Pediatrics and OB Emergencies Flashcards

1
Q

5 stages of development

A

Infancy, toddler, preschool, school age, adolescence

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2
Q

What age is infancy

A

0-1 year

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3
Q

what age are toddlers

A

1-3

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4
Q

What age are preschoolers

A

3-6

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5
Q

school age

A

6-12

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6
Q

adolescence

A

12-18 year

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7
Q

How do you do a physical assessment for kids under 6 years old?

A

Toe to head

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8
Q

How do you do a physical assessment for kids older than 6 years old?

A

Head to toe

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9
Q

Pediatric Assessment Triangle

A

Appearance (awake, aware, upright), Work of breathing (retraction, noises), Skin Circulation

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10
Q

What is the trend with kids vitals under 6?

A

Higher pulse, low blood pressure, higher respirations. Kids rely on cardiac output

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11
Q

Signs of respiratory distress in kids (5)

A

retraction of intercostal muscles (Ribs showing), Nasal Flaring, Grunting at end of breath, Tripod, Use of accessory muscles

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12
Q

Stages of decompensation (5)

A

Respiratory distress, hypoxia, bradycardia, cardiac arrest, cyanosis (late sign)

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13
Q

When do you begin CPR in Pediatrics?

A

HR <60bpm and signs of poor perfusion

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14
Q

What are signs of poor perfusion?

A

Poor cap refill, respiratory distress, cyanosis, ALOC

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15
Q

How fast should Cap refill occur?

A

<2 seconds

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16
Q

CPR rates 1 rescuer Pediatrics?

A

Neutral Sniffing Position, 30:2, BMV 1 Breath every 2-3 seconds. 1.5” or 1/3 depth of chest

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17
Q

CPR Rates 2 rescuer Pediatrics?

A

Neutral Sniffing Position, 15:2, BMV 1 Breath every 2-3 seconds. 1.5” or 1/3 depth of chest

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18
Q

What is Pediatric age for AED

A

1-8 years old

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19
Q

What is Pediatric age for CPR?

A

1-puberty

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20
Q

Modified CPR?

A

Visualize airway before ventilate

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21
Q

How to treat a baby choking?

A

5-5- visual. 5 back blows, 5 compressions, visualize airway

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22
Q

How to use an OPA on ped.

A

Measure, drop straight in

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23
Q

Contraindication for NPA in kids

A

infants (<1 year old)

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24
Q

Status Asthmaticus

A

Asthma unresolved by Albuterol

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25
Q

Key information for dehydration in kids

A

How often changing diapers (6-10 is normal), Fluid intake, Weight, Activity level, Check turgor on belly. ALS needed

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26
Q

Mild Symptoms of Dehydration (3)

A

Dry lips/gums, decreased saliva output, decrease diaper changes

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27
Q

Moderate Symptoms Dehydration (5) think “s”

A

Same as mild but include sunken eyes, sleepiness, irritability, loose skin, sunken fontanelle

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28
Q

Dehydration Severe Symptoms (3)

A

Signs of metabolic hypovolemic shock, Delayed cap refill, tachypnea (fast breathing)

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29
Q

What kind of seizure to kids experience with seizure?

A

Febrile

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30
Q

Meningitis symptoms in kids (5)

A

Nuchal Rigidity, photophobia, increase irritability, bulging fontanelle without crying (ALOC), rash (Serious sign)

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31
Q

Signs of poison

A

Vomiting with no signs of infection, unsupervised for any time

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32
Q

Tx of poison

A

Activated charcoal 12.5-25g

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33
Q

Contraindication for charcoal

A

No patent airway. Ingestion of alkali, acid, or petrol

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34
Q

What to worry about in cases of drowing?

A

C Spine injuries

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35
Q

Contraindication for C collar in Pediatrics?

A

Infancy

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36
Q

When immobilizing spine in infants, what is important?

A

Allowing arms and legs to move. Kids will move whole body if they can’t move arms and legs

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37
Q

Triage “Jump Start” (Kids) labels

A

Green, yellow, red, black

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38
Q

Green tag (Triage)

A

Ambulatory, no life threats. Give command for anyone that can hear you to go to a designated spot

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39
Q

Yellow Tag (Triage) Delayed Treatment

A

Breathing on own 15-45 bpm, Palpable peripheral pulse (infants brachial, others radial), Appropriate response to verbal/painful stimuli

40
Q

Red (Triage) Immediate treatment

A

Respirations less than 15 or more than 45, apneic (BMV 5 breaths and reassess

40
Q

Red Tag (Triage) Immediate treatment

A

Respirations less than 15 or more than 45, apneic (BMV 5 breaths and reassess, black tag if no breath), breathing without pulse, ALOC or inappropriate pain response

41
Q

Black Tag (Triage) Dead

A

Apneaic without pulse or unresponsive to rescue breathing

42
Q

Key information to identify if injuries are abuse

A

Is the injury appropriate?
Is it consistent with story?
Is the caregiver acting appropriately?
Is the child acting appropriately?
Is there evidence of drug/alcohol abuse?
Was there a delay in seeking care?
Are their multiple injuries of different healing stages?
Is there a glove burn? (dipped in hot liquid)
Unexplained LOC, No MOI/NOI, Shaken Baby syndrome
Are weight and hygiene appropriate?

