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Flashcards in BRS Emergency Medicine Deck (121)
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MCC of cardiac arrest in a child is _______

lack of oxygen supply to the heart
heart disease is an uncommon cause in children

1

2 ways to open up the airway

head tilt method
jaw thrust method if suspect cspine injury

2

assess breathing with this method

look listen feel

3

where to assess pulse in infants vs. children

infants- brachial
children- carotid

4

compensated
decompensated
irreversible
*describe these forms of shock

compensated- normal BP and CO with adequate tissue perfusion, maldistributed blood flow to essential organs
decompensated- hypotension, low CO, inadequate tissue perfusion
irreversible- cell death, refractory to medical treatment

5

_____ is the MCC of shock in kids
it is commonly due to _____ or _____

hypovolemic
hemorrhage, dehydration

6

in hypovolemic shock, volume losses > _____ lead to decompensated shock

25%

7

2 phases of septic shock

1. hyperdynamic stage- bounding pulses, high CO, warm extremities, wide pulse pressure
2. decompensated stage- impaired mental status, cool extremities, diminished pulses

8

2 types of distributive shock

anaphylactic- acute angioedema of upper airway, bronchospasm, pulmonary edema, urticaria, hypotension

neurogenic- total loss of distal sympathetic cardiovascular tone with hypotension 2/2pooling of blood within the vascular bed

9

changes in ____ often occur before changes in BP in shock

HR- tachycardia occurs before hypotension

10

initial fluid management in shock

20 mL/kg bolus of NS or LR

11

give ______ for DIC

FFP

12

_____ are the leading cause of trauma in kids

MVA

13

special considerations in trauma in kids

-they have larger heads so head injuries are more common
-rib cage is more pliable so more energy is transmitted to lungs, liver, spleen
-growth plates are weak and are at the highest risk of injury (ligaments are stronger than the growth plate)

14

causes of PEA

cardiac tamponade
tension ptx
profound hypovolemia

15

in addition to primary and secondary survey, do these tests

EKG
urinary cathether
NG tube
CXR

16

seizures are common after head trauma... what do you do?

nothing... they are self limited

17

infants are at risk for bleeding in the ______ and ______ because of open fontanelles and cranial sutures

subgaleal and epidural

18

epidural hematoma is tearing of the ______
on CT, you see _______
tx by _______

middle meningeal artery
lenticular density
surgical drainage

19

subdural hematoma is due to tearing of ______
on CT, you see _______
how to tx

bridging veins
crescentic density
neurosurg consult and usually surgical drainage

20

intracerebral hematoma usually occurs on _____ (side/opposite side) of trauma

opposite side
contrecoup injury

21

______ is an early sign of herniation in children < 4 years of age

bradycardia

22

cushing's triad (late sign of herniation)

bradycardia
HTN
irregular breathing

23

how to manage increased ICP

mild hyperventilation
elevation of head
diuretics like mannitol
neurosurg consult

24

kids are prone to spinal cord injuries w/o radiographic abnormality

yep
SCIWORA

25

distended neck veins, decreased breath sounds, hyperresonance to percussion, displaced trachea, PEA, shock

tension pneumothorax
tx with needle decompression

26

occurs after injury to RUQ (esp bicycle handle bar)
-abdominal pain and vomiting
-bowel obstruction is found on radiographic evaluation

duodenal hematoma

27

lap belt injuries

chance fracture- flexion disruption of the lumbar spine
liver and spleen lacs
bowel perfs

28

_____ are the second MCC of accidental death in children
esp due to _____

burns
scalding injuries from hot liquids

29

classifying degree of burn

first degree- only the epidermis
-red, blanching, painful skin (ex. sunburn)

second degree (partial thickness)- epidermis and part of the dermis
-superficial partial thickness- entire epidermis and outer portion of dermis; moist, painful, red; blister but no scar
-deep partial thickness- entire epidermis and lower portion of the dermis; pale white; may blister and heal with scarring

third degree (full thickness)- epidermis, dermis, part of subcu tissue
-dry, white, leathery
-insensitive to pain b/c nerve endings are destroyed
-skin grafts are needed