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Age for newborns?
Birth - 12 hours
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Age of Infant?
1 month - 12 months
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Age of Toddler
12-36 months
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Age of Preschool?
3-5 years
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Adolescent age?
- End of childhood - 18 years
- Male- 13
- Female- 11
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How old is an infant before the fontenelle closes?
6-7 months
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Infants and toddlers depend on this for adequate tidal volumes.
diaphragm
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What is the oxygen consumption of a toddler and infant?
6-8 ml/kg/min
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Why do you need to get a Bgl on all peds?
limited glycogen and glucose stores
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How much fluid do you administer to a pediatric patient?
20ml/kg
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What are the 4 causes of upper respiratory obstruction?
- Croup
- Foreign body aspiration
- Bacterial tracheitis
- Epiglottitis
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What are the three causes of lower airway disease?
- Asthma
- Bronchiolitis
- Pneumonia
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What age is foreign body aspiration more common?
under 4 years of age
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What is Croup?
inflammatory of the upper respiratory tract involving the subglottic region
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What is the main cause of Croup?
Viral infection
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What age does Croup occur in?
- 6 months - 3 years
- Mostly in boys
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What are the indications of croup?
- Respiratory distress
- Retractions
- Barking (Seal or dog-like)or brassy cough
- Hoarseness
- Fever
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What is "Steeple sign"?
narrowing of the soft tissues on a neck x-ray that form a point.
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Treatment for croup?
- Oxygen- humidified or cool mist at 4-6Lpm
- IV
- Meds-Racemic Epi, Albuterol, and Decadron
- Position of Comfort and keep parents with them
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What is Bacterial Tracheitis?
- Bacterial infection of the upper airway, subglottic trachea, usually following viral croup
- Occurs in children 1-5 yo
- Uncommon, but more common around industrial facilities
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What are the S/S of bacterial tracheitis?
- Respiratory distress
- High-grade fever
- stridor
- coughing up pus/mucous
- sore throat
- usually a history of croup
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What age does Epiglottitis usually occur?
3-7 yo
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What is the pathophysiology of epiglottitis?
- Cellulitis of the epiglottis
- Bacterial infection, usually from hemophilus influenza type B
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S/S of epiglottitis?
- Rapid onset 6-8 hours
- Drooling/unable to swallow
- Stridor
- pale or cyanotic
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Treatment for epiglottitis?
- *Never attempt to visualize the airway if the pt is awake.
- Oxygen
- BVM if obstruction occurs
- Consider needle crich as last resort
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Treatment for Asthma?
- ABC
- O2
- Albuterol nebulizer
- Sub Q Epi 1:1000 if severe distress
- position of comfort
- keep with caregiver
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What age does Bronchiolitis occur?
<2 yo
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What is Bronchiolitis?
- inflammation of lower resiratory tract
- respiratory syncytial virus (RSV) infection of the lower airway
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S/S of Brochiolitis?
- Resp. distress
- Wheezing
- Rales
- May present similar to Asthma
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Treatment of Brochiolitis?
- ABC
- O2
- Iv
- Nebulizer Racemic Epi
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S/S of Pneumonia?
- Decreased breath sounds
- Rhonchi
- Chest pain
- Low Grade Fever
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Treatment for Pneumonia?
- ABC
- O2
- IV
- Position of Comfort
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What is the most common cause of pediatric siezures?
Fever
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Treatment of siezures?
- ABC
- O2
- IV
- BGL
- Ativan (preferred medication)
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When should you suspect Hypoglycemia?
Whenever a child shows altered LOC with explainable cause.
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Treatment for hypoglycemia?
- ABC
- O2
- IV
- BGL
- D25 or D12.5
- Glucogon if no IV
- Repeat BGL in 10 minutes
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What does Hyperglycemia lead to?
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Treatment for Hyperglycemia?
- ABC
- O2
- IV-LR or NS for dehydration
- Insulin and Potassium
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Treatment for S/S of generalized infection of unknown etiology?
- BSI
- ABC
- O2
- IV-LR/NS
- Treat the symptoms- siezure, fever, dehydration, etc.
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What is Meningitis?
- inflammation of the meninges identified by abnormal number of WBC in the CSF.
- highest occurrence in children <1 yo
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Which type of meningitis is worse, Bacterial or Viral?
Bacterial
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What is Brudzinski's sign?
flexion of the hips/knees with the fassive flexion of the neck.
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What is Kernigs sign?
Back pain resistance after flexion of lower legs
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Treatment for Meningitis?
- ABC
- Broad spectrum antibiotics
- Maintain MAP >50
- Acyclovir for suspicion of HSV
- Treat siezures with Ativan (acute) or Cerebyx (prevention)
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Most common cause of cardiac arrest in children?
Respiratory arrest
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How to calculate the intubation tube size?
- Age in years + 16 / 4
- (or use Pinky finger)
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Most common size of chest tube for peds?
10 fr
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What is the best ventilator setting for Peds?
Pressure control
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What is the 4-2-1 Rule?
- 4 ml/kg for first ten kg
- 2 ml/kg for next ten kg
- 1 ml/kg for any additional kg
- (For maintenance fluids only)
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Fluid resuscitation
- medical 10 ml/kg
- trauma 20 ml/kg
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Cardioversion
- first 0.5 joules/kg
- all others 1.0 joules/kg
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Defibrillation
- first 2.0 joules/kg
- all others 4.0 joules/kg
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