IV Insertion in Pediatric Patients: Minimizing Pain and Discomfort

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Questions and Answers

What is the first step in delivering a newborn?

Check for nuchal cord
Clamp and cut cord at 30-60 seconds
Delivery of lower body and umbilical cord
Support perineum controlled descent (correct)

What is the primary method to diagnose endometriosis?

Pregnancy test
MRI
CT scan
Ultrasound (correct)

What is the most important infection control measure?

Handwashing (correct)
Using isolation precautions
Wearing gloves
Wearing a mask

What is the purpose of a travel advisory?

To evolve constantly in response to changing outbreak situations (A) Signup and view all the answers

What is the role of a nurse in identifying a highly infectious disease?

To identify symptoms and isolate patients (D) Signup and view all the answers

What is the primary complication of endometriosis?

Pain and bleeding (D) Signup and view all the answers

What is the purpose of isolation precautions?

To reduce the risk of infection transmission (B) Signup and view all the answers

What is the definition of a highly infectious disease or high-consequence pathogen?

A disease that causes life-threatening illness and requires specific control measures (D) Signup and view all the answers

What is the primary goal of rapid and streamlined triage?

To move the most patients possible as safely as possible (C) Signup and view all the answers

What is the name of the pediatric triage algorithm?

JumpSTART (B) Signup and view all the answers

What is the name of the drills and exercise focused on triage and decanting?

Functional Exercise (C) Signup and view all the answers

How many patient actors were simulated in the IED scenario?

30 (C) Signup and view all the answers

What percentage of patients with potentially survivable wounds could have been saved?

1/3 (A) Signup and view all the answers

What is the focus of the discussion-based HRO crisis management drills?

Crisis management (B) Signup and view all the answers

How many departments participated in the full-scale exercise?

27 (A) Signup and view all the answers

What is the primary role of the trauma team?

Providing medical care (D) Signup and view all the answers

What is the main purpose of the SBAR tool in the emergency department?

To facilitate teamwork and communication during handovers (A) Signup and view all the answers

What is the primary benefit of incorporating bedside handovers into nursing practice?

Enhanced accountability and teamwork among nursing staff (D) Signup and view all the answers

What is the term used to describe an organization's ability to prioritize safety and continuous improvement?

Generative (B) Signup and view all the answers

What is the primary goal of the pediatric triage system?

To provide a standardized approach to patient assessment (C) Signup and view all the answers

What is the term used to describe the collective mindset of a team?

Shared mental model (A) Signup and view all the answers

What is the primary benefit of using the ESI triage system in pediatrics?

To identify patients who require immediate attention (C) Signup and view all the answers

What is the term used to describe the belief that team members will act in ways that promote the aims of the team?

Mutual trust (D) Signup and view all the answers

What is the primary issue with the blood vessels in distributive shock?

They have lost tone. (A) Signup and view all the answers

What is the primary purpose of the 'Stop' step in the questioning attitude process?

To pause and clarify any uncertainty or questions (A) Signup and view all the answers

What is the treatment for anaphylactic shock?

Epinephrine, steroids, and diphenhydramine. (D) Signup and view all the answers

What is the cause of neurogenic shock?

Loss of sympathetic output. (B) Signup and view all the answers

What is the last stage of sepsis?

Septic shock. (C) Signup and view all the answers

Why is giving fluids in distributive shock not sufficient?

Because the problem is with the pipes, not volume. (D) Signup and view all the answers

What is the role of the FDNY in a Mass Casualty Incident?

To determine the MCI level. (C) Signup and view all the answers

What is the purpose of the Mass Casualty Program?

To improve the preparedness of the Manhattan main campus to activate the MCI protocol. (C) Signup and view all the answers

How many members are on the decon team?

65 (D) Signup and view all the answers

What is the first step in comforting a pediatric patient during an IV insertion?

Partnering with the child's caregiver to determine what comforts them (D) Signup and view all the answers

What is the purpose of a child life specialist during IV insertion?

To distract the child during the procedure (D) Signup and view all the answers

Why is it important to keep the child's elbow straight during IV insertion?

