Flashcards in ED Deck (15):
A child presents to ED with suspected DKA. What are first steps in management?
1. Get your labs (bmp, vbg, ua)
2. Start isotonic IVF ( NO K+) at 10 ml/kg run over 1 hour
3. After those fluids doe, IVF (NS + 20 KCL + 20 KPhos) to rehydrate maintenance + estimated fluid deficit evenly over next 48 hours
4. In second hour start continuous I sulking infusion 0.1 units/kg/hr
True or false. You cannot draw labs from an IO line
Most labs (BMP) can be drawn off an IO.
What is the differential diagnosis for a 4 day old who presents to the ED with altered mental status and looks like she is in shock?
What is the acronym?
T= trauma (NAT or accidental)
H= heart disease and hypovolemia
E= endocrine (CAH)
M= metabolic (electrolytes)
I= inborn errors of metabolism
F= formula mishaps
I= intestinal catastrophes (volvulus, nec, intususception)
T= toxins and poisons
What is the differential diagnosis for the child who presents with confusion and lethargy(AMS). What is the acronym?
A= alcohol, abuse of substances
E= epilepsy, encephalopathy, electrolyte issues, endocrine
I= insulin, intususception
O= overdose, oxygen deficiency
T= trauma. (NAT), temp abnormal, tumor
P= poisoning, psych conditions
S= shock, stroke, space occupying lesion (brain)
What are 3 things that can give you a heart rate over 200?
SVT. Look for limited variability in the heart rate
What's the differential diagnosis of a febrile seizure?
1. Infection (meningitis, shigella, roseola)
3. Toxic ingestion
What's the definition of a simple febrile seizure? What makes it complex?
Simple febrile sz
1. Generalized motor seizure
2. Short (< 10-15 min)
3. Does not recur in 24 hrs
4. Recurs within 24 hrs
What is the typical age group for febrile seizures?
6 months to 6 years
Risk factors for recurrence of febrile seizures?
1. Onset less than 1 year
2. Family hx of febrile seizures
3. Associated with low grade fever
4. Do not occur on the first day of illness
When should a CT head always be performed Ina suspected concussed pt?
1. Altered mental status/ GCS< 15
2. Signs of basilar skull fracture
Who with a concussion should undergo observation in ED? Wha else should you consider?
Also consider getting a head CT
Severe mechanism of injury
Severe or worsening headache
True or false: you can get the same cold more than once.
True. Depending on the virus. Some viruses have waning immunity so you can get the same one again. Others have lasting immunity but many serotypes.
How long does it take after inoculation with a cold virus to develop symptoms?
Name 2 evidenced based txs for the common cold.
1. Nasal rinses