Pediatric Emergencies Overview
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Questions and Answers

What is a common sign of internal bleeding in pediatric patients?

  • Bleeding from the nose, ears, or rectum (correct)
  • Fever and chills
  • Abdominal bloating
  • Severe headaches

What should be prioritized in first aid care for a child with internal bleeding?

  • Perform abdominal massage to relieve discomfort
  • Administer pain medication immediately
  • Encourage the child to drink fluids
  • Secure and maintain an open airway (correct)

Which of the following is NOT a potential complication of blood administration in pediatric patients?

  • Allergic reaction
  • Hemolytic reaction
  • Intersitial edema (correct)
  • Fluid overload

In which position should a pediatric patient be placed to manage shock effectively?

<p>Supine position (D)</p> Signup and view all the answers

Which symptom might indicate changes in a child's status due to internal bleeding?

<p>Changes in level of consciousness (B)</p> Signup and view all the answers

What is the least important assessment priority in a pediatric emergency situation?

<p>Pain evaluation (A)</p> Signup and view all the answers

What components are included in the Pediatric Assessment Triangle (PAT)?

<p>Appearance, Work of Breathing, Circulation to Skin (B)</p> Signup and view all the answers

Which tool is used to estimate a child's weight for medication dosage based on length?

<p>Broselow tape (A)</p> Signup and view all the answers

Which medical treatment is typically considered a last resort in emergencies?

<p>Defibrillation (C)</p> Signup and view all the answers

What does respiratory failure indicate in pediatric emergencies?

<p>Inability to maintain oxygenation of the blood (D)</p> Signup and view all the answers

What is the purpose of giving comfort measures during a pediatric assessment?

<p>To alleviate stress and discomfort in a child (D)</p> Signup and view all the answers

What is vital to assess in children potentially experiencing illness, based on caregiver interaction?

<p>Caregiver stress impact on child perception (C)</p> Signup and view all the answers

Which diagnostic test is commonly performed to evaluate electrolyte levels in a pediatric emergency?

<p>ABG's (A)</p> Signup and view all the answers

What is the primary concern when administering activated charcoal in a case of poisoning?

<p>It binds to the toxin and passes through the GI system. (B)</p> Signup and view all the answers

Which injury is characterized by skin being broken and the victim at risk for external bleeding?

<p>Laceration (C)</p> Signup and view all the answers

What should be done immediately for a pediatric patient suspected of having ingested corrosive substances?

<p>Remove dermal and ocular toxins. (C)</p> Signup and view all the answers

What is the most common type of shock in pediatric patients?

<p>Hypovolemic / Hemorrhagic Shock (B)</p> Signup and view all the answers

In cases of closed injuries, which of the following is NOT a typical type of closed injury?

<p>Avulsion (A)</p> Signup and view all the answers

What is a key nursing management action in the treatment of shock?

<p>Administer medications and restore fluid volume (B)</p> Signup and view all the answers

What is the purpose of gastric lavage in cases of poisoning?

<p>To clean out the stomach contents. (D)</p> Signup and view all the answers

What should be done if an object is impaled in a wound?

<p>Stabilize the object and surround it with bulky dressings. (A)</p> Signup and view all the answers

Which of the following is the best method for preserving an amputated limb for potential reattachment?

<p>Rinse, elevate, and wrap it in ice. (B)</p> Signup and view all the answers

Which type of injury results from a sudden blow and may not show external signs?

<p>Crush injury (D)</p> Signup and view all the answers

Which type of shock is characterized by dilation of blood vessels due to a severe infection?

<p>Septic Shock (C)</p> Signup and view all the answers

For pediatric patients who have ingested a harmful substance, what is a crucial precaution regarding food intake?

<p>They should remain NPO (nothing by mouth). (B)</p> Signup and view all the answers

What is a common complication of animal bites, particularly from cats?

<p>Cellulitis and infection. (B)</p> Signup and view all the answers

What is the recommended action when a child is pulseless or has a heart rate less than 60 bpm?

<p>Start cardiac compressions (D)</p> Signup and view all the answers

What is the initial step in managing a bleeding victim?

<p>Assess the severity and duration of bleeding. (A)</p> Signup and view all the answers

Which of the following statements about pediatric trauma assessment is true?

<p>It requires a thorough ABCDE assessment. (A)</p> Signup and view all the answers

What causes anaphylactic shock?

<p>Severe allergic reaction (A)</p> Signup and view all the answers

What is a potential consequence of using a tourniquet?

<p>Lose circulation and function in the limb. (D)</p> Signup and view all the answers

Which condition is a common cause of pediatric cardiac arrhythmias?

