Download ENPC 4th Ed Provider Manual Errata Document

4th edition ENPC Provider Manual Errata
January 2013
Thank you to all who have helped us to find some needed corrections in the ENPC 4th edition Provider Manual. Please update
your books accordingly. All corrections will be made in the next printing.
Chapter Page Error
iv
Ch 1
2
The first sentence in the last paragraph has an unneeded
'are'
The first sentence in the last paragraph should read "Emergency departments
should develop policies and procedures for the care of pediatric patients
including, but not limited to,…"
Ch 1
2
The last sentence in the last paragraph changes in plurality
The last sentence in the last paragraph should read "Emergency nurses should
also serve as champions for family-centered pediatric care in their organizations
and communities."
Ch 2
14
In the first bullet under Pediatric Deaths as a Result of
Illness, the word 'leading' is missing.
The first bullet under Pediatric Deaths as a Result of Illness should read "For
neonates (from birth to the age of 28 days), the leading causes are prematurity
and congenital anomalies."
Ch 2
16
The first two sentences under Violence Against Children
appeared redundant.
Ch 2
22
The first bullet uses the word 'frequent' and the second
uses the word 'relevant' to describe the same thing.
The sentences should be "In 2007, the rate of physical assault against children
and youth was higher than the rate of physical assault against adults. In the same
period of time, sexual assault was five times higher against children than the rate
against adults.25"
The second bullet should be changed to read "In those 10 years and older,
diseases of the digestive system are the most frequent."
Ch 4
58
Her skin color is not described.
v
vi
Elizabeth Cloughessy missing from contributor page
Correction
Front
Matter
Front
Matter
Front
Matter
Name and credentials added. Updated copy to LG and returned and reviewed by
MB, PK, MH, RH on 10/3/12
Sharon Payne missing from contributor page
Name and credentials added. Updated copy to LG and returned and reviewed by
MB, PK, MH, RH on 10/3/12
Kathy Woloshyn contributed to chapter 6, not 7 and doesn't Change the chapter under Kathy Woloshyn to 6 and remove her name from the
feel it was enough to be counted as an author.
chapter page
The last sentence of the first paragraph under Case Scenario E should read "You
note the skin on her face to be reddened with a raised rash, but otherwise her
color is pink."
4th edition ENPC Provider Manual Errata
January 2013
Ch 4
58
Text states "1. Based on the PAT, is this child sick, sicker, or
sickest? This child is behaving developmentally appropriate
for her age, her appearance is abnormal because of the
rash, her breathing is normal, and her color is abnormal.
Based on the two abnormal components of the PAT, this
child should be considered sickest."
Change the text of the paragraph under number 1 to "“This child is behaving in a
developmentally appropriate manner; shyness is normal at this age. Her general
appearance is normal despite the presence of the rash. A rash is evaluated after
the PAT is complete. A normal PAT indicates a rash that is not life-threatening
and isolation precautions should be instituted until the rash is identified. Her
breathing is unlabored; normal. Her circulation to the skin is normal; pink. Based
on no abnormal components of the PAT, this child should be considered sick.”
Ch 5
64
The last sentence in the first paragraph of the right hand
column is unclear that a patient presenting with no history
of trauma may still be a trauma (abuse) victim.
Change the last sentence of the first paragraph in the right hand column to read
"Immobilization of the cervical spine may avoid further injury to a child with no
history of trauma, but may, in fact, be a victim of physical abuse."
Ch 5
66
There is confusion about studies discussed and use of
cricoid pressure in adults, but no source cited.
Please change the first sentence in the first main bullet in the right hand column
to read "The routine use of cricoid pressure during intubation is no longer
recommended. There is no research in the pediatric population demonstrating
its use in preventing aspiration. Any laryngeal manipulation can adversely affect
the ability to visualize or intubate the trachea and should be used with caution."
Ch 5
70
Blood pressure can be taken in both the upper and lower
leg.
The last sentence in the first sub bullet under the Blood Pressure bullet should
read "An appropriately sized BP cuff bladder covers one-half to two-thirds of the
pediatric patient's upper arm, upper or lower leg."
Ch 6
92
There should be two new rows under Sedation/Analgesia
for Thoracentesis and Chest tube placement
There should be two new rows under Sedation/Analgesia in the table 6-8
Common Emergency Department Procedures...for Thoracentesis and Chest tube
placement
Ch 7
102
Not enough emphasis on the use of gastric tubes for
stomach decompression and lung expansion
The 2nd sentence under Gastric Tube Insertion should read "The primary reason
is decompression of the stomach to maximize lung expansion in the intubated
patient. It is also done to perform gastric lavage, instill medications, and
administer fluids and nutrition."
