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Peds Assessment Triangle
Apperance, WOB, and circulation
No touch
3 S's
Sick: nothing abmornal
Sicker: acute disruption
Sickest: 2 or more disruptions
Urgent vs. Emergent
U: need care within 24 hrs
E: threats to life, limb, or eyesight
4 components of Peds Triage
PAT, initial assessment, triage hx, acuity
Gastric Lavage
Needs to be done within 1 hr
Helpful if med slow gastric motility
Iron Ingestion
Tricyclic
Activated Charcoal
Within 1hr
1gm/kg
Will not absorb alcohols, hydrocarbons, caustics, or heavy metals
Whole bowel Irrigation
Golytely
For iron, lead, sustained release
Acetaminophen Ingestion
Liver damage
St.1: 12-24 hr- vague, N/V, anorexia, pallor
St.2: 1-4 days, latent
St.3: 72-96 hr hepatic necrosis
St.4: 7-8 days worse or better
4 hr level, Acetodote
Disc Batteries
Remove immediately, fatal tissue injury
Methanol
, Windshield washer fld, gas additives
GI, CNS, and ocular: acidosis and CNS depression
Formic Acid damages optic nerve
Give Antidote: formepizole or ethanol inhibitors
Isopropyl Alcohol
Rubbing alcohol, hand sanitizer
Absorbed by the GI tract, excreted by kidney, metabolized by liver
Ethanol
alcoholic beverages, perfumes, mouthwash
hypoglycemia
Is the antidote for ethylene glycol and methanol
CNS depression
Ethylene glycol
Antifreeze and deicer
GI, CNS, renal effects, acidosis
Can develop sx after 12 hrs
Renal failure causes by calcium oxalate crystals in urine(occlude kidneys)
Give bicarb, antidote: formepizole, ethanol, pyridoxine
Tricyclic
Any amt toxic to a child
CNS and cardiac problems(wide QRS), hypotension, anticholinergic symptoms
Bicarb for cardiac toxicity, lidocaine to prevent vent. dysrhythmias, benzos for sx
Ca Channel Blockers
small amt lethal
Decontaminate GI
Monitor, Ca Chloride supplement, glucagon to increase HR, insulin
Digitalis
Dysrhythmia, N/V, halos, increased K, brady, dec BP
Antidote: Dig Fab binds to to dig
Lomotil
Mixture opioid and atropine-toxic
Delayed absorption
Lasts 24 hr
1 pill can be toxic
Hydrofluoric acid
Call PC
rust removers, glass etch
causes local and systemic toxicity
Irrigate, watch Ca levels, hard to control pain