To provide a mechanical advantage for the healthcare provider (B) Signup and view all the answers

What is the purpose of a Stat-lock during IV insertion?

To secure the IV in place (C) Signup and view all the answers

What is the benefit of using a vein illuminator during IV insertion?

It helps to locate the vein, making it easier to insert the IV (D) Signup and view all the answers

What is the purpose of LifeFlow Hand-operated rapid infusion device?

To deliver blood or fluids quickly and effectively (C) Signup and view all the answers

How much fluid can be delivered using the LifeFlow device in less than 2 minutes?

500 mL (C) Signup and view all the answers

What is a benefit of using sucrose during IV insertion for babies under 12 months?

It helps to comfort the child (D) Signup and view all the answers

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Study Notes

Delivery Complications and Gynecological Emergencies

Support perineum controlled descent: a crucial step in delivery to prevent complications
Head resistutes: a critical moment in delivery that requires careful attention
Check for nuchal cord: a potential complication during delivery
Oxytocin 10U IM: a medication used to manage delivery complications
Delivery of posterior shoulder: a crucial step in delivery that requires careful attention
Delivery of lower body and umbilical cord: a critical step in delivery that requires proper technique
Clamp and cut cord at 30-60 seconds: a crucial step in delivery to prevent complications

Ruptured Ovarian Cysts and Endometriosis

Ruptured ovarian cysts: a gynecological emergency that requires prompt attention
Ectopic pregnancy: a potential complication that requires rule-out
Pain management: a crucial aspect of managing gynecological emergencies
Endometriosis: a common complication that requires proper diagnosis and management
Diagnostic tools: US or CT scan are used to diagnose endometriosis
Management: pain and bleeding can be managed with contraceptives, and in some cases, DNC or surgery is required to remove some of the cells

Highly Infectious Diseases and High Consequence Pathogens

Highly infectious disease or pathogen: a serious hazard that requires specific control measures
Three steps for success:
- Identify: recognition of outbreaks and pathogens is crucial
- Isolate: isolation is a critical step in controlling the spread of disease
- Contain: containment is key to preventing further spread of disease

Infectious Disease Outbreaks

US-based outbreaks: listeria, Covid-19, fungal meningitis, measles, monkeypox
International outbreaks: ebola, dengue, diphtheria, chikungunya, marburg
Nursing role:
- Identification and isolation
- Real-life anecdote: Covid-19 symptoms and travel advisories
- Current state: remaining hypervigilant to symptoms and masking policies

Mass Casualty Incidents and Triage

Mass casualty incident: a serious situation that requires immediate attention and response
START Triage Algorithm: a critical tool for managing mass casualty incidents
JumpSTART Pediatric Triage: a triage system specifically designed for pediatric patients
Management of Mass Casualty Incidents:
- Decon team comms drills
- Functional exercise: focus on triage and decanting
- Full-scale decontamination scenario

Trauma and Emergency Department Management

Trauma team structure and roles: a critical aspect of emergency department management
Communication:
- Debriefing
- Trauma?Huddle: teamwork SBAR for escalating a concern
Patient Safety in the Emergency Department:
- Nursing Teamwork Survey Subscales
- Key Concepts for Success: communication, improvement models, continuous learning, accountability, transparency

Pediatric Triage and Care

Pediatric triage: a standardized approach that takes into account appearance, work of breathing, and circulation
Airway, breathing, circulation, disability, exposure (ABCDE)
Pertinent history, vaccination, vital signs, fever, and pain
Pediatric high-risk situations:
- Seizures
- Accessory muscle use, retractions, nasal flaring
- Sepsis
- Burns, suspected child abuse
- Fever in newborns
- Head trauma

Pediatric Vital Signs and Management

Pediatric vital signs: pulse, RR, SpO2, and temperature
Management of pediatric emergencies:
- Distributive shock
- Anaphylactic shock
- Neurogenic shock
- Septic shock
IV insertion in pediatric patients:
- Minimize pain of the procedure
- Positioning and comfort measures
- Numbing options and distractions
- Sucrose use

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