ABP Pediatric Emergency Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Pediatric assessment triangle

A rapid visual and auditory assessment of appearance, work of breathing, and circulation to skin used to categorize a child's condition before obtaining vital signs or equipment.

Hypotension threshold in children

Systolic blood pressure below 70 mm Hg plus twice the age in years (for ages 1 to 10) defines hypotension; it is a late and ominous sign in pediatric shock.

Pediatric defibrillation energy

Initial shock for ventricular fibrillation or pulseless ventricular tachycardia is 2 J/kg, second shock 4 J/kg, and subsequent shocks at least 4 J/kg up to 10 J/kg.

Epinephrine dose in pediatric arrest

Give 0.01 mg/kg of 1:10,000 epinephrine intravenously or intraosseously, equal to 0.1 mL/kg, repeated every 3 to 5 minutes during cardiac arrest.

Modified Glasgow Coma Scale

A pediatric adaptation scoring eye, verbal, and motor responses by developmental stage; a total score of 8 or less generally prompts airway protection.

Non-accidental trauma red flags

Injury inconsistent with developmental stage, delayed presentation, changing history, and patterned or non-dependent bruising should prompt reporting to child protective services.

N-acetylcysteine timing

The antidote for acetaminophen overdose is most effective when started within 8 hours of ingestion; risk is stratified using the Rumack-Matthew nomogram.

Naloxone pediatric dosing

For opioid-induced respiratory depression, give naloxone 0.1 mg/kg intravenously or intraosseously, maximum 2 mg, titrated to respiratory effort and repeated as needed.

Carbon monoxide treatment

Administer 100% oxygen; consider hyperbaric oxygen for severe poisoning with syncope, neurologic deficits, or pregnancy, and measure carboxyhemoglobin.

Febrile infant sepsis workup

Infants 28 days or younger with fever require blood, urine, and cerebrospinal fluid cultures, empiric antibiotics, and admission regardless of appearance.

Kawasaki disease treatment

Give intravenous immunoglobulin 2 g/kg as a single dose plus aspirin; obtain an echocardiogram to assess coronary artery involvement.

Croup treatment

A single dose of dexamethasone 0.15 to 0.6 mg/kg reduces symptoms; nebulized epinephrine is added for stridor at rest, with observation for rebound.

Bronchiolitis management

Supportive care with oxygen to keep saturation at least 90% and hydration; routine bronchodilators, corticosteroids, and antibiotics are not recommended.

Adenosine for SVT

Give 0.1 mg/kg rapid intravenous push, maximum 6 mg, for supraventricular tachycardia after vagal maneuvers; a second dose of 0.2 mg/kg may follow.

Prostaglandin E1 use

Start at 0.01 to 0.05 mcg/kg/min in suspected ductal-dependent congenital heart disease; monitor for apnea and be prepared for intubation.

Status epilepticus first-line

Give a benzodiazepine such as lorazepam 0.1 mg/kg intravenously or midazolam 0.2 mg/kg intramuscularly, then a second-line antiepileptic if seizures persist.

Simple febrile seizure

A generalized seizure lasting less than 15 minutes occurring once in 24 hours in a febrile child aged 6 months to 5 years; routine imaging and EEG are not indicated.

Intussusception presentation

Colicky abdominal pain, currant-jelly stools, and a sausage-shaped mass; air or contrast enema is both diagnostic and therapeutic in stable children.

Testicular torsion window

Acute scrotal pain with a high-riding, transversely lying testis requires urgent surgical exploration; viability is best preserved within 6 hours of onset.

Bilious emesis in neonates

Bilious vomiting in a newborn suggests malrotation with volvulus, a surgical emergency requiring urgent upper gastrointestinal contrast study and surgical consultation.

Serotonin syndrome features

Clonus, hyperreflexia, agitation, and hyperthermia after serotonergic agents; stop the offending drug, provide supportive care, and consider cyproheptadine.

Neuroleptic malignant syndrome

Rigidity, hyperthermia, and autonomic instability after antipsychotic use; stop the drug and treat with supportive care plus dantrolene or bromocriptine.

Suicide risk assessment

Ask adolescents directly about suicidal ideation, plan, intent, and access to lethal means; a prior attempt is the strongest predictor of future risk.

Pediatric readiness in EDs

General emergency departments should stock weight-based equipment, train staff in pediatric resuscitation, and use pediatric-specific protocols to improve outcomes.

I-PASS handoff

A structured handoff covering illness severity, patient summary, action list, situation awareness, and synthesis to reduce communication errors at shift change.

Emergency implied consent

When a guardian cannot be reached and delay would risk serious harm, treatment may proceed under implied consent doctrine for life-threatening conditions.

Mandated reporting duty

Physicians must report suspected child abuse or neglect to child protective services; good-faith reports are legally protected.

Family presence during resuscitation

Offering family the option to be present during resuscitation, with a designated facilitator, is supported when it does not impede care.

Rumack-Matthew nomogram

A tool plotting serum acetaminophen concentration against time after ingestion to determine whether N-acetylcysteine treatment is indicated.

Focused Assessment with Sonography

The FAST examination detects free intraperitoneal fluid after trauma but is less sensitive in children than in adults; negative results do not exclude injury.

Tension pneumothorax decompression

Needle decompression at the second intercostal space in the midclavicular line or fourth space in the anterior axillary line, followed by tube thoracostomy.

Diabetic ketoacidosis cerebral edema

Suspect with headache, altered mental status, or bradycardia during DKA treatment; give mannitol 0.5 to 1 g/kg or hypertonic saline and slow fluid correction.