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Diagnosis of medical emergencies at children

MEDICAL EMERGENCIES

State

Symptom complex

369 Acute anaphylaxis

Sharp weakness
Constraint in a breast
Dizziness
Sensation of fear
The hyperemia of the person which is quickly replaced pallor
Cold sweat
Mydriasis
The speeded-up noisy breath
Spasms
Threadlike pulse
Lowering of arterial pressure
Dullness of cordial tones
Involuntary urination and defecation

370 Acute appendicitis

The pains in the right ileal area accruing at dynamic supervision
Reduction of the specified pains in situation on the right side
Temperature increase to subfebrile figures
Vomiting is possible
Intestines dysfunction (obstipatsio or liquid chair)
Lag of a front abdominal wall in the act of breath
Damage of muscles of a front abdominal wall at a stomach palpation
Positive symptom of Shchetkin-Blyumberg
Positive symptom of Sitkovsky
The neutrophylic leukocytosis and SOE accruing in dynamics

371 Aspiration of a foreign body

Sudden attack of a severe cough against full health
Asthma
Cyanosis
Retraction of a thorax in the field of supraclavicular hollows, intercostal spaces, a xiphoidal shoot on a breath
Rigid breath
Radiological — an atelectasis site, Goltsknekhta-Jacobson's symptom

372 Asthmatic status, first stage

The expressed respiratory insufficiency
Expiratory asthma
Unproductive cough
Smoothness of intercostal spaces
Bandbox shade of a pulmonary sound
The weakened breath, the scattered dry, whistling rattles
Absence of effect of administration of adrenaline

373 Asthmatic status, second stage

The expressed respiratory insufficiency
The expressed expiratory asthma
Considerable bandbox sound at percussion over lungs
Auskultativno — a mute lung
Tachycardia

374 Asthmatic status, third stage (hypoxemic coma)

The consciousness is absent
Widespread cyanosis
Xeroderma and mucous
Barrel-shaped shape of a thorax
Sharply expressed bandbox sound over lungs
Lack of rattles and respiratory noise at auscultation of lungs
Dullness of cordial tones
The expressed bradycardia

375 Atsetonemichesky state

1 Development of clinical symptomatology after the use in food of the products containing fats or against a SARS

2 Repeated vomiting

3 Pristupoobrazny abdominal pains

4 An acetone smell from a mouth

5 Dryness of integuments and mucous

6 Decrease in elasticity of skin

7 Retraction of eyes

8 Neutrophylic leukocytosis

9 Normal content of sugar in blood

10 Sharply positive reaction of urine to acetone

376 Botulism

1 Emergence of symptoms in 12 — 72 hours after the use of the infected food

2 Deterioration in health

3 Dizziness

4 Diplopia

5 Decrease in hearing

6 Weight in a stomach

7 Nausea

8 Vomiting

9 Xeroderma and mucous
10 Tachycardia

377 Bronchial asthma, attack

1 The expressed expiratory asthma

2 Unproductive pristupoobrazny cough

3 Percussion and bandbox shade of a pulmonary sound

4 Auskultativno — the dry whistling rattles against the weakened breath

5 The roentgenogram — emfizematoz

378 Gemolitiko-uremichesky syndrome of Gasser

Pallor of skin, existence of hemorrhages
Oliguria
Splenomegaly
Urine of dark yellow or brownish-red color
Hemolitic anemia
Thrombocytopenia

379 Hemolitic crisis at Minkowski-Shoffara's anemia

Temperature increase to febrile figures
Vomiting
Abdominal pains
Asthma
Ikterichnost of scleras
Yellowness of integuments
Pulse increase
Hepatolienal syndrome
Anemia, reticulocytosis
Decrease in osmotic resistance of erythrocytes
Price-Jones curve shift to the left
Increase of level of an indirect bilirubin
Increase of level of urobilin in urine
Microspherocytosis

380 Lung hemosiderosis (crisis)

Sudden aggravation of symptoms
Temperature increase to 38 — 40 With
Abdominal pains and behind a breast
Cough with a phlegm
Gemoptoe
Perkutorno — a site of shortening of a pulmonary sound
Auskultativno — a set of mixed wet rattles in lungs
Radiological in lungs — oblakovidny shadows and sites of emphysema
Existence of siderophages in a phlegm

381 Hyper thermal syndrome

Temperature increase over 38,5
Pallor of integuments
Decrease in a muscle tone
Frequent shallow breathing
Tachycardia
Priglushennost of cordial tones
Lowering of arterial pressure

382 Hypoglycemic state

Sharp feeling of hunger
Concern
Weakness
Tremor of extremities
Hyperhidrosis
Pallor of skin
Tachycardia
Spasms
Hypoglycemia

