Poisonings, Accidents, Child abuse Flashcards Preview

Pediatrics > Poisonings, Accidents, Child abuse > Flashcards

Flashcards in Poisonings, Accidents, Child abuse Deck (28)
1

Iron poisoning
- features
- dx findings
- tx

Initially:
- ab pain
- vomiting
- diarrhea
- hypotensive shock
- metabolic acidosis

Later:
- hepatic necrosis (days)
- pyloric stenosis (later)

Dx findings:
- AG metabolic acidosis
- radiopaque pills on Xray!

Tx
- whole bowel irrigation
- deferoxamine****
- supportive
- syrup of ipecac if no evidence gastroenteritis

2

Tx acetaminophen poisoning

Activated charcoal

N acetylcysteine (best 8-16h of ingestion)

3

When do you gastric lavage EtOH OD?

< 2 h

4

3 phases of salicylate ingestion

1
- respiratory alkalosis from direct stim of respiratory center
- K and bicarb excreted
- can look like diabetic ketoacidosis

2
- paradoxical aciduria as alkalosis continues

3
- metabolic acidosis 2/2 lactic acidosis
- dehydration
- hypokalemia

5

Tx caustics poisoning

Flush a lot with water

DO NOT GI lavage or emesis or charcoal

6

Organophosphate (anticholinesterase) poisoning - sx

Muscarinic
- salivation
- lacrimation
- urination
- defecation
- emesis

Nicotinic
- cramps
- fasiculations
- twitching
- weakness
- areflexia
- paralysis of voluntary muscles
-- > occurs after Muscarinic effects; not seen in mild poisoning

CNS
- anxiety
- ataxia
- HA
- convulsions
0 coma

7

Dx organophosphate poisioning

decreased RBC cholinesterase

Clinical is best

8

Tx organophosphate (anticholinesterase) poisoning

If ingested:
GI lavage
Activated charcoal

If skin:
wash with water

+ atropine
+ pralidoxime (for nicotinic sx)

9

Tx antihistamine poisoning

Activated charcoal

Whole bowel irrigation if sustained release antihistamine given

Risk death from seizures if no tx

10

Main systems affected by TCA poisoning

CNS
Heart

11

Tx TCA posioning

Activated charcoal to --| more absorption

Na bicarb to prevent dysrhythmias
Tx dysrhythmias not responding with lidocaine

12

Tx anticholinergic OD

Physostigmine sulfate

13

Tx CO poisoning

O2

14

Tx cyanide poisoning

Amyl nitrite

then sodium nitrite

then sodium thiosulfate

15

Tx ethylene glycol poisoning

EtOH

16

Tx heavy metal poisoning in general

Chelators

EDTA

Dimercaprol

Penicillamine

2,3-dimercaptosuccinic acid

17

Tx INH poisoning

Pyridoxine

18

Tx methanol poisoning

EtOH

19

Tx methemoglobinemia

Methylene blue

20

Tx opioid OD

Naloxone

21

Tx warfarin poisoning

Vit K

FFP

22

Drowning freshwater vs saltwater

Freshwater
- may have lung damage 22 hypotonic fluid washing out surfactant

Saltwater
- more prone pulmonary edema

23

Degree burns

1 - epidermis

2 - epidermis + dermis

3 - full thickness

24

Fluid resusscitation in burns

Ringer's lactate

25

Hymenal opening size

< 5 mm in < 5yo

< 9 mm in < 9 yo

Not diagnostic though

26

If person is sexually assaulted, specimens should be collected to test for?

Acid phsophatase
G/C
Syphilis
Hep B
HIV

27

Why do you get lead lines?

Usually at wrists and ankles (calcification because lead inhibits osteoclast activity)

28

Clinical manifestations of foreign body aspiration

Signs + Sx
- hx choking
- coughing
- cyanosis
- sudden onset resp distress
- AMS

PE
- focal monophonic wheezing on affected side
- diminished aeration on affected side

Xray
- HYPERinflation or atelectasis of affected side
- foreign body