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Pediatric Emergencies Flashcards

(49 cards)

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1
Q

Colostomy

A

surgical opening through abdominal wall

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2
Q

Fistula

A

surgical connection between artery and vein for dialysis

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3
Q

Mottling (mottled)

A

Abnormal skin color due to vasoconstriction and poor circulation.

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4
Q

Petechiae

A

small, purple spots on skin

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5
Q

Stoma

A

Surgical opening into trachea

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6
Q

Airway / Respiration

A

Proportionally large tongue, little room for swelling.
Lower airway smaller and more easily obstructed.
Larynx higher (more easily compressed)
Newborns/infants are nose breathers and distress can happen if obstructed.
Bradypnea (sign of impending respiratory arrest)

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7
Q

Head

A

Proportionally larger head – significant heat loss source.
Increased risk of head trauma.
Fontanelles: sunken (dehydration) / bulging (increased intercranial pressure)
REQUIRE greater cerebral blood flow as hypoxia can develop RAPIDLY.

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8
Q

Chest / Abdomen

A

Ribs more pliable (greater risk internal injury BUT lesser risk rib fracture)
Lower tidal volume (higher risk of hyperventilation)
Often abdominal breathers, underdeveloped intercoastal muscles.
Abdominal organs more anterior / exposed.

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9
Q

Cardiovascular

A

Bradycardia – sign of hypoxia unless proven otherwise.
Hypotension – does not develop until severely hypovolemic.
(COMPENSATE longer and crash suddenly)

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10
Q

Metabolic

A

Use glucose and oxygen faster.

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11
Q

Skin (Integumentary System)

A

Greater surface area to body mass.
(Increased risk of hypothermia)
Skin thinner, less fat insulation.
Immature thermoregulation.
Different rules of 9.
- Head: 18
- Arms: 18
- Body: 36
- Legs: 27
- Groin: 1

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12
Q

911 Calls

A

More often respiratory problems.
Airway obstruction, respiratory/cardiac arrest (resulting), shock, inhalation injury

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13
Q

Treatment

A

Partial: encourage coughing, provide oxygen, and transport.
Complete:
Sniffing position: place towel under shoulders. (opens airway)
If conscious back blows for infants and abb thrusts for children.
If unconscious CPR.
Suction nasopharynx for 5 to 10 seconds at a time.

Broselow tape – determines correct size and dose for meds.

NPA:
- Conscious typically.
- Not for those with head trauma.

Oxygen:
- Non Rebreather at 10-15 Lpm
- Blow by at 5 -10 Lpm
- Nasal Cannula 1-6 Lpm
- BVM 15 Lpm (Every 2-3 seconds)

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14
Q

Nervous System

A

Brain not protected from concussion.
Weight of occiput increases momentum in fall.
Brain requires GREATER blood flow, oxygen, AND glucose.
Spinal injuries LESS common.

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15
Q

Gastrointestinal System

A

Larger abdominal organs in proportion to body.
Vague / non-specific pain.

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16
Q

Musculoskeletal System

A

Growth plates OPEN. (softer, more flexible)
— Injury can cause abnormal growth.

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17
Q

Scene Size Up

A

PPE/BSI: Prepare pediatric equipment.
Note age and sex.

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18
Q

Pediatric Assessment Triangle (15-30 seconds)

A

APPEARANCE – for mental status
(TICLES)
Tone.
Interactive (alert / reactive)
Consolable
Looking Around
Speech (cry in infants)

BREATHING Work
Head bobbing.
Tugging.
Nasal flare.
Audible sounds.

CIRCULATION (can help identify shock)
Skin color
-Pallor
-Cyanosis
-Mottle
-Jaundice
-Petechiae

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19
Q

ABCDs

A

AIRWAY
Smaller.
BREATHING
Bradypnea leads to respiratory arrest.
CIRCULATION
Brachial pulse if under one and carotid if over. Less than 60 requires CPR.
Bradycardia leads to cardiopulmonary arrest.
Tachycardia can be hypoxia or shock.
DISABILITY
Check pupils, AVPU, and peds GCS.

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20
Q

History

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A

Get on level and include in conversation.
Use open-ended questions.
Avoid words that increase anxiety.

Use Wong-Baker FACES Scale to assess pain.

21
Q

Secondary Assessment

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A

Full-body scan if significant MOI.
Baseline vitals.
Use skin primarily for circulatory status.

22
Q

Vitals

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A

RR:
- Newborn: 20-60
- Infant: 25-50
- Toddler: 20-30
- Pre School : 20-25
- School Age : 15-20
- Adolescent: 12-20
BP: (2/3 arm size cuff)
- Newborn: 50-70
- Infant: 70-95
- Toddler: 80-100
- Pre School : 80-100
- School Age : 80-110
- Adolescent 90 - 110
HR:
- Newborn : 100-180
- Infant : 100-160
- Toddler : 90-150
- Pre School : 80-140
- School Age : 70 - 120
- Adolescent : 60 - 100

23
Q

Respiratory Emergencies

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A

Respiratory Failure May Result From …
- Obstructive Airway
- Inflammation of airway (Eppiglotitis)
- Infection

Partial Blockage: stridor, crowing, cough, cry
Complete Blockage: no sound, altered mental status, unresponsive, cyanosis

24
Q

Croup

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A

Swelling of larynx.
Barking cough while exhaling.
Slow onset.
Viral.