<p>Electrolyte abnormalities (D)</p> Signup and view all the answers

What is the primary cause of death among children aged 1-4 years?

<p>Accidents (B)</p> Signup and view all the answers

What is a leading cause of distributive shock?

<p>Neurogenic injury (C)</p> Signup and view all the answers

In the case of spinal cord injuries, what is the most critical action to take?

<p>Immobilize the neck and secure the head. (D)</p> Signup and view all the answers

Which pediatric emergency assessment component involves checking for signs of distress such as nasal flaring?

<p>Breathing (B)</p> Signup and view all the answers

What is the appropriate use of an AED for children?

<p>For children under 1 who have no pulse and suffered a witnessed collapse (D)</p> Signup and view all the answers

Which scale is used to assess neurological status in pediatric emergencies?

<p>AVPU scale (C)</p> Signup and view all the answers

When managing a bleeding wound, direct pressure should be applied using which method?

<p>With the palm of your hand directly on the wound. (A)</p> Signup and view all the answers

What initial action should be taken if the airway is compromised?

<p>Secure the airway (A)</p> Signup and view all the answers

What factor does NOT significantly influence the severity of bleeding?

<p>Color of the blood. (C)</p> Signup and view all the answers

In pediatric emergency assessment, which sign indicates poor perfusion?

<p>Mottling (B)</p> Signup and view all the answers

What should a nurse assess for under 'Circulation' during a pediatric emergency?

<p>Heart rate and capillary refill (A)</p> Signup and view all the answers

What is the recommended action if a child shows signs of respiratory failure during an emergency?

<p>Provide oxygen or ventilation support (B)</p> Signup and view all the answers

Which age group is most affected by intentional self-harm as a leading cause of death?

<p>Children aged 10-14 years (D)</p> Signup and view all the answers

Flashcards

Pediatric Emergencies

Critical situations requiring immediate attention in young patients.

Leading Cause of Death (1-4 yrs)

Unintentional injuries, congenital abnormalities, and assault.

Leading Cause of Death (5-9 yrs)

Unintentional injuries, cancer, and congenital abnormalities.

Leading Cause of Death (10-14 yrs)

Unintentional injuries, suicide, and cancer.

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Pediatric Emergencies Assessment

Systematic evaluation process for immediate health concerns in children categorized by ABCDE.

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Airway (ABCDE Approach)

First aspect examined, involving ensuring an open and clear airway, checking for obstructions, and securing it if compromised.

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Circulation (ABCDE Approach)

Assessment of skin, heart rate, pulse, and blood pressure. Indicates perfusion and determines actions, such as IV access and fluids.

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Disability (Neurosystem)

Evaluates the patient's neurological status by awareness and response to stimulation, looking for signs of altered mental status (AVPU or GCS).

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Pediatric Assessment Triangle (PAT)

A quick assessment tool for evaluating illness/injury severity in children.

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Apnea

Complete stop of breathing for more than 20 seconds.

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Respiratory failure

Inability to adequately oxygenate the blood.

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Respiratory insufficiency

Increased breathing effort, but still enough gas exchange, not failure.

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Exposure/Environment Assessment

Completely check the child for signs of injury or sickness.

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Broselow Tape

Color-coded tape used to estimate a child's weight by length, used to calculate correct medicine dosage.

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STABLE SECONDARY ASSESSMENT

Secondary check of patient's health after immediate risks are cleared.

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Emergency Labs/Diagnostics

Medical tests used to diagnose and monitor a child's condition in an emergency.

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Hypovolemic Shock

Shock caused by a loss of blood or fluid volume in the body.

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Septic Shock Cause

Severe infection causing blood vessel dilation and low blood pressure, leading to organ failure.

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Cardiogenic Shock

Shock due to a diseased or damaged heart not pumping effectively.

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Distributive Shock

Shock resulting from a loss of stroke volume rate, often related to neurogenic injury.

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Anaphylactic Shock

Shock caused by an allergic reaction, leading to widespread vasodilation and low blood pressure.

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Cardiac Arrhythmias

Irregular heartbeats, often caused by electrolyte imbalances or heart conditions.

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Pediatric CPR

Cardiopulmonary resuscitation for children. Initiate if heart rate is below 60 bpm or the child is pulseless.

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Shock (general)

A progressive, potentially rapid process where the body has difficulty circulating enough blood.

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Internal Bleeding in Children

Internal bleeding in children can occur due to trauma, blunt force, fractures, or injuries to vital organs like the spleen, liver, and kidneys.

