Pediatrics 8.9 Flashcards Preview

Emergency Medicine and Surgical Care > Pediatrics 8.9 > Flashcards

Flashcards in Pediatrics 8.9 Deck (38)
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1

Sick patient big five

oxygen, pulse ox, Cardiac monitor, IV access, CXR/EKG

2

ABCD

Airway, breathing, circulation, disability, environment

3

Fluid resuscitation

Isotonic solutions (normal saline or LR), 20ml/kg bolus until improved perfusion, and resolution of tachycardia. Hemorrhagic-->2 boluses and then PRBC 10ml/kg

4

AMPLE history

Allergies, Medications, PMHX, last meal, events surrounding visit

5

Most common cause of death and disability in children

injury

6

Leading cause of death in ped trauma

head injury

7

"Jump Test"

jump three times= no appendicitis

8

Abdominal Emergency warning signs

Bilious vomiting, vomiting and abdominal distention, pain before vomiting, blood in stool of ill appearing infant, focal abdominal pain, involuntary guarding

9

1-2 months abd emergency

pyloric stenosis

10

6-10 months abd emergency

intusseception

11

pre-school/school age

appendicitis, intussesception, test/ovarian torsion, incarcerated hernia, NAT with blunt abdominal pain trauma

12

adolescent females abd emergency

ectopic pregnancy, ovarian cyst, appendicitis, STD/PID, tuboovarian abscess

13

Intestinal malrotation

hallmark= bilious emesis in a 1-2 week old. Surgical emergency because it can lead to bowel necrosis.
Study of choice is upper GI series. contrast passes in corkscrew formation and shows abnormal position of duodenum.
IV fluid resuscitation, NG tube, call surgeon, upper GI series, laparotomy

14

Intussusception

most common early childhood abd emergency. 5-9 months
severe cramping belly pain in episodes. drawing knees up, blood stool.
Classic image is ultrasound bulls eye or coiled spring.
Manage with IVF, NGT, IV abx, surgery, abd xrays/ultrasound, air enema

15

Classic intussusception triad

pain, palpable sausage shaped mass, currant jelly colored stool

16

air enema contraindications

prolonged symptoms (>3 days), signs of peritonitis, evidence of free air on plain x-ray.

17

Appendicitis

RLQ pain, rovsings, jump test, obturator, surgery! imaging not necessary in classic presentation

18

Ovarian Torsion

sudden onset of unilateral lower abd pain right side > left, nausea and vomiting in 70-80%
most common during reproductive years
1 in 5 are pregnant when it's diagnosed
imaging- ultrasound
emergent operation

19

causes of seizures in children

Fever (50%), congenital malformation, metabolic abnormalities, infections, trauma, vascular event, tumor, drugs, idopathic (35%)

20

Types of seizures

Generalized- tonic clonic, tonic, clonic, absence, atonic, myoclonic
Partial- simple, complex partial, partial with secondary generalization

21

seizure protocol

ABCs, place patient on side, O2, O2 sat, monitor, IV access, bedside glucose, Lorazepam, diazepam, midazolam.

22

febrile seizure criteria

temp of >100.4,

23

febrile seizure

12-18 months, viral or bacterial infection, vaccinations, familial

24

complex febrile seizure

>15 mins, focal features or postical paresis (todd's paralysis), recurrence within 24 hrs

25

factors that increase risk of recurrent febrile seizure

young age, family history, baseline developmental delay, complex febrile seizure

26

indications for admission in febrile seizure

prolonged postictal phase, complex febrile seizure, age

27

Absence epilepsy

absent staring w/ or w/o eyelide flutter

28

Juvenile myoclonic epilepsy

AM, early adolescence, precipitated by stress, may have tonic-clonic or absence as well

29

Benign epilepsy of Childhood with centrotermporal spikes

Somatosensory changes, speech arrest, facial twitching, drooling, may have tonic-clonic seizures at night. may not require therapy and is often out grown

30

infantile spasms

sudden flexion, extension or mixed movements, of trunk and proximal muscles, more urgent