Ch 7
Ch 7
108
110
Add a row to Table 7-4 for Capnography
The second row under During the Procedure states oxygen
should be given by mask or according to hospital policy. It
could be other methods.
Add a row to Table 7-4 for Capnography
The second row under During the Procedure should read "Administer O2"
4th edition ENPC Provider Manual Errata
January 2013
Ch 8
119
Pressure bags and IV pumps are mentioned, but the
recommended method (taught in the Clinical
Considerations) of a 20 mL syringe and stopcock is not
noted at all.
Change content in the first paragraph at the top of the right hand column
starting with the second sentence to "To administer an intravenous fluid bolus
rapidly, the most accurate and efficient method is to use a stopcock with a 20 mL
syringe and push a number of times equal to the weight in kilograms. For
adolescents, a pressure bag may be used, but they are not accurate enough for
children. Infusion pumps are accurate, but slower as most have an upper limit of
999 mL/hour. For rapid administration a large-bore catheter should be used. For
nonemergent infusions, use the smallest bore needed for the infusion."
Ch 9
127
There is no discussion regarding advancing the IO too far.
The second sentence in fifth bullet in the left hand column should read
"Advancing beyond this point can penetrate the bone on the opposite wall,
causing an infiltration."
Ch 10
132
In the Clinical Significance column, the 16th row the first
word should be "Allows", not "Allow"
In the Clinical Significance column, the 16th row the first word should be
"Allows", not "Allow"
Ch 10
135
The first main bullet in the right hand column states the
infant's nares should be suctioned, but no mention of
suctioning for any other age group.
The first main bullet in the right hand column should read "Suction as needed.
Use a rigid suction tip, suction catheter, or bulb syringe as indicated."
Ch 10
136
The last sentence of the 3rd bullet at the top of the left
Change the last sentence of the 3rd bullet at the top of the left hand column to
hand column states "…than the calculated size of the cuffed "…than the calculated sized of the uncuffed ETT diameter."
ETT diameter." It should be 'uncuffed' instead.
Ch 10
137
In the left hand column of the table, the 2nd row under
interventions states "Provide supplemental oxygen as
tolerated." Add to read as "Provide supplemental oxygen,
cool mist, or humidified air as tolerated."
Ch 10
137
The last sentence under the left hand column states "Use of The last sentence under the left hand column should read "Steroids (e.g.
steroids may be considered". It is much more often
dexamethasone) are often given."
prescribed than it sounds.
In the left hand column of the table, the 2nd row under interventions states
"Provide supplemental oxygen as tolerated." Add to read as "Provide
supplemental oxygen, cool mist, or humidified air as tolerated."
4th edition ENPC Provider Manual Errata
Under the last row on the left hand column add a new row
"Discharge teaching: Teach caregivers to take child into cool
air, open the freezer, or run the shower for steam and sit
with the child in the bathroom. This change in temperature
or humidity can decrease inflammation in the upper
airway."
Suctioning is the most important intervention for RSV and it
is missing from the text.
January 2013
Ch 10
137
Under the last row on the left hand column add a new row "Discharge teaching:
Teach caregivers to take child into cool air, open the freezer, or run the shower
for steam and sit with the child in the bathroom. This change in temperature or
humidity can decrease inflammation in the upper airway."
Ch 10
141
Ch 10
141
The last sentence before Pertussis in the right hand column The last sentence before Pertussis in the right hand column should read "Current
confuses the use of ribavirin and palivizumab.
evidence does not support the use of ribavirin, an antiviral agent with limited
efficacy and has been associated with adverse effects for both patient and
provider. Palivizumab, an immunization for RSV, has been effective for high-risk
infants or young children with chronic lung or heart disease or prematurity."
Ch 11
148
In the left hand column under Specific Diagnostic Studies,
"throat culture" is missing
Change the sub bullet Blood culture under Specific diagnostic Studies to read
"Blood and throat cultures"
Ch 11
150
Several revisions to allow more room for additions to the
Rash table (11-3)
The first two paragraphs should read "Rashes are common complaints seen in
the pediatric patient presenting to the emergency department. A comprehensive
medical history and physical examination are often needed to identify skin
disorders. Assessment includes a thorough inspection of the skin and accurate
description of the location, size, shape, color, and distribution of the lesions. The
appropriate terminology for documentation is in Table 11-2."
Ch 11
150
Several revisions to allow more room for additions to the
Rash table (11-3)
The first two sentences in the second paragraph should read "Rashes are often
associated with a systemic illness (Table 11-3). Although the incidence of some
of these diseases has dropped with immunization, many cases are still reported
annually."
