CLIPP 23

Question 1

How do you assess whether a child is perfusing major organ systems?

Answer 1

Brain (alert vs lethargic)
Skin (well-perfused, flushed, or cool and clammy)
Kidneys (urine output)
Lungs (respiratory rate, work of breathing, cyanosis)

Question 2

What are the 4 types of shock?

Answer 2

distributive
hypovolemic
Cardiogenic
Septic

Question 3

What are common signs of fulminant meningitis?

Answer 3

purpura
shock

Question 4

What drugs can be used for N meningitis prophylaxis? Which ones are not recommended for pregnant women?

Answer 4

ciprofloxacin, rifampin, ceftriaxone, and azythromycin

ciprofloxacin and rifampin are not recommended for pregnant women

Question 5

What is a very sensitive measure of volume status?

Answer 5

tachycardia is the first and most subtle sign of possible inadequate perfusion

Question 6

What are the ABCDEs?

Answer 6

Airway
Breathing
Circulation
Disability/dextrose

• neurologic assessment should be performed to uncover signs of ICP and poisonings
• Dextrose is to remind us to check for hypoglycemia cuz its easily reversible

Exposure and Environment

• Expose and examine all parts of the patient and keep patient warm during evaluation)

Question 7

What drugs do ED docs give if meningitis is suspected?

Answer 7

ceftriaxone, vancomycin, doxycycline (if in RMSF territory)

Question 8

When placing a line, name some places where access is achieved?

Answer 8

peripheral venous access > central venous line > intraosseous line