Acute Care Flashcards
(39 cards)
Who is in the PICU? What are they at risk for?
• Intense close monitoring of critically ill or injured children.
• At risk for: – respiratory, neuro, CV failure – post-op – mechanical vent – multi-system organ failure – acute trauma
What is the role of a PT in the PICU?
– Positioning
– Mobility
– Stimulation
True of false: TBI is the most common cause of
traumatic death in children and adults
True
Shaken baby syndrome
most often in infants up to
one year, with infants aged two to four months being most at risk
What are the categories of a GCS for kids?
Eye opening
Verbal responses
Motor response
What are the ranges a kid could score on a GCS? Which is good?
Higher is better
15-3
True or False: Treating kids with TBI is, in some ways, easier because they’re attracted to all toys
FALSE you could really freak them out if you over stimulate them
What should be documented as a child progresses out of a coma?
– Generalized/specific responses
– Movement: purposeful, spontaneous, random
– Communication status: +/- following commands
– If the child is agitated, what
increases/decreases agitation?
What are some factors that affect final prognosis of a child with TBI?
Age, mechanism of injury, co-traumas/ insults, and extent of injuries
Very young and pre-school-aged children
have ________ mortality and long-term disability
outcomes.
Poorest
The GCS motor component is a better predictor of _____________ at 72 hours after injury
functional outcomes and future disability
What are 3 factors that may prevent a child from OOB clearance
- WB-ing status
- Neuro concerns
- Intracranial pressure
True or false: Mobility usually returns before cognition and
judgment
True
ORGAN TRANSPLANT?! Damn it, Jim. I’m a PT, not a general surgeon.
What can physical therapists do for patients?
- help children maintain optimal level of pre-operative function.
- Counteract the sequelae of post-operative immunosuppression
**star trek reference
Who are PTs more involved with, patients getting a heart or lung transplant?
Heart
True or false: PT is recommended before surgery in pulmonary lung transplant candidates
False: PT is contraindicated until after surgery in
pulmonary lung transplant candidates
PT should ALWAYS be able to view EKG
monitor and note stress changes such as:
- Circumoral cyanosis/other changes
- Diaphoresis
- Decreased verbalization
- Change in respiratory pattern
What is the goal of Pre-transplant PT?
To maintain optimal condition and function
as tolerated by child
Why is positioning important?
- Optimize respiration
- Facilitate symmetry
- Normalize tone
- Encourage behavioral organization
True or false: Don’t teach patient deep breathing, assisted coughing techniques until after surgery because it won’t be the same.
Teach patient deep breathing, assisted coughing techniques to increase post-op function and comfort after surgery.
What are you monitoring for with Aerobic Activity?
– Fatigue – Dizziness – SOB – Changes in mental status – Arrhythmias (increased HR/”pounding”) – 10% decrease in SaO2
PT interventions change with change in
status secondary to:
– New meds – Seizure activity – Fluid balance problems – Behavioral changes – Cardiac changes – Changes in coagulation times
OH NO! My patient’s central line broke! What do I do?
Clamp between the break and the child
OH NO! My patient’s central line is dislodged! What do I do?
Place child on their left side with head lower than feet
