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PAR3032 - Special Populations > Week 9 > Flashcards

Week 9 Flashcards

1
Q

what are the components of the AV paediatric assessment triangle.

A

Appearance
Work of breathing
Circulation to the skin

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2
Q

what are the elements to the appearance arm of the paed assessment triangle

A
  • tone
  • interactiveness
  • consolability
  • look/gaze
  • speech/cry
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3
Q

what are the elements to the work of breathing arm of the paed assessment triangle

A
  • abnormal breath sounds
  • abnormal positioning
  • retractions
  • nasal flaring
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4
Q

what are the elements to the circulation to the skin arm of the paed assessment triangle

A
  • pallor
  • mottling
  • cyanosis
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5
Q

what are the reasons of the injury patterns seen in paeds?

A
  • multi-trauma more common
  • anatomy closer together
  • less body mass
  • bones still flexible
  • less muscle, less subcutaneous tissue`
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6
Q

whats the most common abdominal injury in paeds?

A

spleen (39%)
liver (37%)

  • lose a lot of blood
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7
Q

what are the rules to exlcude intraabdo injury in paeds?

A
  • no evidence of abdo wall trauma or seat belt sign
  • GCS less than 14
  • no abdo tenderness
  • no evidence of thoracic wall trauma
  • no complaints of abdo pain
  • no decreased breaths sounds
  • no vomitting
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8
Q

What is reponsible for 30-40% of traumatic death?

A

Exsanguination

  • haem control
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9
Q

What are early signs of haemorrhagic shock in paeds?

A
  • cool and pale extremities
  • weak peripheral pulses and poor capillary refill
  • mottled skin
  • ACS
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10
Q

What should you consider with paeds and haemorrhage?

A

Children compensate well then deteriorate rapidly

- drop in blood pressure is a very late sign

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11
Q

what is a greenstick fracture?

A

bone bends instead of breaks

immature bone more flexible and thicker periosteum

  • often mistaken for sprains
  • more common in kids less than 10
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12
Q

what is the key difference bween a child and adults bone?

A

childs bone has physis (growth plate)

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13
Q

What is a type 2 physeal (growth plate) fracture?

A
  • type 2 most common

- transverse fracture through growth plate and a verticle fracture through the metaphysics

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14
Q

what is a key consideration for a physeal injuries?

A

can heal very quickly, in a good or bad position.

  • should be reduced within 24 hours
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15
Q

What are complications of physeal injuries?

A

Majority heal quickly and recover fully.

  • it can however cause growth disturbance or arrest growth
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16
Q

What can cause physeal growth disturbances?

A
  • avascular necrosis
  • direct crushing
  • the formation of a bny bar
  • non-union
  • hyperaemia
17
Q

what is the number one cause of single body system death?

A

TBI

18
Q

why are kids more likely to have TBIs?

A
  • large head to body ratio
  • skull bones thinner
  • less myelinated brain tissue
  • more susceptible to secondary injury (hypoxia/hypovolaemia)
19
Q

When should TBI be considered with paeds?

A
  • suspicion of mechanism of injury
  • LOC
  • multiple episodes of emesis
  • needs airway management
  • extracranial injuries
20
Q

What do we want to know with neuro-trauma in a paed?

A
  • time and mechanism of injury
  • circumstances of injury
  • LOC? and duration
  • nausea and vomiting
  • clinical course prior to consultation (stable/deteriorating/improving)
  • other injuries sustained
  • past history of bleeding tendency
  • presence of amnesia
  • post injury seizure
  • presence of headache
21
Q

When is neuro imaging required with neuro-trauma in paed?

A
  • any sign of basal skull fracture
  • focal neurological deficit
  • suspicion of open or depressed skull fracture
  • any GCS ubnder 8
  • GCS persistently under 13
  • suspected non-accidental injury
  • seizures after impact
22
Q

What are the signs of severe head trauma in paeds?

A
  • GCS less than 8
  • presence of focal neurological signs
  • signs of intracranial haemorrhage
  • signs of basal skull fracture
23
Q

When should you consider intubation of a paed with head trauma?

A
  • child unresponsive to pain or not responding purposefully
  • GCS less than 8
  • Loss of protective laryngeal reflexes
  • respiratory irregularity or suspected hypoventilation
24
Q

How many paed with spinal cord injury will have a TBI?

A

50%

25
Q

What is the most common cause of SCI in paeds?

A

MVA

- sport second most

26
Q

are burns more likely in males of female paeds?

A

boyssss cos they drop mad fire

27
Q

what are the most common burns in paed?

A
  • scalds - 57%

- contact secondmost

28
Q

What is the jacksons burn model?

A
  • zone of coagulation (irreversible)
  • zone of ischaemia/zone of necrosis (potentially viable)
  • zone of hyperaemia (fully revesible)
29
Q

what are the three elements determining burn severity?

A
  • temp
  • duraction
  • effected % of body surface area
30
Q

What are signs of inhalation burns?

A
  • soot in mouth
  • carbonaceous sputum
  • single facial hair
  • hoarse voice
  • cough
  • stridor
31
Q

how can burns impact breathing?

A
  • circumfrential burns can cause restriction of chest and trunk
  • smaller size of paed increased chance of burning large areas
32
Q

how can burns impact circulation?

A
  • hypovolaemia post post burn is a late sign
33
Q

What are signs of non-accidental burns?

A
  • glove and stocking scalds
  • artefact shape of burn
  • absence of splash marks
  • inconsistent history
  • delay in presentation
  • signs of other injuries
  • repeated presentation
  • witness to event not at ED
34
Q

what is the leading cause of accidental paed death worldwide?

A

drowning

  • highest in under 5’s
35
Q

what are the key principles of drowning management?

A
  • maintain adequate oxygenation
  • prevent aspiration
  • stablise body temperature
36
Q

what do we do for hypothermia?

A

if temp less than 34

  • warmed IV fluids
  • Humidified o2
  • forced air warming blankets
37
Q

what is a non-accidental injuriy?

A

physical force by a childs caregiver that result, or have potential to result in physical harm

38
Q

what are the types of child abuse?

A
  • neglect
  • physical
  • emotional (most common)
  • sexual

PAR3032 - Special Populations (13 decks)

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