Pediatric Injuries and Poisoning Flashcards Preview

Peds 2 > Pediatric Injuries and Poisoning > Flashcards

Flashcards in Pediatric Injuries and Poisoning Deck (15)
Loading flashcards...
1
Q

What is the leading cause of death and disability among children and adults (1-44)?

Unintentional injury deaths peak ages ___ years and again at ages ___ years.

What is leading cause of unintentional injury?

A

trauma by unintentional injury!

Unintentional injury deaths peak during 1-4YO and again ages 15-24.

Leading cause of unintentional injury is FALLS!

2
Q

what is the leading cause of ACCIDENTAL death in children?

MC cause of motor vehicle injuries?

A

Motor vehicle injuries

MC cause of MVA:

  • Alcohol
  • excess speed
  • no seat belts
  • texting
3
Q

Infants less than 1YO and weight less than 35lbs should be restrained how in vehicle?

Ages 1-4 and weight 20-40lbs should be restrained how in vehicle?

Ages 4-6 should be restrained how in vehicle?

A

less than 1YO and less than 35lbs should be in an infant-only or rear facing child safety seat

ages 1-4 and weight 20-40lbs can be in a forward facing only in the back seat of the vehicle.

Ages 4-6 needs a booster seat installed in the back seat of the vehicle (booster seat for children under 60lbs)

4
Q

Submersion injuries:

  • locations of occurrence
  • prevention
A

locations: pools, lakes, streams, oceans, bathtubs, 5 gal buckets.
prevention: SUPERVISE YOUR KIDS!

5
Q

Bicycle injuries:

-MC in who?

A

boys ages 5-14YO.

6
Q

Which cartilaginous structure is weaker than bone and predisposed to injury in pediatric sports injuries?

MC fractured bone in children?

A
  • the physis (growth plate)
  • peds bone has higher water content and lower mineral content.
  • less brittle than adult bone..

most fx bone in children is clavicle
(kids are more prone to upper extremity fxs)

7
Q

peds head trauma:

  • risk factors
  • always consider ___ on DDX.
  • when do you image?
A

Risk factors:

  • large head
  • thin skulls
  • poor muscle control

always consider Concusiion on DDX,

Image when LOC greater than 1 min, evidence of skull fx, focal neurological findings, GCS of 13-14

8
Q

Coma score of ___ correlates with mild brain injury.

Score of ___ - ___ is moderate injury.

Score less than ___ is a severe brain injury.

A

13 or higher = mild TBI

9-12 is moderate brain injury

8 or less = severe brain injury.

9
Q

Head Trauma:

-signs of elevated ICP

A

Signs of elevated ICP
-AVPU (alert, voice, pain, unresponsive)

  • pupils
  • vomiting
  • cushing response (htn, bradycardia, apnea)
10
Q

Concussion:

  • presentation
  • tx
A
  • HA
  • confusion/disorientation
  • difficulties with memory
  • inattentiveness
  • dizziness

Tx:

  • physical and cognitive rest are primary interventions
  • meds for HA and nausea
  • gradual return to activity after sx resolve.
  • gradual return to play protocol:
  • -no activity
  • -light aerobic exercise
  • -sport specific exercise
  • -non contact training drills
  • -full contact practice
  • -return to play
11
Q

Common causes of poisoning

A
  • cosmetics and personal care products
  • cleaning substances
  • analgesics
  • plants
  • cough and cold remedies
  • tylenol, aspirin, iron, lead.
  • SSRIS, sedatives, antipsychotics, stimulants, illicit drug, cardiac drugs
12
Q

Acetaminophen Overdose

  • assessment?
  • presentation stages
  • tx
A

assessment: serum acetaminophen level (draw 4 hrs following ingestion); use toxicity nomogram to determine need for tx.

Presentation:
-stage 1: 1st 24hrs- minimal signs and sx, anorexia, n/v, pallor, and malaise

-stage 2: 2-3 days; signs of hepatotoxicity including RUQ pain and tenderness, elevated LFTs and bili.

Stage 3: 3-4days; some progress to fulminant hepatic failure, metabolic acidosis, coagulopathy, renal failure, encephalopathy, recurrent GI sx

Stage 4: pts who survive stage 3

Tx: N-acetylcysteine; works to counteract hepatic toxicity by replenishing glutathione.
-activated charcoal

13
Q

Aspirin Overdose

  • presentation
  • dx
  • Tx
A

Presentation:

  • tinnitus & vomiting
  • hyperpnea, fever, lethargy, confusion, coma, resp/cardiac failure

Dx: plasma salicylate concentrations

Tx:

  • no specific antidote
  • activated charcoal
  • alkalinization of IV bicarbonate
  • Dialysis may be necessary
14
Q

Iron overdose

  • presentation
  • tx
  • dose causing toxicity and death
A

Presentation:

  • vomiting, abd pain, GI bleed, diarrhea
  • has a stable period of 6-24hrs where sx may resolve)

dx:
- abd xray (for iron pills only)
- serum iron concentrations

Tx:

  • whole bowel irrigation
  • Deferoxamine IV (chelating agent) for severe cases.

Death from iron toxicity has been reported from 60-300mg/kg elemental iron.

15
Q

Lead Poisoning

  • aka
  • causes
  • presentation
  • tx
A

aka: plumbism

Cause: 
-paint/chip ingestion 
-contaminated household dusts in old homes 
-living near lead smelter 
-lead-contaminated soils 
...in flint its in the water!!!! 

Presentation:
-weakness, irritability, weight loss, vomiting, colicky abd pain, developmental delay, sz, peripheral neuropathy, anemia

Tx:

  • interrupt ingestion
  • chelating therapy with succimer