Ch 11
150
Lumbar puncture is missing under Specific Diagnostic
Studies
The last bullet under Specific Diagnostic Studies should read "Blood culture and
lumbar puncture if indicated"
Add under "Additional Interventions" as the first bullet; "Suction nose to clear
secretions and open the airway for infants who are obligate nose breathers."
4th edition ENPC Provider Manual Errata
January 2013
Ch 11
150
Rash table (11-3) expanded to include Strep/scarlatina rash, See attached table.
roseola, and fifth disease.
Ch 11
152
Lumbar puncture is missing under Specific Diagnostic
Studies
The second sub bullet under Specific Diagnostic Studies should read "CBC and
lumbar puncture"
Ch 11
153
There needs to be a differentiation between lorazepam as
the first choice medication for seizures and diazepam per
rectum as a second choice if there is no IV access.
Add the following sentence to the first sub bullet under the 5th bullet Anticipate
the administration of medication, "Diazepam (Valium) per rectum may be
considered as a second choice if there is no intravenous access."
Ch 11
155
Add "constant" before abdominal pain in the first sentence. Add "constant" before abdominal pain in the first sentence.
Ch 11
155
In the last two sentences of the first paragraph under
Intussusception more emphasis on pain is needed.
In the last two sentences of the first paragraph under Intussusception should
read "Lethargy and drawing up of the legs are most commonly reported signs.
However, because the severe pain is episodic, some patients…"
Ch 12
171
Table defines Neonate as first 27 days, It should be 28.
Change to 28
Ch 12
180
In the middle column of Cardiac, "sever" should be "severe" In the middle column of Cardiac, "sever" should be "severe"
Ch 12
181
The list for Seizures should include Hydrocephalus,
Neurologic injury or dysfunction, Increased intracranial
pressure, and meningitis
The list for Seizures should include Hydrocephalus, Neurologic injury or
dysfunction, Increased intracranial pressure, and meningitis
Ch 12
181
The list for Hypothermia should not include Neurologic
injury or dysfunction, Increased intracranial pressure
The list for Hypothermia should not include Neurologic injury or dysfunction,
Increased intracranial pressure
Ch 12
182
The list for Bulging anterior fontanel should not include
Formula intolerance or antibiotic adverse effect
The list for Bulging anterior fontanel should not include Formula intolerance or
antibiotic adverse effect
Ch 12
182
The list for Diarrhea should include Formula intolerance or
antibiotic adverse effect
The list for Diarrhea should include Formula intolerance or antibiotic adverse
effect
Ch 12
189
Under number 5, the last sentence is redundant
Delete the last sentence under number 5.
Ch 12
193
The second and third bullet at the top of the right hand
The second and third bullet at the top of the right hand column should be
column says one way to obtain a urinalysis and another for combined to read "Urine culture and analysis (sterile catheterized specimen or
the urine culture. If getting both, use one method.
suprapubic bladder tap only)
4th edition ENPC Provider Manual Errata
January 2013
Ch 12
193
At the bottom of the right hand column, there is an "If"
missing before "jaundice"
The last sentence at the bottom of the right hand column should read "If
jaundice is visible at birth, persists beyond the first three days…"
Ch 13
206
The last sentence before the bulleted list under Teenaged
Driving should have "injuries", not "injury"
The last sentence before the bulleted list under Teenaged Driving should have
"injuries", not "injury"
Ch 14
228
Second section in first row under characteristics states
"…versus 75-90 mL/kg per beat per minute in an adult." It
should be 75-90 mL per beat per minute
Change to "…versus 75-90 mL per beat per minute in an adult."
Ch 14
235
Under Pathophysiology "Angioedema" the term is missing
from Anaphylactic.
Ch 14
236
Epinephrine should be move to Treatment in early shock
Ch 15
155
Amiodarone cannot be given endotracheally
Ch 15
256
Hydrogen ion (acidosis) is missing from the list of H's
Change the sentence for Anaphylactic to "Anaphylactic: Hypersensitivity reaction
causing angioedema, a condition characterized by vasodilatation and capillary
leakage."
Move "Epinephrine, given intramuscularly, via manual syringe or autoinjector" to
Treatment in early shock under Supportive respiratory care. Capitalize
Diphenhydramine as it now begins the sentence.
The first main bullet in the right hand column should read "If there is still no
change, consider amiodarone (Cordarone) given via intravenous or intraosseous
routes. May be repeated up to two times."
Add a new bullet to the list of H's under Hypoglycemia "Hydrogen ion (acidosis)"
Ch 16
269
In the 5th sub-bullet under "Establish two peripheral
Change the sentence to "Anything can be infused into the IO needle that can be
intravenous…" the second person "you" should be changed. infused into a peripheral intravenous catheter."
Ch 16
270
The criteria for CT to minimize radiation citation was left
off.
