Pediatric Emergencies
Core concepts
Understand the pediatric assessment triangle (appearance, work of breathing, circulation) and the differences in pediatric resuscitation: weight-based dosing, appropriate equipment sizing, and the use of the Broselow tape. Know the management of pediatric respiratory distress (bronchiolitis, croup, asthma, foreign body) and the recognition of sepsis in children.
Recognize the common pediatric emergencies: febrile seizures, dehydration and gastroenteritis, intussusception, and the approach to the child with a limp or non-accidental trauma. Understand the differences in pediatric airway anatomy and the approach to the difficult pediatric airway. Know the signs of shock in children, which may present late with hypotension.
Traps
Questions test whether you recognize that hypotension is a late sign in pediatric shock. Another trap is failing to consider non-accidental trauma when the history does not match the injury. Watch for the child with a fever and petechiae where meningococcemia must be considered.
Worked example / rule of thumb
A child with barky cough and inspiratory stridor: croup, treat with dexamethasone and nebulized epinephrine if moderate-severe. Rule of thumb: "Children compensate until they crash - treat shock before the blood pressure falls."