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ENPC Study Set 1
Terms in this set (37)
Components in the prioritization of pediatric emergency care (4)
PAT, Focused Assessment (objective information), Focused pediatric Hx(subjective information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components
Appearance. Work of Breathing. Circulation to the skin. This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
Pediatric Assessment Triangle : Appearance
Most important. Reflects adequacy of ventilation, oxygenation, brain perfusion, and central nervous system function.
Assess for : tone, interactiveness, consolability, look/gaze, and speech/cry.
Pediatric Assessment Triangle : Work of Breathing
Breathing easy, even, and unlabored or tripod position, nasal flaring, retractions, supraclavicular retractions
Pediatric Assessment Triangle : Circulation to the skin
Mottling or PWD
PQRST for Pain
Precipitating and palliating factors
Severity, symptoms, and site
Time or triggering factors
Verbal Report for pain
Self-report is the most reliable indicatior of pain; however not all pediatric pt are capable or wiling to verbalize their discomfort.
What age is the respiratory system considered fully developed?
8 years old
Most ______ age __to____, are concrete thinkers and interpret words literally.
Where as, most _____ age ___ to ___, are magical and illogical thinkers. They often confuse coincidence with causation, and have difficulty distinguising fantasy from reality.
Most Toddlers age 1yo to 3yo , are concrete thinkers and interpret words literally.
Where as, most Preschoolers age 3yo to 5yo, are magical and illogical thinkers. They often confuse coincidence with causation, and have difficulty distinguising fantasy from reality.
Hypotension related to hypovolemia in pediatric trauma patients is a _____ sign and may indicate a loss of ___% to ___% of their circulating blood volume.
20% to 25% of circulating blood volume
6P's Assessment for Musculoskeletal Trauma
Pallor : color different from uninjured
Burn Transfer Criteria
1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
If live interpreter not available for 15mins use ________
Language line interpreter
Infants are obligate nose breathers. If nose is obstructed ___________
Neutropenic pt with a temperature
Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern
Bicycle accident concerns
Did pt strike handle bars?
Possible abdominal injury
Ribs are more horizontal and provide less protection.
Normal Urine Output for child
1 to 2ml / Kg / Hr
Differences of child vs adult : BSA, blood volume, glycogen storage, metabolic rate
Children have : increased BSA(predispose to temp dysregulation), decreased circulation blood volume(predispose to hypovolemia), decreased glycogen storage(predisoposed to hypoglycemia), Increased metabolic rate.
Oral Rehydration for 9month old with mild dehydration.
Glucose and sodium solution, every 2 to 5min with 5 to 10ml
6week old infant, no medical hx. eating poorly, vomiting, "hard to wake up", responsive to pain. Anterior fontanel bulging, tachypnic. Diagnostic evaluation expected?
Possible shaken baby syndrome
Minimal Acceptable BP's
Newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)
All critically ill patients require _____ level
glucose due to low glycogen stores
Altered Mental Status is considered ______ until proven otherwise
decreased cerebral perfusion
Decompensated shock in children #1 sign
Best place for an IV
Hand(ask if there is a certain side thumb they suck)
Scalp if less than 9months.
Not in feet if they walk.
Tension Pneumothorax Tx
Needle chest decompression
2nd ICS MCL
MD has to say when they can return, not the pt or caregiver.
Should be a "gradual return to play"
Cardiopulmonary Arrest usually from (2)
Bradycardia pharm treatment
Epinephrine (1:10,000), 0.01mg/kg every 3-5min
Jump START triage : colors and designation
Determined by ability to ambulate, respirations, perfusion, and mental status.
Black (dead or unsalvageable)
Red (immediate care)
Yellow (delayed care)
Green (minor or ambulatory)
Jump START triage : breathing
not breathing -> position upper airway, now breathing = red(immediate)
-5 rescue breaths wo breathing, no pulse = black(deceased)
Jump START triage : Respiratory rate
<15 or >45 = immediate (red)
Jump START triage : Pulse
If breathing with resp rate 15-45.
No pulse = immediate (red)
Jump START triage : AVPU
If breathing, resp rate 15-45, with palpable pulse.
P(inappropriate), posturing or unresponsive = immediate(red)
A,V, P(appropriate) = delayed(yellow)
THIS SET IS OFTEN IN FOLDERS WITH...
ENPC Test Questions
ENPC Test Questions 2
Assessment and Prioritization-ENPC
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