Card Set Information
EMS Peds Flash Cards
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?
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
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
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
What are the symptoms of cardiomyopathy?
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?
Excess vagal stimulation
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
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"?
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
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?
How do we manage a tracheostomy tube that has become blocked and cannot be cleared?
Replace with another tube
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?
How do we manage local infection of a VAD?
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
How do we manage obstruction of a VAD?
What is the neonate/pediatric dose and concentration for epinephrine for cardiac use?
0.01 mg/kg 1:10,000 IV/IO q 3-5 mins
0.1 mg/kg 1:1000 ETT
What is the NS bolus amount for a neonate?
What is the dose and concentration for dextrose for a neonate?
D10 0.2g/kg SIVP
What is the neonate/pediatric dose for Narcan?
0.1 mg/kg SIVP
What is the neonate/pediatric dose for sodium bicarbonate?
1 mEq/kg SIVP
What is the neonate/pediatric dose for IV valium?
0.1 - 0.2 mg/kg SIVP
What is the neonate/pediatric dose for dopamine?
1 mcg/kg/min IVD
What is the pediatric dose for rectal valium?
What is the pediatric dose for APAP?
10-15 mg/kg PO
What is the pediatric dose for activated charcoal?
1 g/kg PO
What is the pediatric dose for adenosine?
0.1 mg/kg RIVP max 6 mg 1st dose
0.2 mg/kg RIVP max 12 mg 2nd and 3rd doses
All followed by 5-10cc flush
What is the pediatric dose of albuterol?
2.5 mg via nebulizer max 5 mg
Must be on the monitor at 5 mg
What is the pediatric dose for amiodarone in VTac with a pulse?
5 mg/kg IV/IO over 20 minutes
What is the pediatric dose for amiodarone in pulseless VTac/VFib?
5 mg/kg IV/IO max 15 mg/kg IV/IO
What is the minimum age of a child to give atropine for bradycardia?
1 y/o preferably 2 y/o
What is the dose of atropine for symptomatic bradycardia in a child?
0.02 mg/kg IV/IO max 0.5 mg single dose max 1.0 mg total dose
What is the dose of atropine for symptomatic bradycardia in an adolescent?
0.02 mg/kg IV/IO max 1 mg single dose max 2.0 mg total dose
What is the ETT dose for atropine in a pediatric?
0.04 - 0.06 mg/kg
What is the pediatric dose for atropoine in an organophosphate OD?
0.05 mg/kg IV/IO
What is the pediatric joule setting for synchronized cardioversion?
1 J/k first dose, 2 J/k subsequent doses
What is the pediatric joule setting for defibrillation?
2 or 4 J/k first dose, 4 J/k subsequent doses
What is the pediatric dose and concentration for dextrose?
0.5 - 1 g/kg SIVP
What is the pediatric dose for diphenhydramine?
What is the pediatric dose for fentanyl?
1-2 mcg/kg SIVP
What is the pediatric dose for glucagon?
0.1 mg/kg IM max 1 mg
What is the pediatric dose for a lidocaine bolus?
1 mg/kg IV/IO
What is the pediatric dose for a lidocaine drip?
20-50 mcg/kg/min IVD
What is the pediatric dose for lidocaine down the tube?
2-3 mg/kg ETT
What is the pediatric dose for magnesium sulfate?
25-50 mg max 2 g SIVP
What is the pediatric dose for morphine?
0.1 mg/kg max 10 mg SIVP
What is the NS bolus amount for a pediatric?
What is the Parkland Burn Formula?
4cc X kgs X BSA = Total CC/ 24 hrs
Divide by 2 = First 8 hours
Divide by 8 = CC/hr
Break down the BSA burn % approximations for an infant by body area and percentage.
Head = 18%
Trunk = 18%
Arms = 9% each
Legs = 13.5% each
Genetalia = 1%
Break down the BSA burn % approximations for a child by body area and percentage.
Head = 12%
Trunk = 18%
Arms = 9% each
Legs = 16.5% each
Genetalia = 1%
Break down the BSA burn % approximations for an adolescent by body area and percentage.
Head = 9%
Trunk = 18%
Arms = 9% each
Legs = 18% each
Genetalia = 1%
What is the Moro reflex and when is it appropriate?
Make a loud noise near the infant, and the legs will flex, the arms will make an embracing gesture, and the infant will usually give a brief cry
If the Moro and/or Babinski reflexes are found in an older child, what might it indicate?
Spinal cord damage
What is the formula for typical systolic BP in children 1-10 years?
90 + age x2 = mmHg
What is the lower range of normal systolic BP in children over 10 years?
What is the formula for the lower limit of systolic BP in children 1-10 years?
70 + age x2 = mmHg
What is cystic fibrosis?
Inherited metabolic disease of the lungs and digestive system
Manifests in childhood
Causes the glands in the lining of the bronchi to produce excess thick mucus
Predisposes the patient to chronic lung infections
Pancreas also fails to produce enzymes required for breakdown of fats and absorb them
What are the SXS of cystic fibrosis?
Persistent cough and breathlessness
Pneumonia, bronchiectasis, bronchitis
Abnormally salty sweat
Pale, greasy-looking, fowl-smelling stool
What is cerebral palsy?
Nonprogressive disorders of movement and posture
Results from damage to the fetal brain
Most common cause is cerebral dysgenesis
No cure exists
Widely varying range of functionality and disability
What is muscular dystrophy?
Inherited muscle disorder that results in slow but progressive deterioration of muscle fibers
Respiratory failure/congestive heart failure are our main concerns
What is spina bifida?
Congenital defect which leaves a portion of the spinal cord exposed
Wide range in severity
What is Trisomy 21?
AKA Down's syndrome
Three of the 21st chromosome instead of a pair
Mental disability, heart defects, hearing defects, and other illnesses are very common with it
What is Trisomy 18?
AKA Edward's syndrome
Three of the 18th chromosome instead of a pair
Congenital heart disease
Airway issues/GI issues
What is the AHA Chain of Survival for Pediatric Cardiac Arrest?
Early Access to the Emergency Response System
Integrated Post-Arrest Care
What are the major types of acyanotic congenital heart defects?
Coarctation of aorta
AV canal defect
What are the major types of cyanotic congenital heart defects?
Tetralogy of Fallot
Hypoplastic left heart syndrome
Transposition of the great vessels (D and L types)
What type of medication is commonly prescribed to help close a PDA?
What type of medication is commonly prescribed to help keep a PDA open?
What defect do the Fontan and Hemi-Fontan procedures treat?
Single ventricle defects
What has been discussed as a possible cause for SIDS in new research?
Low serotonin levels in the brain
What are some risk factors associated with SIDS?
Maternal smoking/smoking in house = 3x more likely
Narcotic use during pregnancy = 10x more likely
Immune system disorders