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Flashcards in peds65 Deck (49):
1

scalding injuries

from hot liquids; most common types of burns

2

glasgow coma scale assess what?

eye opening (1-4), best motor response (1-6), and best verbal response (1-5)

3

eye opening

none, response to pain, response to voice, spontaneously

4

motor

none, decerebrate, decorticate, flexion withdrawl, localizes pain, obeys commands

5

verbal

none, incomprehensible, innapropriate words, disoriented conversation, oriented

6

glasgow coma scores

13-15 mild head injury; 9-12 moderate; less than 8 severe

7

first degree burns

involve only the epidermis; characterized by red, blanching, painful skin that heals without scarring

8

second degree burns

involve the entire epidermis and part of the dermis; superficial or deep

9

second degree superficial burn

partial thickness burns involve the entire epidermis and outer portion of the dermis; moist, painful and red; they blister but does not scar

10

second degree deep partial thickness burns

involve destruction fo the entire epidermis and lower part of the dermis; burns are pale white. They may blister and they heal with scarring

11

third degree burns

full thickness burns involve the complete destruction of the epidermis, dermis, and part of the subcutaneous tissue; bruns are dry, white, and leathery to the touch and skin grafts are needed

12

skin grafts for third degree burns

yes right

13

painful third degree burns?

no, usually victim is insens to pain

14

management of burns

ABCs (endotracheal intub, assess oxygenation, IV access through nonburned skin)

15

why is fluid resuscitation critical in management of burn victims

lots of fluid can be lost through the skin and leaky capillaries

16

first degree burns management

moisturizers and analgesics

17

second degree burns management

analgesics, debridement of dead skin to prevent infection; bullae (large blisters are not removed because forms barrier; ruptures bullae should be removed

18

third degree burn management

skin grafting and hydrotherapy; escharotomy may be needed if burn restricts blood flow or chest expansion

19

escharotomy

surgical removal of a constricting scar

20

antibiotics are important in the treatment of scars

in second and third degree burns; topical 1 percent silver sulfadiazine

21

what is a "near drowner"

victim who survives sometimes only temporarily, after asphyxia when submerged in a liquid

22

how does death by drownign happen?

asphyxia by aspirating liquid (wet drowner) or from larygospasm (dry drowner)

23

how does inhaling liquid hurt you?

denaturing of surfactant, alveolar instability and collapse and pulm edema

24

respirations in a near drowner

absent or irreg; and the victim may cough up a pink frothy material;

25

lungs in a drowner on physical exam

rales, rhonchi, or wheezes

26

how does a drowner get pneumonia

aspiration of fluid containing mouth flora

27

how does a drowner get neuro insult

hypoxia

28

other features of near drowning

CV abnormalities, heamtologic abnormalities, renal failure

29

management of near drowner

ABCs, cervical spine immobilization, removal of wet clothing, intubation and mechanical ventilation, rewarming of body core

30

why do you do cervical spine immobilization

possibility of coexistent head trauma

31

why removal of wet clothing in a near drowner?

to reduce heat loss

32

how to rewarm a patient who has drowned

warm saline gastric lavage, bladder washings, or peritoneal lavag should be perforemd if needed. Resuscitation should continue until patient temp is 32 deg C

33

prognosis in a near drowner

children have a better outcome than adults because their primitve dive reflex shunts blood to vital organs

34

risk of child abuse is greatest in which kids?

less than 4 years old; mental retardation; history of premature birth; chornic illness

35

bruises inflicted injury vs noninflicted trauma

inflicted in bruises on fleshy or protected areas; exposed areas are typically noninflicted

36

accidental vs nonaccidental burns

accidental have irreg, splashlike config; nonaccidental have a clear line of demarcation (glovelike pattern suggests submersion)

37

what fracturs are highly suggestive of abuse?

metaphyseal fractures (bucket or corner fractures); fractures of the posterior or first ribs, sternum, scapula, and vertebral spinous processes

38

leading cause of death and morbidity due to child abuse

head injury

39

shaken baby syndrome

kids les than 2 yo; head injury

40

lab studies for suspected child abuse

within 72 hours of abuse; tests for STDs, incl HIV; pregnancy test and test vaginal fluid for sperm

41

SIDS

death of an infeant younger than 1 year whose death remains unexplained after a thorough case eval

42

most common cause of death in kids less than 1 years

SIDS

43

peak incidence of SIDs

2-4 mos

44

typical victim of SIDs

found dead in the morning in bed after being put to sleep at night

45

most common autopsy finding in SIDS

intrathoracic petechiae (unknown cause), pulm congestion or edema, small airway inflamm and evidence of hypoxia

46

how do most poisonings happen

kids less than 6 yo; 90 percent are accidental; at home when the childs caregiver is distracted; usually ingested; mortality less than 1 percent

47

most common toxic exposures

cosmetics and personal care products; cleaning agents; cough and cold preparations; vitamins (iron); analgesics; plants, alcohols; carbon monoxide; prescription meds

48

bitter almond

cyanide

49

garlic smell on a kid that ingested a poison

arsenic or organophosphates