CCT Peds

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Author:
wdzracer
ID:
12208
Filename:
CCT Peds
Updated:
2010-03-29 20:40:32
Tags:
Pediatric
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Description:
CCT Pediatric emergencies
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  1. Age for newborns?
    Birth - 12 hours
  2. Age of Infant?
    1 month - 12 months
  3. Age of Toddler
    12-36 months
  4. Age of Preschool?
    3-5 years
  5. School age?
    6-12 years
  6. Adolescent age?
    • End of childhood - 18 years
    • Male- 13
    • Female- 11
  7. How old is an infant before the fontenelle closes?
    6-7 months
  8. Infants and toddlers depend on this for adequate tidal volumes.
    diaphragm
  9. What is the oxygen consumption of a toddler and infant?
    6-8 ml/kg/min
  10. Why do you need to get a Bgl on all peds?
    limited glycogen and glucose stores
  11. How much fluid do you administer to a pediatric patient?
    20ml/kg
  12. What are the 4 causes of upper respiratory obstruction?
    • Croup
    • Foreign body aspiration
    • Bacterial tracheitis
    • Epiglottitis
  13. What are the three causes of lower airway disease?
    • Asthma
    • Bronchiolitis
    • Pneumonia
  14. What age is foreign body aspiration more common?
    under 4 years of age
  15. What is Croup?
    inflammatory of the upper respiratory tract involving the subglottic region
  16. What is the main cause of Croup?
    Viral infection
  17. What age does Croup occur in?
    • 6 months - 3 years
    • Mostly in boys
  18. What are the indications of croup?
    • Respiratory distress
    • Retractions
    • Barking (Seal or dog-like)or brassy cough
    • Hoarseness
    • Fever
  19. What is "Steeple sign"?
    narrowing of the soft tissues on a neck x-ray that form a point.
  20. Treatment for croup?
    • Oxygen- humidified or cool mist at 4-6Lpm
    • IV
    • Meds-Racemic Epi, Albuterol, and Decadron
    • Position of Comfort and keep parents with them
  21. What is Bacterial Tracheitis?
    • Bacterial infection of the upper airway, subglottic trachea, usually following viral croup
    • Occurs in children 1-5 yo
    • Uncommon, but more common around industrial facilities
  22. What are the S/S of bacterial tracheitis?
    • Respiratory distress
    • High-grade fever
    • stridor
    • coughing up pus/mucous
    • sore throat
    • usually a history of croup
  23. What age does Epiglottitis usually occur?
    3-7 yo
  24. What is the pathophysiology of epiglottitis?
    • Cellulitis of the epiglottis
    • Bacterial infection, usually from hemophilus influenza type B
  25. S/S of epiglottitis?
    • Rapid onset 6-8 hours
    • Drooling/unable to swallow
    • Stridor
    • pale or cyanotic
  26. Treatment for epiglottitis?
    • *Never attempt to visualize the airway if the pt is awake.
    • Oxygen
    • BVM if obstruction occurs
    • Consider needle crich as last resort
  27. Treatment for Asthma?
    • ABC
    • O2
    • Albuterol nebulizer
    • Sub Q Epi 1:1000 if severe distress
    • position of comfort
    • keep with caregiver
  28. What age does Bronchiolitis occur?
    <2 yo
  29. What is Bronchiolitis?
    • inflammation of lower resiratory tract
    • respiratory syncytial virus (RSV) infection of the lower airway
  30. S/S of Brochiolitis?
    • Resp. distress
    • Wheezing
    • Rales
    • May present similar to Asthma
  31. Treatment of Brochiolitis?
    • ABC
    • O2
    • Iv
    • Nebulizer Racemic Epi
  32. S/S of Pneumonia?
    • Decreased breath sounds
    • Rhonchi
    • Chest pain
    • Low Grade Fever
  33. Treatment for Pneumonia?
    • ABC
    • O2
    • IV
    • Position of Comfort
  34. What is the most common cause of pediatric siezures?
    Fever
  35. Treatment of siezures?
    • ABC
    • O2
    • IV
    • BGL
    • Ativan (preferred medication)
  36. When should you suspect Hypoglycemia?
    Whenever a child shows altered LOC with explainable cause.
  37. Treatment for hypoglycemia?
    • ABC
    • O2
    • IV
    • BGL
    • D25 or D12.5
    • Glucogon if no IV
    • Repeat BGL in 10 minutes
  38. What does Hyperglycemia lead to?
    • Dehydration
    • Ketoacidosis
  39. Treatment for Hyperglycemia?
    • ABC
    • O2
    • IV-LR or NS for dehydration
    • Insulin and Potassium
  40. Treatment for S/S of generalized infection of unknown etiology?
    • BSI
    • ABC
    • O2
    • IV-LR/NS
    • Treat the symptoms- siezure, fever, dehydration, etc.
  41. What is Meningitis?
    • inflammation of the meninges identified by abnormal number of WBC in the CSF.
    • highest occurrence in children <1 yo
  42. Which type of meningitis is worse, Bacterial or Viral?
    Bacterial
  43. What is Brudzinski's sign?
    flexion of the hips/knees with the fassive flexion of the neck.
  44. What is Kernigs sign?
    Back pain resistance after flexion of lower legs
  45. Treatment for Meningitis?
    • ABC
    • Broad spectrum antibiotics
    • Maintain MAP >50
    • Acyclovir for suspicion of HSV
    • Treat siezures with Ativan (acute) or Cerebyx (prevention)
  46. Most common cause of cardiac arrest in children?
    Respiratory arrest
  47. How to calculate the intubation tube size?
    • Age in years + 16 / 4
    • (or use Pinky finger)
  48. Most common size of chest tube for peds?
    10 fr
  49. What is the best ventilator setting for Peds?
    Pressure control
  50. What is the 4-2-1 Rule?
    • 4 ml/kg for first ten kg
    • 2 ml/kg for next ten kg
    • 1 ml/kg for any additional kg
    • (For maintenance fluids only)
  51. Fluid resuscitation
    • medical 10 ml/kg
    • trauma 20 ml/kg
  52. Cardioversion
    • first 0.5 joules/kg
    • all others 1.0 joules/kg
  53. Defibrillation
    • first 2.0 joules/kg
    • all others 4.0 joules/kg

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