43
Q

Signs of baby shaken syndrome

A

Bulging fontanelle, no illness/trauma, unconscious

44
Q

SUID

A

Sudden unexplained infant death

45
Q

signs of SUID

A

2-4 months old, Health with no home hazards such as poor sleeping arrangements that could cause suffocation

46
Q

Contraindication for CPR in infants

A

Blood tinged fluid from nose/mouth, petechial rash, rigor mortis, dependent lividity

47
Q

ALTE

A

Apparent life threatening event

48
Q

Signs of ALTE

A

cyanosis, apnea, choking, responds to physical stimuli.

49
Q

Treatment of ALTE

A

Load and go to hospital, airway management

50
Q

Umbilical vein function

A

Carries oxygen and nutrient rich blood to fetus

51
Q

Umbilical Artery function

A

Carries oxygen poor blood to placenta

52
Q

What vital changes happen during pregnancy

A

HR and Respiratory rate increase

53
Q

Pre-Eclampsia

A

HTN induced by pregnancy. Headache, vision disturbance, anxiety, edema (30th week)

54
Q

Eclampsia

A

Seizures induced by HTN

55
Q

Compression of inferior vena cava in pregnant women while in supine position

A

Supine Hypotension syndrome.

56
Q

Treatment of Supine Hypotension syndrome

A

left lateral position

57
Q

Gestational diabetes and complications

A

Diabetes induced by pregnancy, causes baby to be large due to excess glucose

58
Q

Patient has history of PID, unilateral pain in Lower quadrants

A

Ectopic pregnancy

59
Q

Placenta abrupto signs and causes

A

Premature tearing of placenta from uterus. lots of pain but little bleeding. Usually due to trauma

60
Q

Placenta Provia signs and cause

A

placenta develops over cervix. Lots of bleeding but little to no pain

61
Q

Patient is experiencing regular contractions. What stage?

A

stage 1. Until full dialation

62
Q

Patient is at full dilation to birth. What stage?

A

Stage 2

63
Q

Patient has delivered baby. What Stage?

A

Stage 3

64
Q

Imminent signs of delivery (4)

A

Urge to push, crowning, bulging at perineum, contractions 2-3 minutes apart

65
Q

Key questions for patient delivering baby.

A
  1. Expected due date/last menstrual period 2. Gravida (How many times pregnant) 3. Para (How many births and type) 4. Rupture of amniotic fluid, color/smell 5. Pre natal care/important information 6. complications such as diabetes or pre-eclampsia 7. drug/alcohol use 8. multiple births
66
Q

Para

A

How many births and the type of birth (Natural, C section, miscarriage/abortion)

67
Q

Gravida

A

How many pregnancies?

68
Q

Meconium

A

Fecal matter from baby in womb due to fetal distress

69
Q

What kind of clean must OB kit be?

A

Sterile

70
Q

When using the OB kit what kind of clean should it be?

A

Medically clean

71
Q

Medically Clean

A

Sterile equipment with non sterile BSI

72
Q

What to look for while delivering a baby?

A

Nuchal Cord, meconium

73
Q

How to treat nuchal chord

A

finger under cord and over babies head or Clamp, clamp, cut (check for pulse before cut)

74
Q

How level to keep baby at after birth

A

level with mothers pelvis left lateral trendenberg

75
Q

APGAR

A

Appearance, pulse, grimace/irritability, Activity, respirations

76
Q

Appearance Score and observations (APGAR)

A

2 all pink 1 peripheral cyanosis 0 cyanosis all over

77
Q

Pulse Score and observations (APGAR)

A

2 >100 1<100 0 no pulse

78
Q

Grimace/Irritability Score and Observation (APGAR)

A
  1. Cries/tries to move away from stimuli 1. weak cry doesn’t pull away from stimuli 0. no response
79
Q

Activity (APGAR)

A
  1. Resists gentle leg straightening 1 weak response 0 no response/limp
80
Q

Respirations (APGAR)

A
  1. 40-60 1. <40 0. none
81
Q

DOT umbilical cord clamping regulations

A

1-2” from baby second clamp 2” past that

82
Q

LA umbilical cord clamping regulations

A

4-6” from baby second clamp 2” past that

83
Q

When should placenta be delivered?

A

Within 30 minutes after delivery. Code 3 if not delivered

84
Q

signs of placenta delivery (3)

A
  1. urge to push 2. lengthening of umbilical cord 3. Gush of blood
85
Q

What massage after delivery of placenta?

A

Fundal Massage

86
Q

Breech delivery

A

Legs first, we can deliver this type. Make V with hand to make airway for baby if head gets stuck

87
Q

Limb Presentation

A

one foot out. We cannot deliver. Transport immediately. Cover foot with warm sterile dressing

88
Q

Prolapse Cord

A

Cord comes out before baby.

89
Q

How can we intervene during a prolapse cord?

A

Use fingers to move baby’s head anterior or posterior to relief pressure on cord

90
Q

NeoNatal has a heart rate <100, central cyanosis, but adequate respirations. How do you treat?

A

Blow by o2 using an NRB

91
Q

NeoNatal has gasping or inadequate breath. How do you treat?

A

BMV with room air for 30 seconds. Reassess

91
Q

NeoNatal has gasping or inadequate breath. How do you treat?

A

BMV room air 1 breath per second

92
Q

NeoNatal has an heart rate 60-100 and central cyanosis. How do you treat?

A

BMV room air 90 seconds

93
Q

CPR ratio for Neonate

A

3:1

94
Q

Compression depth for neonate

A

1/2”-3/4”

95
Q
A