Pediatric Injuries and Poisoning Flashcards Preview

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Flashcards in Pediatric Injuries and Poisoning Deck (15)
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1

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!

2

what is the leading cause of ACCIDENTAL death in children?

MC cause of motor vehicle injuries?

Motor vehicle injuries

MC cause of MVA:
-Alcohol
-excess speed
-no seat belts
*texting

3

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)

4

Submersion injuries:
-locations of occurrence
-prevention

locations: pools, lakes, streams, oceans, bathtubs, 5 gal buckets.

prevention: SUPERVISE YOUR KIDS!

5

Bicycle injuries:
-MC in who?

boys ages 5-14YO.

6

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)

7

peds head trauma:
-risk factors
-always consider ___ on DDX.
-when do you image?

Risk factors:
-large head
-thin skulls
-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

8

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.

9

Head Trauma:
-signs of elevated ICP

Signs of elevated ICP
-AVPU (alert, voice, pain, unresponsive)

-pupils

-vomiting

-cushing response (htn, bradycardia, apnea)

10

Concussion:
-presentation
-tx

-HA
-confusion/disorientation
-difficulties with memory
-inattentiveness
-dizziness


Tx:
-physical and cognitive rest are primary interventions
-meds for HA and nausea
-gradual return to activity after sx resolve.
-gradual return to play protocol:
--no activity
--light aerobic exercise
--sport specific exercise
--non contact training drills
--full contact practice
--return to play

11

Common causes of poisoning

-cosmetics and personal care products
-cleaning substances
-analgesics
-plants
-cough and cold remedies
-tylenol, aspirin, iron, lead.
-SSRIS, sedatives, antipsychotics, stimulants, illicit drug, cardiac drugs

12

Acetaminophen Overdose
-assessment?
-presentation stages
-tx

assessment: serum acetaminophen level (draw 4 hrs following ingestion); use toxicity nomogram to determine need for tx.

Presentation:
-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.
-activated charcoal

13

Aspirin Overdose
-presentation
-dx
-Tx

Presentation:
-tinnitus & vomiting
-hyperpnea, fever, lethargy, confusion, coma, resp/cardiac failure

Dx: plasma salicylate concentrations

Tx:
-no specific antidote
-activated charcoal
-alkalinization of IV bicarbonate
-Dialysis may be necessary

14

Iron overdose
-presentation
-tx
-dose causing toxicity and death

Presentation:
-vomiting, abd pain, GI bleed, diarrhea
* has a stable period of 6-24hrs where sx may resolve)

dx:
-abd xray (for iron pills only)
-serum iron concentrations

Tx:
-whole bowel irrigation
-Deferoxamine IV (chelating agent) for severe cases.

Death from iron toxicity has been reported from 60-300mg/kg elemental iron.

15

Lead Poisoning
-aka
-causes
-presentation
-tx

aka: plumbism

Cause:
-paint/chip ingestion
-contaminated household dusts in old homes
-living near lead smelter
-lead-contaminated soils
...in flint its in the water!!!!

Presentation:
-weakness, irritability, weight loss, vomiting, colicky abd pain, developmental delay, sz, peripheral neuropathy, anemia

Tx:
-interrupt ingestion
- chelating therapy with succimer