Peds ED

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Peds ED
2014-10-20 10:25:55
ED Emergency Poisoining

Pediatric ED
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  1. What are the signs of salicylate poisoning in children?
    • 20,000 reported cases to United States poison control centers annually.
    • Low-dose aspirin as primary prevention for cardiovascular disease in adults means that aspirin is readily available and potentially accessible to children in many households.
    • Mild symptoms (<300 mg/kg)
    • Moderate symptoms (>300 mg/kg) lead to moderate toxicity
    • Severe symptoms/death (>500 mg/kg)
    • Early/mild signs and symptoms include: fever/hyperpyrexia, nausea, vomiting, diarrhea, and tinnitus.
    • Tachypnea/hyperpnea, tachycardia, hypoglycemia, metabolic acidosis with an elevated anion gap, altered mental status (lethargy to coma), and seizures are commonly seen in more severe poisonings
  2. What are the indications for a tetanus vaccine booster in patients who present to the office after stepping on a nail?
    • 1. ? status or <3 doses=Vaccine+IG
    • 2. ≥3 doses AND last was ≥5 years ago
  3. What are the indications for TIG in a patient who presents with a tetanus-prone wound?
    • 1. ? status or <3 doses
    • 2. ≥3 doses but last >10 years ago
    • 3. Any child with HIV or <1 year s/p BMT