Emergency Flashcards
(25 cards)
What are the 5 components of alertness in ABC?
1) Tone
- should resist attempts to straighten their limbs
- abnormal: limp, rigid, atonic
2) Irritability
- no crying/cannot be stimulated to cry
3) Consolability
- cannot be consoled by usual caregivers or preferred toys
4) Look (gaze)
- vacant stare, lack of eye contact
5) Speech
- unable to express/cry
What are the 3 components of breathing in ABC?
1) Rate
2) Effort
3) Added sounds
What are the 4 components of colour in ABC?
1) Pallor
2) Mottling
3) Flushing
4) Cyanosed
What are the components of a primary survey?
1) Airway
2) Breathing
3) Circulation
4) Disability
5) Exposure
What are the components of the secondary survey?
1) Full set of vitals
2) SAMPLE Hx
- S/S
- Allergies
- Medications
- PMH
- Last oral intake
- Events
3) Head to toe exam including back
What are 3 forms of respiratory emergency?
1) Disordered breathing control
- eg. seizure
2) Upper airway obstruction
- AMT → poor upper airway tone
- ↑secretions
3) Inappropriate airway manoeuvres by bystanders
What are 6 steps of airway/breathing management?
1) Open airway
2) Remove secretions/foreign body
3) Oral airway if tolerated
4) Basic ventilatory support with BVM ventilation
5) O2
6) Consider advanced airway management
What are 5 reversible causes of seizures?
1) Hypo/Hyperglycaemia
2) Hypo/Hypernatraemia
3) Hypocalcaemia
4) Hypomagnesemia
5) Toxins/Withdrawal states
What are the clinical signs of dehydration?
1) Weight loss
2) AMT
3) Oliguria
4) Hypotensive, bradycardic, low pulse volume
5) Deep and rapid respiration
6) Cool skin with lack of skin tugor
7) Prolonged CRT
8) Dry eyes, mucosa and lack of tears
What is the goal of dehydration management?
Restore circulating volume
True or false: In any dehydration case, the first line treatment is to give a fluid flush then replace over time.
False:
Fluid flushes are only indicated if signs of impending circulatory collapse
- aim to replace loss (if severe: 10%) over 24-48hrs to avoid rapid shifts in serum osmolarity
What is the 1st line treatment of seizures?
Benzodiazepines
Why are children 1-4y/o more susceptible to accidental poisoning?
1) mobility, exploratory behaviour
2) Hyperactive, impulsive, pica-prone
True or false: The majority of household products are non or minimally toxic after typical accidental exposures. Hence, treatment is rarely required?
True
- VERY important to check the potential toxicity of all ingested products
- but generally self-resolving may cause GI upset
What are important components of a toxin ingestion history?
1) What toxin/medication
2) Time of exposure/ingestion
3) How much?
4) What other medications?
5) Accidental/intentional?
6) Symptoms
7) Home treatment
8) PMH/psychiatric Hx
What are the features of a hx suspicious of an occult poisoning?
1) Acute onset
2) 1-5years
3) Pica-prone behaviour
4) Environmental stressors
5) Multi-organ dysfunction
6) Altered sensorium
7) Puzzling clinical picture
What does a breath that smells like bitter almonds indicate?
Cyanide
What does a breath that smells fruity indicate?
Isopropanol
What does a breath that smells like wintergreen oil indicate?
Methyl salicylates
What does a breath that smells like rotten eggs indicate?
Sulphur dioxide
Hydrogen sulfide
What does a breath that smells like pears?
Chloral hydrate
What does a breath that smells like garlic?
Organophosphates
Arsenic
What does a breath that smells like mothballs?
Camphor
What are some red flags for non-accidental injury?
1) Vague, inconsistent, contradictory, inadequate or implausible story
2) History not in keeping with the child’s developmental abilities.
3) Delay in seeking medical attention.
4) Inappropriate parent or caregiver response.
5) The child is not immunized.
6) There is failure-to-thrive
7) Sexual behaviour beyond the child’s years and supposed knowledge.
8) Multiple injuries of various types and of different ages.
9) Injuries to specific areas – like bruises to padded areas
10) Genital injuries associated with a vague or inconsistent history.
11) Sexually transmitted disease in children
12) Subdural haematoma associated with bilateral retinal haemorrhages in an infant, suggestive of shaken baby syndrome
