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63 Cards in this Set
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- Back
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FRC/TLC in peds vs adults?
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Same
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Which lung parameters are changed in peds pts?
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FRC, VC, PaO2 are decreased
MV, RR, MV/FRC increased |
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At what level is the glottis in infants vs adults?
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C3-4 vs C5-6 in adults
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Why do peds pt desaturate faster than adults?
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Primary reason is higher metabolism and secondariy higher MV/FRC
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Narrowest part of pediatric airway compare to adults?
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Cricoid cartilage vs glottic opening in adults.
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Infants total body water %age when compared to adults?
Extracellular fluids? |
80% vs 60% for adults.
40% vs 20% for adults |
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Why is induction of VA faster in infants?
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higher MV/FRC ratio
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What is the sensitivity of infants to sux?
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Less sensitive
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Hypoglycemia in infants of < 4.5 meq/l can present as?
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seizures, tetany, laryngospasm, hypotension.
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What is the dose of Sux (IV vs IM) in children?
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2mg/kg IV
4mg/kg IM |
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MAC:
infants vs adults Neonates vs adults |
infants vs adults > 40%
Neonates vs adults > 15% |
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Complications of Bicarb administration in children?
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cerebrel edema
hemorrhage hypernatremia hypercarbia |
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Most common type of tracheoesophageal fistula?
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Upper esophagus ends in blind pouch.
Lower esophagus attach to the back of the lower trachea. |
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What is the preferred method of intubation for tracheoesophageal fistula?
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1) Awake intubation if possible. 2) Inhalation induction with SV, ETT advance until R main stem, tube pulled back until BS are heard in stomach, then advance until, BBS.
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What procedure is critical for preventing gastric distension and aspiration in TEF?
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Gastrostomy
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When should paralysis begun in TEF?
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once chest is opened and fistula is ligated
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When should one defibrillate in peds?
What is the energy in joules? |
Vfib or SVT
2 joules/kg |
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Mechanism of hypoglycemia in neonates?
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Occurs in infants of diabetic mothers because during pregnancy glucose crosses the placenta but insulin does not. After birth glucose does not cross but neonatal pancreas insulin is acitve.
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Defined neonatal hypoglycemia?
How do you treat it? |
blood sugar < 20-30mg/dl
give 20% glucose (1-3cc/kg) over 5min |
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What is hypocalcemia in neonates?
Sx's? |
< 4.5meq/l
seizures, tetany, laryngospasm, hypotension |
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What is the diagnosis if unable to insert suction catheter through each nares?
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Choanal atresia
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How do you initially manage pt with choanal atreasia?
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oral airway
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What medication closes PDA?
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indomethacin
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What is a complication of PDA repair?
How does it present? |
Recurrent laryngeal nerve damage
Hoarseness |
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Name some R --> L shunts?
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TOF
Transpostion of great vessels Pulm stenosis with ASD Eiesenmenger's syndrome |
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What kind of shunt not improve by increasing FiO2?
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R to L shunt
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How does R --> L shunt affects:
IV induction? VA induction? |
IV induction = speeds induction
VA induction = slows induction |
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How does L --> R shunt affects:
IV induction? VA induction? |
IV induction = slows induction
VA induction = if normal CO no effect, if low CO then speeds |
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Vomiting in neonates with bile present, where is the obstruction?
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below the ampulla of vater
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Pyloric stenosis chem and ph derangements?
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hypochloremic, hypokalemic, Hypdontremic, metabolic alkalosis.
If severe dehydration can have metabolic acidosis. |
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If a child weighed 4kg 2 days ago and now is 3kg, how many cc of water is lost?
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1000cc/kg
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Induction for pyloric stenosis?
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RSI
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Under what post conceptual age must a pt be held overnight after surgery.
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<60 wks
2/2 to risk of apnea |
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Herniation of abd viscera into base of umbilical cord with a covering sac?
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Omphalocele
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abd wall eviscerates thru lateral defect with no membrane covering sac?
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Gastrochisis
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After repair of omphalocele/gastrochisis the pt vitals signs are unstable and compromised, what is the next step.
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open the abdomen.
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Scaphoid abdomen and bowel sounds heard in the chest.
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congential diaphragmatic herniation
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Where is the defect that most often occur in CDH?
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Left posterior foramen of Bochdalek
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Most common complicaton of CDH?
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contralateral PTX usually caused by barotrauma.
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Anesthesia for CDH
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VA, fentanyl, muscle relaxant, no no no N2O.
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Thumb print sign on lateral neck x-ray, usually bacterial, sore throat, fever, pt sitting up and leaning forward, drolling.
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Acute epiglottitis
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Tx for acute epiglotitiis
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intubation and abx (ampicillin)
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Neck x-ray shows steeple signs, stridor, inspiratory cough.
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Croup
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tx for Croup
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O2, cool mist, racemic epi, dexamethasone
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Which (acute epiglottitis or croup) is supraglottic and which in subglottic?
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Acute epiglottitis is supraglottic
Croup is subglottic |
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Largest component of heat loss in children?
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Radiation
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Micrognathia, congenital heart dsz, cleft palate, glossoptosis.
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Pierre Robin Syndrome
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Tongue differences between Pierre Robin vs Treacher Collins?
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PR = floppy tongue that falls back causing asphyxiation
TC = small tongue |
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Management of Pierre Robin and Treacher Collins syndrome
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Inhalational induction, SV with FOBI, ENT standby for surgical airway.
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Signs and symptoms of hypoglcemia in neonates?
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Irritabiliy, seizures, apnea, and bradycardia
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Caudal dose
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0.25% bupi with epi
1cc/kg |
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First signs of high spinal in peds.
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respiratory depression and hypoxia
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For retinopathy of prematurity:
What should the Sat/PaO2 be? Until what weeks Post-con age? |
Sat 93-95%
PaO2 <80 Until 44 wks PC age |
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Neonate--infant--5yo--adult
Sys BP HR Hgb blood vol |
Sys BP: 65--90--95--120
HR: 130--120--90--80 Hgb: 17--11--13--14 BV (cc/kg): 85--80--75--65 |
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Which neonatal condition is associate with increase incident of congenital heart dsz?
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omphalocele
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In neonates spinal cord ends at?
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L3
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Most common initial sx of esophageal atresia and tracheoesophageal fistula?
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regurgitation during feeding
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Omphalocele with macrosomia, macroglossia, hypoglycemia
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Beckwith-Wiedeman Syndrome
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age of infants?
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3-12mos
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PVR in infants is elevated but approaches that of adults by?
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1yr of life
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What is the fluid replacement in 1st 24hr if 40kg child with 50% burn.
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4x40x50% = 8.0L
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Preterm infant displays irritability, seizure, hypotension?
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give calcium
hypoglycemia would sometimes have apnea and brady cardia. |
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EMLA cream consists of?
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Lidocaine and prilocaine
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