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What does ALTE stand for?
apparent life threatening event
What does CSHCN stand for?
children with special health care needs
What does DUMBELS stand for?
What does LANE stand for?
What does PHAILS stand for?
What does RSV stand for?
- Respiratory Syncytial Virus
- virus that usually causes bronchiolitis
What does TICLS stand for?
- Look (gaze)
- Speech (cry)
What is the Wong Baker faces scale?
Pediatric pain scale
What is the STARR program?
- developed by the NHTSA
- See the problems with safety
- Talk to the family
- Assess adverse home environment
- Remedy situation
- Review and monitor over time
What is the EMSC program?
- Emergency Medical Services for Children
- national program designed to ensure that all children and adolescents, no matter where they live, attend school, or travel, receive appropriate care in a health emergency
What is respiratory distress?
abnormal physiologic condition identified by increased work of breathing
What is respiratory failure?
- the infant or child exhausts energy reserves or can no longer maintain oxygenation and ventilation
- may occur when chest wall muscles get tired or when there is a failure of central respiratory drive from injury or toxicity
- identified by abnormal appearance or cyanosis in a child with an increased work of breathing
- also identified by an abnormally low respiratory rate and decreased respiratory effort usually with bradycardia
What is respiratory arrest?
absence of effective breathing
What is a unique sign/symptom of bacterial tracheitis?
A cough with pus
What is a unique sign/symptom of croup?
What are some unique signs/symptoms of epiglottitis?
- Drooling and dysphagia
- Sudden onset
- Muffled voice
What disease is RSV often associated with?
What is Bronchopulmonary Dysplasia?
Chronic lung disease associated with premature birth
How do we treat exascerbated BPD?
- High flow O2
- Consider nebulized epinephrine
What is the VS that differentiates between compensated and decompensated shock in children?
What percentage of TBW fluid loss compromises cardiac output and perfusion in a child?
What percentage of TBW fluid loss compromises cardiac output and perfusion in an adolescent?
What is cardiomyopathy?
- Any disease of the heart muscle that causes a reduction in the force of heart contractions
- Decreases the amount of blood circulated to the lungs and to the rest of the body
What does cardiomyopathy usually result from?
- Congenital abnormalities that affect both ventricles
- Viral infection
What are the symptoms of cardiomyopathy?
- Chest pain
- SXS of heart failure and cardiogenic shock
- (Crackles, JVD, Hypotension, Peripheral Edema)
How do we manage cardiomyopathy?
- If decompensated, IV with antidysrhythmics, diuretics, or vasopressors
- Avoid fluid resuscitation to avoid volume overload
What are the four major causes of pediatric dysrhythmias?
- Structural heart disease
What is the first cause you should think of when observing bradycardia in a child?
What are some causes of bradycardia besides hypoxia?
- CNS injury
- Excess vagal stimulation
- Toxic ingestion
What is the most common nonarrest rhythm in kids?
What is the heart rate that can distinguish SVT from sinus tach in infants?
What is the heart rate that can distinguish SVT from sinus tach in kids?
What are some causes of VTach with a pulse in kids?
- Congenital heart disease
- Reversible causes
- Metabolic causes
What does "DOPE" stand for?
What is the normal tidal volume in a pediatric patient?
What are some signs of impending cerebral herniation?
- Unequal or dilated unresponsive pupils
- Respiratory irregularities or apnea
- Reduced response to stimulation
What are some things we can consider doing if suspecting impending cerebral herniation?
- Elevate head of bed to 30 degrees if BP is adequate
- Keep head midline
- Short periods of hyperventilation
Under what age is a positive Babinski's reflex considered normal?
What is the Monroe-Kellie doctrine?
- Basic principle that there is limited space in the cranium allocated to CSF/blood and brain matter
- If the brain begins to swell, it forces CSF/blood out
- If excessive CSF/blood is present, it forces the brain out
What are some characteristics of febrile seizures?
- No evidence of other causes
- Usually between 6 mos and 5 years
- Occur with rapid rise in fever
- May be tonic-clonic or more subtle
- Duration usually <5 mins
How is epilepsy defined?
Seizure disorder involving >2 afebrile seizures
What is considered hypoglycemia in infants and children?
What is considered hypoglycemia in newborns?
What is the level at which we consider a fever dangerous and may cause brain damage?
How do we manage hyperglycemia in a child?
- IV fluid therapy if signs of dehydration are present
What is a common complication of alcohol ingestion in young children?
What are the "One-Pill Killers"?
- Imipramine (Tricyclics)
What is "QUEST" and what does it stand for?
- Outlines the steps to take to evaluate pain in young children
- Use pain scale
- Evaluate behavior and physiological signs
- Seek parents' input
- Take action and assess results
What are some known risk factors for SIDS?
- Maternal smoking or drugs
- Mother <20 y/o
- No prenatal care
- Social deprivation
- Premature births
What are the hours during which SIDS usually occurs?
Midnight to 6 am
Most SIDS deaths occur within what age group?
- Most (85%) under 6 months
- Typical age range is up to 1 year
What complications can be seen with tracheostomy tubes?
- Air leakage
How do we manage a tracheostomy tube that has become blocked and cannot be cleared?
- Replace with another tube
- Suction first
- Replace temporarily with ET tube if necessary
What is a VAD?
- Vascular access device
- Seen in patients who need prolonged access to venous circulation for drug or fluid therapy
What are some complications of VADs?
- Cracked line
- Air embolism
- Local infection
How do we manage local infection of a VAD?
- Sterile technique
- Remove old bandages
- Cleanse the sight
- Replace clean bandages
How do we manage hemorrhage at the site of a VAD?
- Gentle, direct pressure with aseptic technique
- Fluid replacement if hypovolemic
How do we manage a suspected air embolus from a VAD?
- Stop the infusion
- Left side head down position
- High flow O2
- Rapid transport
How do we manage obstruction of a VAD?