CPEN Exam (coont punch emergency nerd exam) Questions With 100% Correct Answers.

CPEN Exam (coont punch emergency nerd exam) Questions With 100% Correct Answers. Halo traction and Gardner wells tongs What would be a potential treatment for an unstable cervical spine fracture? Stretches and straightens a severely compressed or curved spine. Can be used in cervical instability. Function of halo traction Provides spinal traction for the reduction of a cervical spine injury Function of Gardner wells tongs Most commonly used trauma scoring system for adults. Combines revised trauma score, injury severity score, and the patients age. Define: TRISS face, legs, activity, cry, consolability What does FLACC stand for? Thready, weak pulse Tachycardia Change in consciousness Hypotension Peripheral vasoconstriction Name 5 signs of hemorrhage in a pediatric patient Respiratory failure What is the most common cause of death within the first hour of a burn injury? Administration of oxygen, and monitor for signs of increased respiratory distress What are two interventions that should be done in the case of a burn injury? Liver, spleen, and kidneys due to proximity to the impacting forces What are the three most vulnerable abdominal organs in the case of a trauma in a toddler? 1. Ability to maintain airway 2. Systolic blood pressure 3. CNS status 4. Open Wound 5. Skeletal What are the 5 factors taken in consideration in a pediatric trauma score? Pain in the tip of the shoulder when the patient is lying down and the legs are elevated. Caused by presence of blood in the peritoneal cavity. May be a sign of a ruptured spleen. Define: Kehr's sign Under the age of 1 year. How does ESI define an infant in terms of age? Chin lift, jaw thrust In the case of a child in c-spine, how would you open the airway? Kehr's sign What is the correct term for a sign that is often present with bleeding in the peritoneum? Irrigation of cold water into the external ear canal. Tests for neurologic function, specifically the vestibular ocular reflex. It can also be used to test for brain death. How do you perform cold caloric testing, and what does it test for? The four traditional responses are: 1. Absent response (brain death) 2. Dysconjugate deviation of the eyes 3. Caloric nystagmus 4. Conjugate deviation What are the responses to the cold caloric testing, and what is their meaning? Elevate head of bed to 30 degrees. Irrigate the ear with 50 mL cold water. Allow 1 minute to pass before testing, and 5 minutes to pass between testing either side. How do you perform cold caloric testing? MODS: Multi organ dysfunction syndrome. The progressive deterioration of two or more organ systems. Define MODs and describe Hypovolemic shock What is the most common type of shock in a pediatric patient? Brain stem encephalitis Medullary infarction Posterior fossa tumors Severe asphyxia following near-drowning Name potential causes of acquired central hypoventilation syndrome Central hypoventilation syndrome refers to a build up of CO2 in arterial serum due to inadequate gas exchange. It is caused by a problem in the central nervous system, as opposed to the respiratory system. Define: acquired central hypoventilation syndrome Narrowing of the airway below the vocal cords AKA level of the glottis. Define: subglottic stenosis 100-180 Normal heart rate for an awake neonate 80-160 Normal heart rate for a sleeping neonate the mitral and tricuspid valves close What happens during S1? aortic/pulmonic (semilunar) valves close, occurs at the beginning of diastole. What happens during s2? Rapid entry of blood into ventricles. Can be a sign of heart failure. What happens if you hear an S3 sound? May indicate the stiffening of the walls of the ventricles. Can be a sign of cardiac dysfunction. What happens if you hear an S4 sound? Acute enteroviral infection of spinal cord. Neuromuscular paralysis. Short-term viremia. Fever, headache, sore throat, myalgia (muscle pain). Drooling. Signs and symptoms of poliomyelitis 2-60 days What is the pulmonary incubation period for anthrax? 1-7 days What is the pulmonary incubation period for cutaneous and GI mode of anthrax exposure? Hypoxia Trauma Thromboembolic event Hemorrhage Ischemia What are potential causes of increased ICP? Cerebral Perfusion Pressure [estimate of cerebral blood flow] MAP-ICP=CPP What is CPP and how is it calculated? Pulmonary congestion, due to blood backing up in the pulmonary system. There may also be enlargement in the right ventricle and atria to due increased pressures in the lungs, causing more work to push the blood through. What is a potential problem in a child with a large ventricular septal defect? An infection of the trachea caused by bacteria, often found in children with a tracheotomy. S/s: respiratory stridor, high fever, copious secretions Define: bacterial tracheitis Bacterial tracheitis signs and symptoms A weakness/flaccidity of the tracheal walls that is present at birth. Can cause the tracheal wall to collapse. Define: congenital tracheomalacia Bronchospasm. What does the "shark fin" on a wave capnography signify? Hypotension, jugular venous distention, muffled heart sounds Name the components of Beck's Triad Pericardial tamponade What does Beck's triad signify? Pericardiocentesis What is the treatment for pericardial tamponade? 1. Immediate needle decompression 2. Chest tube placement What is the treatment for a tension pneumothorax? Supplemental oxygen Anticoagulant therapy (heparin) Thrombolytic therapy (altaplase) Umbrella filter Surgical (if severe enough) What is the treatment for a pulmonary embolism? bilirubin induced brain dysfunction. Define: Kernicterus When bilirubin is being made too quickly in the newborn, sometimes the newborn can't keep up and is unable to conjugate it all. When the levels of unconjugated bilirubin are too high, it can cross the blood brain barrier, leading to a build up in the brain. Describe the pathophysiology of kernicterus Lethargy, irratibility, hyperactivity, floppy muscles Signs and symptoms of kernicterus Adenosine 0.1 mg/kg rapid bolus (up to 6mg), if this fails, 0.2 mgkg rapid bolus (up to 12 mg) Which medication do you give for SVT that is non responsive to non pharmacological intervention? Dosing? DUMBELS: Defecation/disphoresis Urination Miosis Bronchospasm/bronchorrhea Emesis Lacrimation Salivation Signs and symptoms of organophosphate exposure Pesticides, insecticides, nerve gases, flame retardants Examples of common organophosphates Cardioversion What treatment should be given in an infant with unstable super ventricular tachycardia? Petechiae What the most common sign of meningococcal meningitis? Subluxation of the radial head AKA nursemaid's elbow What is the most likely injury when a child's arm is pulled on, then refuses to move it? Topical analgesics If a child comes in with severe eye pain, but the globe is intact, what is the priority intervention? You need two witnesses to sign that consent was given by the parent to the surgeon for the procedure. What needs to occur if a parent is giving verbal consent over the phone in an emergency surgery? Inflammation of the epiglottis, often caused by bacterial infection. Dysphagia Dysphonia Drooling Distress Define, and describe Signs of epiglottitis? (Pneumonic) Haemophilus influenzae type B infection, which has been greatly reduced by the HIB vaccine What is a common cause of epiglottitis that we see rarely due to a vaccine?