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Peds Emergencies


croup bugs parainfluenza 1&2, adenovirus, RSV
croup s/s afebrile, normal sats; retractions, tachypnea, audible stridor; steeple sx on neck xray
croup tx normal: neb mist, O2, poss neb epinephrine, steroids if stridor at rest; if upper airway obstruction, intubate (watch for post pulmo edema)
bronchiolitis paraflu, 100k hosps/yr; 2-6 mos old, winter-spring
bronchiolitis s/s tachypnea, fever, tachy, hypoxia, nasal flaring, retractions; rales, wheezes, long exp phase; xray hyperinflation, hypoxia on ABG
Fever (>38C), <28 days old Admit, blood cx, ucc, LP; poss cxr; IV amp/gent; NO ROCEPHIN d/t kernicterus risk
Fever (>38C), 28 days - 3 mos blood cx, ucc, LP, poss cxr; Rocephin 50 mg/kg; d/c home if cxs neg; f/u in 24 hr
Fever (>39C), 3 mos - 3 yo ucc (M <6 mo, F <2 yo); poss cxr if sxs; poss stool cx; close f/u
SIDS epidemiology usu 2-4 mos old; 90% are <60 mos; 40% reduction since Back to Sleep; 2-10% may be undx'd abuse
most common site of intussusception ileocecal valve (pt of ileum into ascending colon)
intussusception s/s 6-9 mos; abd pain, n/v, colicky, drawing up legs, currant jelly stools; early: sausage-like abd mass; in 48 hrs lethargy, tachyp, fever, hypotension
intussusception dx/tx cardiac monitor, IVF, CMP, coag, cbc, T&C; u/s or xray; barium or air enema both dx/tx
Introduce solid foods (cereal, fruits) 4 – 6 mo; after 6 mo add meat, eggs, starchy foods
1st tooth (central incisor) 6 – 8 mo
Walks alone 15 mo
3 words, feeds self w/ spoon, builds tower 24 mo
< 2mo fever Septic w/u - blood Cx, LP
< 5yo fever, seizures Febrile seizure
Premature birth, fetal maturity Give corticosteroids
Meconium-stained amniotic fluids Fetal distress
Positive osmotic fragility test G6PD deficiency (hemolytic anemia w/ oxidative drugs – sulfa, nitrofurantoin, quinidine)
Mousy urine PKU
Vit D def / Rickets: genetics X-linked dominant
Hemophilia A, Duchennes MD: genetics X-linked Recessive
Neurofibromatosis: genetics Autosomal dominant
Sickle cell, CF, PKU: genetics Autosomal Recessive
Created by: Adam Barnard Adam Barnard