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Signs of Internal Bleeding

Symptoms of internal bleeding include nosebleeds, ear bleeds, rectal bleeding, coughing or vomiting blood, rigid abdomen, blood in urine, altered consciousness, restlessness, cool clammy skin, weak rapid pulse, and rapid breathing.

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First Aid for Internal Bleeding

First aid for internal bleeding involves securing an open airway, checking for fractures and splinting if necessary, keeping the child quiet and calm, positioning for shock, providing comfort, monitoring vital signs every 5 minutes, and calling for emergency medical services.

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Blood Transfusions in Children

Blood transfusions are used to replace lost blood components, treat anemia, or manage other medical conditions in children. Potential complications include allergic reactions, fever, hemolytic reactions, infections, and fluid overload.

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What is Hemolytic Reaction?

A hemolytic reaction is a serious complication of blood transfusion where the recipient's immune system attacks the transfused red blood cells, causing their destruction.

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Poisoning: Initial Steps

The first steps in managing a poisoning case involve ensuring the patient's safety by managing their airway, breathing, and circulation. Then, focus on detoxification by removing or neutralizing the ingested poison.

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Gastric Lavage

A medical procedure, also known as stomach pumping, that empties the contents of the stomach by flushing it with a liquid. Often used for poisoning or overdose.

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Activated Charcoal

A substance commonly used to treat poisonings. It binds with toxins in the digestive system, preventing their absorption into the bloodstream.

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Cathartics

Medications that speed up the movement of food and waste through the digestive system, helping to expel toxins from the body.

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Acetaminophen & Liver Damage

Acetaminophen, commonly known as Tylenol, can cause serious liver damage if overdosed. It's a critical poison to be aware of.

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Closed Injuries

Injuries where the skin remains intact, but underlying tissues are damaged. They may not be obvious externally.

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Open Injuries

Injuries where the skin is broken, exposing the wound to external bleeding and infection.

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Abdominal Injuries

Injuries to the abdomen, which can be closed (skin intact) or open (skin broken). They require careful assessment and management to avoid complications.

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Impaled Object: Removal?

Do not remove an impaled object unless in a hospital emergency room or operating room. It may be controlling bleeding, and removal could worsen the injury.

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Amputation: What to do?

Preserve the severed limb for potential reattachment. Rinse it, elevate it, wrap it, and place it on top of ice.

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Animal Bites: Most dangerous?

Dog bites are common, while cat bites are more likely to lead to infection. Human bites are very difficult to manage due to the multitude of bacteria in the mouth.

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Bleeding: Severity Factors

The severity of bleeding depends on several factors, including age, weight, duration of bleeding, blood flow, and whether it is internal or external bleeding.

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Direct Pressure: How it Works

Applying pressure directly to a wound helps to compress the blood vessels, reducing blood flow and promoting clotting.

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Elevate Affected Limb: Why?

Elevating the bleeding limb helps to reduce blood flow to the area, minimizing blood loss and potential swelling.

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Pressure Bandage: Function

A pressure bandage is used to hold pressure directly on a wound, helping to control bleeding by compressing the blood vessels.

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Tourniquet: When to Use?

Use a tourniquet as a last resort in emergency situations when direct pressure is ineffective in controlling severe bleeding.

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Study Notes

Pediatric Emergencies

  • Leading cause of death in children aged 1-4 is accidents.
  • Children aged 5-9: Accidents, cancer, congenital abnormalities
  • Children aged 10-14: Accidents, self-harm, cancer, congenital abnormalities

Pediatric Codes

  • Most pediatric codes involve respiratory failure or shock.
  • Pediatric nurses are certified in PALS (Pediatrics Advance Life Support) and PEARS (Pediatrics Emergency Assessment, Recognition, and Stabilization).

Pediatric Emergency Assessment (PEARS)

  • A - Airway: Ensure the airway is open and clear. Look for obstructions and abnormal sounds. Secure the airway if compromised.
  • B - Breathing: Monitor rate/pattern, O2 status, work of breathing, and signs of breathing effort (nasal flaring, accessory muscles). Assess breathing effectiveness by checking rate, effort, and quality. Look for distress signs like retractions, flaring, and cyanosis. Provide oxygen or ventilation support if needed.
  • C - Circulation: Check skin color, temperature, capillary refill, heart rate, and pulse strength. If absent, start CPR.

Other Key Information

  • Disability (Neurological Status): Assess level of consciousness, activity level, response to the environment, pupils, and altered mental status or seizures. Use the AVPU scale (Alert, Voice, Pain, Unresponsive) or the Glasgow Coma Scale.
  • Exposure/Environment: Fully expose the child to identify injuries or signs of illness. Maintain body temperature. Look for rashes, wounds, or abnormalities.
  • Pain: Least important assessment because the child is still alive and breathing.
  • Pediatric Assessment Triangle (PAT): rapid assessment tool to quickly evaluate the severity of illness or injury (Appearance, Work of Breathing, Circulation).

