Flashcards in Pediatric Injuries and Poisoning Deck (15)
What is the leading cause of death and disability among children and adults (1-44)?
Unintentional injury deaths peak ages ___ years and again at ages ___ years.
What is leading cause of unintentional injury?
trauma by unintentional injury!
Unintentional injury deaths peak during 1-4YO and again ages 15-24.
Leading cause of unintentional injury is FALLS!
what is the leading cause of ACCIDENTAL death in children?
MC cause of motor vehicle injuries?
Motor vehicle injuries
MC cause of MVA:
-no seat belts
Infants less than 1YO and weight less than 35lbs should be restrained how in vehicle?
Ages 1-4 and weight 20-40lbs should be restrained how in vehicle?
Ages 4-6 should be restrained how in vehicle?
less than 1YO and less than 35lbs should be in an infant-only or rear facing child safety seat
ages 1-4 and weight 20-40lbs can be in a forward facing only in the back seat of the vehicle.
Ages 4-6 needs a booster seat installed in the back seat of the vehicle (booster seat for children under 60lbs)
-locations of occurrence
locations: pools, lakes, streams, oceans, bathtubs, 5 gal buckets.
prevention: SUPERVISE YOUR KIDS!
-MC in who?
boys ages 5-14YO.
Which cartilaginous structure is weaker than bone and predisposed to injury in pediatric sports injuries?
MC fractured bone in children?
-the physis (growth plate)
*peds bone has higher water content and lower mineral content.
*less brittle than adult bone..
most fx bone in children is clavicle
(kids are more prone to upper extremity fxs)
peds head trauma:
-always consider ___ on DDX.
-when do you image?
-poor muscle control
always consider Concusiion on DDX,
Image when LOC greater than 1 min, evidence of skull fx, focal neurological findings, GCS of 13-14
Coma score of ___ correlates with mild brain injury.
Score of ___ - ___ is moderate injury.
Score less than ___ is a severe brain injury.
13 or higher = mild TBI
9-12 is moderate brain injury
8 or less = severe brain injury.
-signs of elevated ICP
Signs of elevated ICP
-AVPU (alert, voice, pain, unresponsive)
-cushing response (htn, bradycardia, apnea)
-difficulties with memory
-physical and cognitive rest are primary interventions
-meds for HA and nausea
-gradual return to activity after sx resolve.
-gradual return to play protocol:
--light aerobic exercise
--sport specific exercise
--non contact training drills
--full contact practice
--return to play
Common causes of poisoning
-cosmetics and personal care products
-cough and cold remedies
-tylenol, aspirin, iron, lead.
-SSRIS, sedatives, antipsychotics, stimulants, illicit drug, cardiac drugs
assessment: serum acetaminophen level (draw 4 hrs following ingestion); use toxicity nomogram to determine need for tx.
-stage 1: 1st 24hrs- minimal signs and sx, anorexia, n/v, pallor, and malaise
-stage 2: 2-3 days; signs of hepatotoxicity including RUQ pain and tenderness, elevated LFTs and bili.
Stage 3: 3-4days; some progress to fulminant hepatic failure, metabolic acidosis, coagulopathy, renal failure, encephalopathy, recurrent GI sx
Stage 4: pts who survive stage 3
Tx: N-acetylcysteine; works to counteract hepatic toxicity by replenishing glutathione.
-tinnitus & vomiting
-hyperpnea, fever, lethargy, confusion, coma, resp/cardiac failure
Dx: plasma salicylate concentrations
-no specific antidote
-alkalinization of IV bicarbonate
-Dialysis may be necessary
-dose causing toxicity and death
-vomiting, abd pain, GI bleed, diarrhea
* has a stable period of 6-24hrs where sx may resolve)
-abd xray (for iron pills only)
-serum iron concentrations
-whole bowel irrigation
-Deferoxamine IV (chelating agent) for severe cases.
Death from iron toxicity has been reported from 60-300mg/kg elemental iron.