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Flashcards in Infants & Children Deck (23):
1

common causes of most deaths

-Motor vehicle injuries
-falls
-poisoning
-assaults
-drowning

2

signs of shock in children

SBP lower than 70 with tahcycardia and cool skin is an indicator of shock in children

3

hypovolemic shock causes (2)

1. acute dehydration
2. acute blood/fluid loss

less common causes of shock:
vasodilation seen with sepsis, anaphylaxis and spinal cord shock
-tension pneumothorax
-cardiac tamponade

4

possible causes of cardiogenic shock (3)

† Previous congenital heart disease
† Acute infection of myocardium
† Severe contusion to heart

5

peds ABC primary assessment

appearance
breathing
circulation

6

secondary assessment

pt's history
-chief complaint
-SAMPLE
-assess breath sound 1st then circulation
-trunk to head approach
-check BP and cap refill children over 3

7

stiff neck indication of

- ndicates infection in brain or its coverings
(meningitis)
† Child may have meningitis without stiff
neck or bulging fontanel

8

Respiratory disorders

Respiratory disorders
Ø Upper airway
• Major upper airway diseases requiring
emergency attention:
† Croup
† Epiglottitis
† Choking
• Distinction must be made between infectious
causes and foreign body presence because
management will differ

9

Croup affect what body parts and produce what sound

Croup
• Viral infection affecting:
o Larynx
o Trachea
o Bronchi
• Causes airway narrowing:
• Produces stridor

10

S&S of croup

Signs & symptoms
† Hoarseness
† Low-grade fever
† Cough that sounds like a barking seal
† Varying degrees of inspiratory stridor
† Retractions with inspiratory effort
† Often worse at night or on awakening

11

Croup common among what age group?
-management

• Most common from age 6 mos to 3 yrs
• Effective management
† Humidification
† Hydration
† Oxygenation

12

Epiglottitis is?
caused by?
age group?
S& S (8)?

Epiglottitis
• Infectious swelling of epiglottis
† Caused by bacterial infection
• Rapid onset of 10 to 12 hrs
• Usually affects children ages 2 to 7 yrs
Major signs & symptoms
† High fever
† Sore throat
† Dysphagia (difficulty swallowing)
† Occasional inspiratory stridor
† Drooling
† Restlessness
† Flushed face
† Signs of dehydration
Potentially life threatening
• Stimulation of the pharynx with tongue blade
can cause reflex spasm
† Results in total airway obstruction

13

management of epiglottitis

Approach to management
o Use gentle and calm handling, staying away
from child’s airway
o Let child stay in parent’s arms
o Offer humidified O2; if child resists, do not
persist
o Hold mask near airway
o If cyanosis & lethargy evident – attempt PPV

14

lower airway diseases and management

Ø Lower airway
• Primary diseases
† Bronchiolitis
† Asthma
† Pneumonia
† Other infectious processes
† Small foreign objects
Management
† Reduce stress & exertion
† Administer humidified O2

15

Bronchiolitis

Lower airway
• Bronchiolitis
o Viral illness affecting infants – causing swelling
and mucus production in the lower and smaller
airways
o Follows upper respiratory tract infection
o Often occurs in winter

16

asthma

Lower airway
• Asthma
† Affects children and adults
† Causes bronchospasm with mucus &
edema production
† Patient can die when obstruction is severe
† Asthma can be triggered by different
conditions in different patients
† Be wary of child with AMS, becomes
lethargic and wants to lie down
† In some cases, ventilation cannot be
adequately accomplished without drugs to
relax that airway constriction

17

Pneumonia

Lower airway
• Pneumonia
† Often follows simple upper respiratory tract
infection
† Patient usually has complaint/history of
fever & cough
† Dehydration & signs of recent upper
respiratory infection may be present
† May cause abdominal pain because
irritation of the diaphragm may be
interpreted as abdominal
† Rales may be heard with/without wheezing
† Possible pleuritic pain

18

lower airway management for all

Ø For all pediatric patients with lower airway
disease, treatment is based on:
• Administration of humidified O2
• Reduction of exertion & emotional stress
• Keep in upright position or in a position of
comfort

19

evidence of inadequate oxygenation

† AMS
† Extreme weakness or sleepiness
† Dilated pupils
† Assess HR & pulse strength

20

febrile seizure

Febrile seizure
• Common during childhood
• Most are Brief (less than 5 min)
• Associated with fever and tonic-clonic
generalized convulsion

21

Complex febrile seizure

Complex febrile seizure
• More than 15 min duration
• Localized to part of the body
• Multiple episodes in 24 hrs
• 5% will present in status epilepticus
˜ Must evaluate every child with seizure to find
the underlying cause

22

Causes of seizures

Causes
• Infections
† Encephalitis
† Meningitis
† Roseola
† Shigellosis
Metabolic disorders
† Hypoglycemia
† Hypoxia
† Fever
† Hyponatremia
† Hypocalcemia
Toxic substances
† Lead
† Aminophylline
† Lidocaine
† Cocaine
† Nicotine
† Phenothiazine
† Drug withdrawal
• Structural problems
† Trauma
† Bleeding
† Mass lesion
† Scar in brain
• Idiopathic

23

Complications of seizures

Respiratory problems
† Lower respiratory drive
† Airway obstruction by the tongue
† Risk of aspiration during unconscious period
† Ineffective respiratory muscles during
seizure activity
† Contribute to low oxygenation and
retention of CO2
Metabolic problems
† Rise of body temperature from persistent
muscular activity
† Depletion of glycogen stores and blood
glucose
† Cell damage
• CNS affected from:
† Prolonged electrical activity of the brain
† Respiratory and metabolic problems