency
1, 2, 4
Epiglottitis is associated with a HIGH FEVER and is ALWAYS an emergency!
Which of the following are true about croup?
- Bacterial
- Fast onset
- Mild fever
- Barking seal-like cough
- Not always an emergency
3, 4, 5
Croup is a VIRAL infection and has a SLOWER onset!
Pallor, mottling, and cyanosis are all associated with which aspect of PAT?
Circulation to skin
Abnormal sounds/position, see-saw respirations, retractions, nasal flaring, apnea, and gasping are all associated with which aspect of PAT?
Work of Breathing
Normal appearance + increased WOB =
Respiratory distress
Abnormal appearance + increased/decreased WOB =
Respiratory fatigue
Normal appearance + poor circulation =
Observe patient
Abnormal appearance + poor circulation =
Shock
Abnormal appearance + normal circulation + normal WOB =
Brain dysfunction
Is the pediatric primary survey a rapid or stepwise evaluation of cardiopulmonary & neurologic function?
Rapid, step-wise evaluation
What acronym is associated with the pediatric primary survey?
A - airway B - breathing C - circulation D - disability E - exposure
What is the age croup associated with croup?
6 mo - 6 yrs
T/F: Intubation is difficult and nearly impossible to perform on children with epiglottitis.
True
T/F: FBA can cause unilateral wheezing and stridor.
True
What findings would you see on a drowning CXR?
Air trapping, atelectasis
If a foreign body cannot be seen with a traditional X-ray, then inspiratory and expiratory phase films may show hyperinflation or air-trapping which suggests an aspirated foreign body.
What is the treatment for FBA?
Rigid bronchoscopy
ACT if necessary
Define cold shock cardiac reflexes.
Sudden immersion <25C water
Dry drowning is defined as:
Laryngospasm with glottic closure, prevents aspiration of large amounts of liquid.
Wet drowning is defined as:
When liquid is completely aspirated during drowning, leads to ARDS.
Freshwater and salt water can both lead to:
Pneumonitis and bronchospasm
T/F: Salt water worsens lung injury more than freshwater.
True. Salt water irritates alveolar surface more than fresh water and worsens injury.
What is fluvial water?
Slightly salty water rivers meet oceans. Contains pathogens and infects lungs.
How do diving accidents occur?
Ascending too quickly from depth
What are two other names for diving accidents?
Bends or decompression sickness
What three laws are associated with causes of decompression sickness?
Henry’s law, Boyle’s law and water pressure.
What is the primary treatment for decompression sickness?
Hyperbaric chamber
What is another use for hyperbaric chambers?
Wound healing, crush injuries, peripheral ischemia, CO POISONING!
CO has 200x affinity for Hbg than O2. Best treatment for CO is O2.
Benzo drugs are all -lams and -pams except:
Chloridiazepoxide.
What are toxidrones?
Group of signs & symptoms used as a basis for diagnosis of poisoning.
What is the treatment for opioid overdose?
Narcotic antagonist - Nalaxone (Narcan). Short acting.
What are benzodiazepines?
Common CNS depressent. Treatment is Romazicon (Flumazenil) which is a GABA receptor.
What are the 3 C’s associated with TCA overdose?
Convulsions, Coma, Cardiotoxicity.
What is the treatment for acetaminophen OD?
NAC infusion (mucomyst)
What is the acronym for the S/S of organophosphate poisonings?
D - diarrhea U - urination M - miosis B - bronchoconstriction B - bradycardia E - emsis L - lacrimation S - sweating/salvation
Normal Hb is ___% in healthy people.
<3%. Measured with hemoximetry.
What treatments are used for croup (LTB)?
- Cool bland aerosol - mild
- Racemic epi - moderate
- Intubation/tracheostomy - severe, uncommon
