pediatric emergencies Flashcards
(20 cards)
foreign body obstruction sign and symptoms
partial obstruction
choking
cough
stridor
epidemiology
90% less than 5 years
65 < infants
Common offenders : Aspiration: food, nuts, grape, popcorn
other: corn, marble, ballon
treatment with children less one year
head down and back blow x 4 tunrover chest thrust x 4 heatilt chin lift visualize and remove ventilate
treatment child
heimlich maneuver
visualize and extract
ventilate
if the above doesn’t work
obstruction above the larynx or in larynx perform cricothyrotomy
obstruction below the larynx: attempt to in tube and push past it past the bifurcation of trachea and attempt to ventilate with high pressure
croup
infection of the subglottic region causing inflammation and edema of respiratory mucus which produces edema of cords and subglottic area
etiology of croup
parainfluenza
RSV
other viruses
sign and symptoms
croupy barking cough tachypnea retraction Hx of upper respiration infection inspiratory-expiratory stridor age 8 month to 5 yrs
treatment for croup
minimal pathology supplemental o2 racemic epinphrine decadron more profound pathology: hospital admission resp. failure stridor, hypoxemia, retraction Hx of tracheal stenosis, recurrent croup, hx of post-intubation croup, previous intubation/ventilation parents unable to provide care
intubation criteria
Pao2 55 mmHG
progressive acidosis
marked anxiety, tachycardia, tachypnea
severe obstruction
hospitalization course
5-6 days
extubation 2-5 days
air leaks indication improvement since pediatric tubes don’t have coughs
follow the extubation with racemic eli and close observation
eppiglottitis and etiology
an infection of the supraglottic including the epiglottis
Hemophilus age group is 3-5 years
sign and symptoms
very gray and ashen appearance upright hyperextended posture sudden temp > 39 excess saliva signs of partial airway obstruction enlargment cervical lymph nodes may become unconscious or even arrest
epidemiology
peak ages 3-6 and range is 17 month to adult
can visualize the swollen structure on a lateral neck film
treamtment
position them where they are comfortable
minimize movement
give supplemental o2 as require
intubation if require: one shot, extubation criteria 24 hours antibiotics and swelling reduce also air leak indicates improvements
antiobiotics
ampicillin
cefuroxime 200 mg/kg/day
ceftriacone 100 mg/kg/day
Picu care
sedation versed is sometimes helpful close observation humidity supplemental o2 sometimes CPAP emergency situation emergencies situation: mask CPAP, needle cricothyroidtomy, trach
tracheitis
bacterial infection of the trachea and major bronchi
Etilogy: Staph Aures(60%) , H. influenza, Strep group A. 2 years peak age range 1 month -9 years
kind rare
sign and symptoms
upper resp. infection stridor and barking cough resp.arrest may occur if airway become fully obstructed by pus labs and x-ray: elevated WBC and left shift negative blood culture but positive sputum culture from deep suctioning subglottic edema infiltrates on chest x-ray 50%
treatment
humidity and o2 promt bronchoscopy under controlled condition intubation if severe antibiotics: cefuroxime chlrophenical nefacilin