25
Epiglottitis
Swelling of epiglottis. Rapid onset. Life-threat if untreated. Bacterial.
26
Asthma
Spasm of bronchioles with excess mucous production and airway swelling. Wheezing when exhaling. Tripod position indicator and recommendation. Treatment: Albuterol with nebulizer per local protocol or assist with rescue inhaler. Humidified oxygen. Transport: comfort. Resource: ALS
27
Respiratory Infection
Signs - Distress - Crackles - Nasal Flare - Tachypnea Bronchiolitis: inflammation of bronchioles. Signs: dehydration, SOB, fever Pertussis: bacteria Signs: cough, sneeze, runny nose
28
Cardiopulmonary Arrest
Associated with respiratory arrest/failure. Treatment: CPR, AED
29
Shock (hypoperfusion)
Greater risk with over 25% blood loss. Signs: - Altered mental status. - Pale, cool, clammy skin. - Poor capillary refill. - Pulse over 160 (tachycardia) - Decreased urine output. - Absence of tears. - Depressed fontanelles - Late blood pressure drop
30
Anaphylaxis
Hypersensitivity / allergic response. Two or more systems must be involved. Edema may develop due to smaller airway. Treatment: Maintain airway and give oxygen. Transport.
31
Altered Mental Status (AMS)
Causes: - Seizures - Poisoning - Meningitis
32
Seizure
Signs: Infants - abnormal gaze Children - muscle movements Treatment: - Protect airway - Use recovery position if vomiting. - If febrile remove clothing and fan / sponge. - Transport priority if epileptic seizure lasts OVER 5 minutes. (Status Epilepticus)
33
Meningitus
Inflammation of meninges in the spinal cord and brain. Causes: bacteria, virus, fungi, or parasite. Risk: males, newborns, compromised immune system, children with head trauma or shunt. Sx: headache, stiff neck, high fever. Signs: rash, altered mental status Children may have seizures Infants may have apnea or cyanosis PPE: Mask, gloves, AND eye protection. Follow Up Treatment: Oxygen, ventilations.
34
Fever
100.4 F or higher is abnormal. Treatment: moist towels, remove excess clothing.
35
GI Emergency
Appendicitis. Peritonitis. Nausea or vomiting may lead to dehydration.
36
Bleeding Disorders
Hemophelia: congenital condition in which patients lack normal clotting factors. Do not delay to apply tourniquet if it is a life threatening hemorrhage.
37
Poisoning
Source, time, quantity, and route. Routes: absorption, ingestion, inhalation Treatment: contact med direction or poison control. Activated charcoal. Oxygen / ventilation. ALS
38
Dehydration
Fluid losses are greater than fluid intake. Hypoperfusion. Pediatric patient have a smaller fluid reserve. Diarrhea is a major risk. ALS can give fluids.
39
Submersion
SECOND most common cause of accidental death in children. Hypoxia and hypothermia. Secondary Drowning syndrome: occurs after breathing restored. Treatment: ABC management. Administer 100 % oxygen. Apply c-spine if trauma suspected. Perform CPR in cardiopulmonary arrest. ALS
40
Pediatric Trauma
Leading cause of death in ages 1 to 14. Contact sports, motor vehicle accidents, head injury.
41
Immobilization
Use padding under shoulders. Short board for infants if car seat damage or significant injuries. Place towels around voids and head. Secure torso first.
42
Chest Injury / Abdominal
Internal injuries without external wounds. Blunt trauma. Liver and spleen exposed due to underdeveloped abdominal muscles. Diaphragmatic breathers can have gastric distention.
43
Burns
Thermal or chemical. Suspect chemical if burns around lips or mouth. Use BSA rule of 9. Treatment: Prevent hypothermia if shock suspected. Bradycardia then ventilate. Pain Management: positioning, ice, elevation.
44
Disaster Management
JumpStart triage system. Under 8 years old and under 100 pounds. Green: minor, not immediate treatment. (able to walk) Yellow: delayed treatment. (spontaneous breathing, peripheral pulse, responsive to pain) Red: Immediate response. (apnea responsive to rescue breathing, breathing but no pulse, or inappropriate painful response) Black: decreased or expectant deceased. (apneic with no pulse or unresponsive to rescue breathing)
45
Abuse/Neglect
Abuse: Improper or excessive action to injure or harm. Neglect: insufficient attention or respect to someone who has claim to it. Signs: - Atypical injury pattern. - Story does not match pattern. - Drug or alcohol on site. - Delay seeking care. - Overly or under concerned parent. - Injuries in multiple healing stages. - Unusual marks or bruising. - Burns on hands and feet. - Unexplained change in mentals status. - Rectal or vaginal bleed. - Cleanliness and weight. - Living conditions. Concerning Fractures: tibia, femur, or skull.
46
Shaken Baby Syndrome
Caused by blow to head or forceful shaking. C-Spine Injury Intercranial bleed. Increased cranial pressure. Diffuse axonal injury.
47
SUID / SIDS
SUID: Sudden Unexplained Infant Death - Cause unknown until investigated. SIDS: Sudden Infant Death Syndrome - Cause unknown after investigation. Risk Factors: - Premature birth - Mother under 20 years old. - Mother smoke, used alcohol or drugs. - Low birth weight. - Infant sleeping prone. Possible Causes - Overwhelming infection. - Abuse - Airway obstruction. - Meningitis. - Accidental or intentional poisoning. - Hypoglycemia. - Congenital metabolic defects. Treatment: CPR even with rigor mortis or dependent lividity. ALS
48
Pediatric Psych Patients
Safety: consider police. Scene: - Remove parents from direct proximity of child if they exacerbate. Restraint: as last resort.
49
Apparent Life-Threatening Event
Infants who are cyanotic, not breathing, and cyanotic but resume breathing and regain color with stimulation. Signs: distinct change in muscle tone, chocking, or gagging.

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