Common Medical Treatments

  • Suctioning, Oxygen, Bag-Valve-Mask Ventilation, Intubation
  • IV Fluids, Blood Products – improving circulation
  • Cervical Stabilization – to prevent further damage
  • Defibrillation – last resort in emergencies

Medication Doses and Equipment Sizes

  • Many facilities prepare code reference sheets when a child is admitted and use color coded Broselow tape for weight-based medication dosage.

Respiratory Emergencies

  • Respiratory insufficiency: Increased work of breathing, but adequate gas exchange.
  • Respiratory failure: Inability to maintain oxygenation of the blood.
  • Apnea: Cessation of respirations for more than 20 seconds (can be central or obstructive).
  • Respiratory arrest: Complete cessation of respirations
  • Airway obstruction: Can be due to aspiration of a foreign body.
  • Pediatric intubation: Nurses are vital on the intubation team, aiding in equipment setup, medication administration, suctioning, and ET tube securing.
    • Macintosh Blade: C-curve blade, most used for a wider range of patients, useful in adults and children. Directly lifts the epiglottis for good visualization.
    • Miller Blade: L-straight blade, often used for pediatric patients or those with a floppy epiglottis. Directly lifts the epiglottis and allows excellent visualization of vocal cords, useful in anatomical situations.

Pediatric Intubation

  • Nurses are a vital part of the intubation team, assisting with equipment, medication administration, suctioning, and endotracheal tube placement.

Other Pediatric Respiratory Emergencies

  • BRUE (Brief Resolved Unexplained Event): Alarming episode in infants (under 1 year old) involving apnea, color change, muscle tone change, or altered responsiveness. Resolves on its own.
  • SIDS (Sudden Infant Death Syndrome): Sudden, unexpected death of an otherwise healthy infant, often during sleep, during the first year of life. Prevention focuses on safe sleep practices.

Pediatric Shock

  • An inadequate delivery of blood to cells; left untreated, shock is fatal.
  • Progressive, gradual or rapid process that requires immediate recognition and treatment.

Cardiac Arrhythmias and Arrrests

  • Common causes include electrolyte abnormalities, toxic drug ingestion, congenital cardiac defects, potential life-threatening arrhythmias (prolonged QT syndrome, Hypertrophic cardiomyopathy), and traumatic cardiac injury.
  • Pediatric CPR: Initiate cardiac compressions if child is pulseless or heart rate less than 60 bpm. Use an AED for children under 1 who have sudden, witnessed collapse.
  • AHA recommends using an AED for children less than 1 who have no pulse and suffered a sudden, witnessed collapse.

Submersion Injuries

  • Third leading cause of preventable deaths.
  • Near-drowning/Submersion injuries: Child survives longer than 24 hours, after submersion in water.
  • Drowning: Asphyxia and death within 24 hours; primary respiratory impairment.
  • Water aspiration leads to poor oxygenation, pulmonary edema, and hypoxemia.

Ingestions & Poisoning

  • Ingestion of harmful substances is most common in the home environment.
  • Ex. Medications, household chemicals, plants, food, alcohol, drugs.
  • Prevention is crucial for children and adolescents.
  • Potential symptoms— vomiting, abdominal pain, decreased level of consciousness, seizures, respiratory distress.

Injuries & Trauma

  • Common cause of death in children and adolescents (unintentional injuries).
  • Closed Injuries: soft tissues damaged beneath the skin (bruises, hematomas).
  • Crush Injuries: underlying layers of skin severely damaged.
  • Clamping Injuries: severe damage to tissues and blood vessels.
  • Open Injuries: Skin is broken (abrasions, lacerations, avulsions, penetrating/punctured wounds)

Impaled Objects

  • Do not remove impaled objects unless in an OR.

Bleeding

  • Common causes include trauma, falls, accidents, sports injury.
  • First aid: Stop the bleeding immediately by applying direct pressure, or elevating the bleeding area.

Internal Bleeding in Pediatric Patients

  • Can result from trauma, blunt trauma, fractures, or injuries to vital organs (spleen, liver, kidneys).

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Pediatric Emergencies Lecture Guide PDF

Description

This quiz focuses on key aspects of pediatric emergencies, including the leading causes of death in children, critical pediatric codes, and the PEARS assessment process. Gain insights into airway management, breathing assessment, and circulation evaluation in emergency situations involving children.

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