ABP Pediatric Emergency Medicine key terms

A rapid, hands-off visual and auditory screen of appearance, work of breathing, and circulation to skin used within seconds of a child's arrival to judge illness severity and the need for immediate intervention.

A state in which cardiac output is inadequate for tissue needs but blood pressure remains normal because of increased heart rate and vasoconstriction; children maintain this longer than adults before decompensating.

Circulatory failure in which blood pressure has already fallen below age-specific thresholds, indicating exhaustion of compensatory mechanisms and an imminent risk of cardiac arrest.

Distress is increased work of breathing with preserved oxygenation and ventilation; failure is inadequate gas exchange marked by diminished effort, altered mental status, cyanosis, or rising carbon dioxide.

A structured transfer of patient care using illness severity, patient summary, action list, situational awareness and contingency planning, and synthesis by receiver to reduce omissions and errors.

A technique in which the receiver repeats back an order or instruction and the sender confirms it, ensuring the message was heard correctly during high-stakes team care.

A quality and safety framework that distinguishes human error, at-risk behavior, and reckless conduct so that reporting is encouraged while accountability for unsafe choices is preserved.

A structured, team-based review after a serious safety event that maps contributing system factors and produces targeted, measurable changes rather than blaming individuals.

Acidosis with a widened difference between measured cations and anions, prompting evaluation for toxins, ketoacidosis, lactic acidosis, or renal failure; in children, ingestions such as salicylates and alcohols are key causes.

Poisoning that causes vomiting, tachypnea, tinnitus, altered mental status, and a mixed respiratory alkalosis with anion gap metabolic acidosis; treatment includes urine alkalinization and, in severe cases, hemodialysis.

Ingestion of methanol or ethylene glycol producing an osmolal gap early and an anion gap metabolic acidosis later, with visual or renal injury; therapy uses an alcohol dehydrogenase blocker and hemodialysis when indicated.

The difference between measured and calculated serum osmolality; an elevated value suggests the presence of unmeasured osmotically active substances such as alcohols or glycols.

Hepatotoxic overdose treated with N-acetylcysteine; risk is assessed with a timed serum level plotted on the Rumack-Matthew nomogram, and antidote is most effective when started early.

A recognizable cluster of vital sign and physical findings that identifies a class of poisoning, such as anticholinergic, cholinergic, sympathomimetic, opioid, or sedative-hypnotic patterns, guiding empiric treatment.

A drug-induced hyperserotonergic state with agitation, clonus, hyperreflexia, tremor, and autonomic instability, often from combining serotonergic agents; treatment is supportive with benzodiazepines and cyproheptadine in selected cases.

A rare reaction to dopamine-blocking drugs causing rigidity, high fever, altered consciousness, and elevated creatine kinase; management includes stopping the agent, cooling, and supportive care.

An opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression; because its duration may be shorter than the opioid, prolonged observation and repeat dosing or infusion are often needed.

Tissue hypoxia from carboxyhemoglobin that impairs oxygen delivery; pulse oximetry is falsely reassuring, so diagnosis requires co-oximetry, and treatment is high-flow oxygen with hyperbaric therapy for selected severe cases.

Conditions such as poor perfusion, motion, abnormal hemoglobin species, and methemoglobin or carboxyhemoglobin can make saturation readings inaccurate, so they must be interpreted with the clinical picture.

Life-threatening infection with dysregulated host response and new organ dysfunction, identified in children by fever or hypothermia plus signs such as altered mentation, hypotension, or elevated lactate; early antibiotics and fluids are time-critical.

Situations in which cerebrospinal fluid sampling is deferred or preceded by imaging and antibiotics, including focal neurologic findings, unstable vital signs, coagulopathy, or skin infection at the puncture site.

Infection of the meninges with fever, headache, neck stiffness, and altered mental status; empiric antibiotics and steroids should not be delayed by diagnostic testing in an unstable child.

A viral lower respiratory infection of infancy marked by rhinorrhea, cough, tachypnea, wheeze, and crackles; management is supportive with hydration and oxygen, and routine bronchodilators or steroids are not recommended.

Viral laryngotracheitis producing a barking cough, hoarse voice, and inspiratory stridor; nebulized epinephrine and a single dose of dexamethasone reduce airway edema and symptoms.

A harsh, typically inspiratory sound from turbulent airflow through a narrowed upper airway; its presence at rest signals significant obstruction and warrants prompt evaluation and airway readiness.

Acute supraglottic infection causing sudden high fever, drooling, muffled voice, and tripod positioning; the airway is at high risk of occlusion, so agitation and unprotected instrumentation are avoided while expert airway management is arranged.

Structural heart defects that require a patent ductus arteriosus for adequate pulmonary or systemic blood flow; closure after birth causes acute cyanosis or shock, and prostaglandin infusion reopens or maintains the ductus.

A sudden increase in right-to-left shunting in tetralogy of Fallot causing deep cyanosis and a loud murmur becoming softer; treatment uses calming, knee-chest positioning, oxygen, fluids, and vasoconstrictors or beta-blockade.

A narrow-complex tachyarrhythmia in infants and children that is often abrupt in onset and may cause shock; vagal maneuvers, then adenosine, then synchronized cardioversion are used in unstable patients.

Continuous seizure activity or repeated seizures without recovery lasting five minutes or more; treatment proceeds stepwise with benzodiazepines, then second-line anticonvulsants, while airway and glucose are addressed.

Ongoing electrographic seizure activity with altered consciousness but minimal or no motor manifestations; diagnosis requires electroencephalography and should be considered in unexplained persistent encephalopathy.

Inflicted brain injury in infants and young children, often from violent shaking with or without impact; findings include subdural hemorrhage, retinal hemorrhage, and fractures, and reporting is mandated.

A systematic evaluation for inflicted injury using injury pattern, developmental stage, inconsistent history, and occult injury imaging such as skeletal survey and head imaging in young children.

Prevention of secondary brain injury through airway and blood pressure support, avoidance of hypoxia and hypotension, and urgent imaging or neurosurgical consultation when indicated.

Telescoping of bowel causing episodic colicky pain, vomiting, and bloody stools in young children; an enema is both diagnostic and therapeutic in stable patients without perforation.

Hypertrophy of the pyloric muscle causing progressive nonbilious projectile vomiting in the first months of life, with hypochloremic hypokalemic metabolic alkalosis corrected before surgery.

Twisting of the spermatic cord that compromises blood flow and causes sudden severe scrotal pain; urgent surgical exploration is needed, and time to detorsion determines testicular salvage.

A structured, direct inquiry about suicidal ideation, plan, intent, and access to lethal means, paired with safety planning and appropriate disposition for any child presenting with behavioral concerns.

Focused evaluation to identify and stabilize medical causes or complications of agitation or altered behavior before or alongside psychiatric placement, avoiding unnecessary testing while not missing organic disease.

An approach that supports children's coping and involves caregivers in decisions and procedures, reducing distress and improving cooperation during emergency care.