The third bullet under Diagnostic Procedures and Additional Interventions should
end with a superscripted "37"
Ch 16
273
The last sub bullet under Circulation reads urine output
should be 0.5 to 2 mL/kg/hour. In another place we use 1
mL/kg/hour as the minimum.
Change the last sub bullet under Circulation to read "Urine output should be
greater than 1 to 2 mL/kg per hour."
Ch 16
275
In the 2nd bullet at the top of the left column the term is
creatinine kinase, and is should be creatinine
phosphokinase.
Change the sentence to "If an electrical burn occurs, be sure to obtain blood for a
creatine phosphokinase level and monitor for dark (tea-colored) urine that is
suggestive of myoglobinuria."
4th edition ENPC Provider Manual Errata
Ch 16
276
Ch 16
276
Ch 16
277
In the third bullet under "Additional Interventions…" it
Change the bullet to "ensure adequate oxygenation and ventilation to maintain a
states "Ensure adequate oxygenation and maintain a partial partial pressure of CO2 between 30 and 35 mm Hg."
pressure of CO2 of 30 to 35 mm Hg." It is ventilation that
controls CO2, not oxygenation.
Ch 16
277
Sublimaze (Fentanyl) does have analgesic properties
Delete Sublimaze (Fentanyl) from the list of medications for RSI
Ch 16
284
Under Pressure, it states that normal intracompartmental
pressures are less than 100 mm Hg. This is true for adults.
Normal pressures are higher in children.
Please change the 2nd sentence to "Pressures in adults are normally 5 to 10 mm
Hg. Children have a slightly higher normal between 13.3 and 16.6 mm Hg."
Reference is Staudt, J. M, Smeulders, M. J, & van der Horst, C. M. (2009). Normal
compartment pressures of the lower leg in children. The Journal of Bone and
Joint Surgery, British edition, 90(2), 215-219.
Ch 16
Ch 16
Ch 18
In the third bullet in the left hand column, the last sentence
does not include eye movement as seizure activity for the
infant.
In the fourth bullet under Assessment in the left hand
column, the size and presence of a hematoma is missing.
January 2013
284-285
293
318 The last sentence of the first paragraph should use the term
Latina, not Latino
In the third bullet in the left hand column, the last sentence should read "They
may exhibit abnormal eye movements, lip smacking, or bicycling movements."
In the fourth bullet under Assessment in the left hand column, add a sentence
that should read "Note presence and size of a hematoma."
Assure that all subsequent citation numbers are revised.
Add the reference cited above
Change the sentence to "Hispanic/Latina teenage girls have the highest number
of suicide attempts."
Ch 18
324
In the first sentence of the first full paragraph, the
medication aripiprazole (Abilify) is misspelled.
Change from apripiprazole to aripiprazole
Ch 19
330
In the first paragraph under Heat Stroke the last sentence
should have a temperature of 40.5 C, instead of 45 C
The sentence should be "Heat stroke is characterized by an elevated core
temperature of 104°.9 F (40.5° C) or greater with central nervous system
dysfunction."
Ch 19
334
In the second to last bullet at the bottom of the right
column, angioedema the term, should be included.
Change the bullet to "Systemic reactions indicating hypersensitivity/allergy will
begin within 30 minutes, if not sooner. Symptoms includes hives, redness, and
generalized edema which is a sign of angioedema, a condition characterized by
vasodilatation and capillary leak."
4th edition ENPC Provider Manual Errata
January 2013
Ch 20
345
In the left hand column under Traditional remedies that
contain lead, the words "greta" and "azarcon" were
incorrectly spelled as "greata" and "azaron".
Change to "greta" and "azarcon"
Ch 20
351
The first sentence in the 2nd paragraph under Abusive Head Change to "Injuries from shaking and blunt trauma have the potential to result in
Trauma, the term mental retardation is used.
death or permanent neurological disability, including static encephalopathy,
cognitive and developmental delays, cerebral palsy, cortical blindness, seizure
disorder, and learning disabilities."
Ch 22
370
The second paragraph under Ambulatory states that
children can be ambulatory, with a resp rate, and a pulse
and be unresponsive. It's not possible.
The second paragraph under Ambulatory should read "Children who are
ambulatory, possess acceptable respiratory rates, and have a palpable pulse, but
are inappropriate in their responses are triaged red/ immediate."
Ch 22
380
In Case Study 2 question 1, the correct answer should be
"Red (Immediate)", not Yellow
Change the Answers to Case Study 2 to "1. Red (Immediate)
Mgt
Ill/Inj
393
In the bulleted list under History, the 3rd bullet states
"Specialized history" the term should be "Focused history"
Change the term in the 3rd bullet under History to "Focused history"
4th edition ENPC Provider Manual Errata
January 2013