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Neonate/OB Emergencies Flashcards

(46 cards)

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1
Q

What is TOF?

A

Tetralogy of Fallot Is the MOST common cyanotic heart defect and the most common cause of Blue Baby Syndrome

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2
Q

What are the four heart defects for TOF?

A

Pulmonary stenosis
- A narrowing of the pulmonary valve (valvular stenosis) or just below it (Infundibular stenosis)

Right Ventricular Hypertrophy
- increase in size of the ventricle while compensating for obstruction

Overriding Aorta
- An Aortic valve with biventricular connection to the left and right ventricles

Ventricular Septal Defect
- A hole between the bottom two ventricles

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3
Q

VEALS / CHOPE

A 
Variable Decel - Cord compression
Early Decel - Head compression by cervix
Accelerations - Ok~fetal well being
Late Decel - Placental~Uterus insufficient
Sinusoidal - Emergency C Section
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4
Q

What are signs of subtle seizures?

A
  • Repetitive mouth/tongue movement
  • Bicycling movement
  • Eye deviation
  • Staring
  • Apnea
  • Repetitive blinking
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5
Q

What is Prostaglandins E1?

A

It’s used during transport for neonates that depend on their Patent Ductus Arteriosus for pulmonary flow

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6
Q

Neonatal ET Tube size Estimates

A

Preterm = 3.0 or 2.5(if less than 28 weeks)
Full-term = 3.5
One year = (Age in years + 16) / 4

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7
Q

What is PPHN and what is the cause?

A

Persistent Pulmonary Hypertension

Right-to-Left shunt

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8
Q

What are the side effects for prostaglandins E1 (PGE1)?

A

-Apnea and Hyperventilation

  • Fever
  • Vasodilation
  • Diarrhea
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9
Q

What is Patent Ductus Arteriousus?

A

It is a vessel that connects the pulmonary artery to the aortic arch. It allows blood flow from the RV to bypass the lungs going into fetal circulation.

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10
Q

How do you accelerate PDA closure?

A

Administer Indomethacin or ibuprofen

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11
Q

How do you keep the PDA open?

A

Administer Prostaglandin E1

Administration can cause apnea

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12
Q

What are neonate defects?

A

Ventricular Septal Defect
-A hole between the two bottom chambers of the ventricles

Overriding Aorta
-An aortic valve with a Bi-ventricular connection to the left and right ventricles

Right Ventricular Hypertrophy
-Increase in size while compensating for obstruction

Pulmonary Stenosis
-Narrowing of the pulmonary valve or just below it

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13
Q

What is the Tetralogy of Fallot

A
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14
Q

What is the Urine Output for children?

A

Newborn - 1 year
2mL/kg/Hr

Toddlers
1.5mL/kg/Hr

Adolescent
1mL/kg/Hr

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15
Q

When should a Blood transfusion be initiated?

A

After 40 - 60ml/kg of fluids are given

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16
Q

What are the Symptoms and Antidotes for Ethylene Glycol Poisoning?
(Sweet Taste)

A
  • Intoxicated
  • Metabolic Acidosis
  • Cardiovascular Dysfunction
  • Acute Kidney Failure

ANTIDOTES

  • Ethanol
  • Fomepizol
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17
Q

What is Reye’s Syndrome

A

Aspirin overdose [Fatal]

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18
Q

Persistent Pulmonary Hypertension (PPHN)

A

It results in a Right-to-Left Shunt

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19
Q

For children younger than 10, where is the narrowest portion of the trachea?

Study These Flashcards
A

The cricoid process

20
Q

Steeple sign is a sign of?

Study These Flashcards
A

Tracheal narrowing /Croup

21
Q

What is a Diaphragmatic Hernia?

Study These Flashcards
A

When the pleuroperitoneal cavity fails to close

-Cause by early gestation

22
Q

What qualifies as Hypoglycemia?

Study These Flashcards
A

-A serum glucose less than 40

TREATMENT
2-4mL/kg of D10% BOLUS
80mL/kg/24hrs of 10% Dextrose

23
Q

Important details for pediatric Nasal Intubations

Study These Flashcards
A
  • Never perform on kids less than 12 years old

- The acute angle makes it difficult

24
Q

What is Kehr’s sign?

Study These Flashcards
A

Left shoulder pain due to diaphragmatic irritation from bleeding
(Indicates Splenic Rupture)

25
What is the Years to Weight (kg) formula?
(Age in years x 2) +8 = ____kg
26
What is the circulating blood volume for Newborns, Pediatrics, and Adults?
Newborns 80mL/kg Pediatric 70-80mL/kg Adult 60mL/kg
27
Who can get needle cric’s, and who can get surgical cric’s?
Needle Cric’s=Younger than 11 years old | Surgical Cric’s=Older than 11 years old
28
What is the best treatment for bronchiolitis?
Intubate and ventilate is best | *Steriods are not indicated*
29
Infants on room air with acute hypoxia indicates?
A fixed right to left shunt. Which means deoxygenated blood is mixing with oxygenated blood
30
Simultaneous ABG’s with a difference greater than 10mm for PO2 indicates?
A right to left shunt
31
Are Neonate’s nose breathers or mouth breathers?
Nose breathers | Suction the mouth first, then nose
32
What is dangerous about meconium and when deep suction indicated?
- Surfactant is an activated by meconium | - Only when the neonate is not vigorous Deep suction is indicated
33
What is the official weight and age for a preterm neonate?
Less than 5 lbs / less than 28 days from DOB
34
What are the top three killers in the first 24 hours
- sepsis - respiratory complications - cardiac problems
35
What is a common causes and treatment for neonatal sepsis?
- Most common cause is Group B Strep | - Treatment is Ampicillin + Gentamicin
36
 For every increase of 1° over 37° how much does your heart rate increase?
10 BPM
37
What is respiratory distress syndrome?
It is the number one killer of premature infants. It causes a surfactant deficiency. Consider giving surfactant (via ET tube) when transporting.
38
What is Persistent Pulmonary Hypertension (PPHN)?
”Right to Left Shunt” it is when a patient has pulmonary hypertension that causes hypoxia. * consider giving surfactant with 100% O2*
39
What is Omphalocele?
It’s when the abdominal wall is under developed, and the intestines protrude from the abdomen.
40
What is a Ventriculoperitoneal Shunt (VP)?
It is a drain for patients with increase CSF in congenital hydrocephalus (water on the brain)
41
Shaken baby syndrome causes what kind of injury?
Diffuse axonal injury (DAI)
42
What is the 2/3/4 Rule?
2 x ETT size = Suction/NG Foley diameter 3 x ETT size = insertion depth 4 x ETT size = Chest Tube size
43
What is Becks triad?
Muffled heart tones Hypovolemia JVD Narrowed Pulse Pressures
44
How low can your hemoglobin and hematocrit get before you need blood products?
Hemoglobin <6 | Hematocrit <30%
45
What are the symptoms for Diabetes Insipidus?
``` Polydipsia = Excessive Thirst Polyuria = Excessive urination Polyphasic = Excessive hunger ```
46
What is the treatment for Diabetes Insipidus?
- IV Fluids | - Vasopressin

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