383 DVS — a syndrome, the I stage (a hypercoagulation stage)

Needle thrombosing at venipunctures
Pallor
High systolic ABP
Hyperthermia, resistant to antipyretic therapy
Hyperglobulia, thrombocytosis, sharp increase of SOE
Increase of level of fibrinogen
Increase of a prothrombin ratio
The compensated metabolic acidosis

384 DVS — a syndrome, the II stage (blood circulation centralization)

 

Cold integuments, their sharp pallor or mramornost
Hemorrhagic rash
Slackness, block

Increase of the systolic and diastolic ABP
Progressing of a hyperthermia
Anemia, decrease in level of thrombocytes
Decrease in levels of fibrinogen and prothrombin
Decompensated metabolic acidosis

385 DVS — a syndrome, the III stage (herds of an afibrinogenemiya)

Hemorrhagic rash
Bleedings from places of injections
Hematemesis
Bloody diarrhea
The progressing anemia, thrombocytopenia
Afibrinogenemiya
Decompensated metabolic acidosis

386 Retropharyngeal abscess

Intoxication
Hyperthermia
Pain when swallowing
Difficulty of breath
Nasal shade of a voice
Puffiness of peritonsillar area on the party of defeat
Pharynx hyperemia
Neutrophylic leukocytosis, the increased SOE

387 Invagination

 

The acute abdominal pains having pristupoobrazny character
Vomiting in the period of an attack of abdominal pains
Chair delay
Release of the blood mixed with slime from an anus
Meteorism
Tension of a front abdominal wall in the period of an attack of abdominal pains
Intussusceptum palpation in the vnepristupny period

Detection of a local shadow  of an abdominal cavity, at some patients — Kloyber's bowls (horizontal levels of liquid in guts) at survey roentgenoscopy of an abdominal cavity)
Irrigoskopiya — defect of filling

388 The coma is diabetic

The consciousness is absent
Kusmaul's breath
Acetone smell from a mouth
Normal body temperature
Oliguria
Sharp pallor
Dryness of integuments
Decrease in elasticity of skin
Dry, hyperemic language
The expressed hypomyotonia
Decrease in a tone of eyeglobes
Small frequent pulse
Lowering of arterial pressure
Ekstr asystolia or ciliary arrhythmia
Hypo - or an areflexia
Hyperglycemia
Glucosuria
Giperketonemiya
Gnpernatrnemiya, hypopotassemia, hypochloraemia
High relative density of urine

389 Bleeding is gastric

Vomiting "a coffee thick"
Tar-like chair
Weakness
Pallor
Tachycardia
Priglushennost of cordial TONES
Lowering of arterial pressure
Breath increase
Anemia
Positive reaction of Gregersen

390 Bleeding from upper parts of intestines

Tar-like chair
Weakness
Pallor
Tachycardia
Priglushennost of cordial tones
Breath increase
Anemia
Positive reaction of Gregersen

391 Bleeding from lower parts of intestines

Scarlet blood in a chair
Weakness
Pallor
Breath increase
Tachycardia
Priglushennost of cardiac sounds
Anemia
Positive reaction of Gregersen

392 Laryngospasm

It is observed at children in the rickets reconvalescence period
Appears suddenly, more often in a spring season
Deep noisy breath
Pallor, Crocq's disease
Cold sweat
Neck muscle tension
Lack of reaction of pupils to light
Threadlike pulse

393 Urolithiasis, attack

 

Kolikoobrazny abdominal pains
Dysuric frustration
Intoksikatsionny syndrome
Hamaturia, leykotsiturnya, salts in urine

Radiological — concrements in kidneys or urinary tract

394 Neurotoxicosis, irritativny phase

Sharp concern
Vomiting
Tremor of extremities
The hyperthermia 39 — 39,5 which is removed antipyretics
Hyperesthesia
Increase of tendon jerks
Hyperemia of integuments
Increase of systolic arterial pressure
The tachycardia corresponding to a hyperthermia

395 Neurotoxicosis, soporous phase

The consciousness is kept
Slackness, sharply expressed block
Maskoobraznost of the person
Increase of neuromuscular excitability
The resistant hyperthermia which is stopped at the combined use of antipyretics and vasodilators
Mramornost of integuments
Cold snap of extremities
Positive symptom of a white spot
Tachycardia, corresponding hyperthermia
Increase of systolic and diastolic arterial pressure
Development of the IDCS is possible

396 Neurotoxicosis, average
brain coma

 

The consciousness is absent
Motive automatism
Spasms
Hyperthermia 40 * above, and giving in to effect of antipyretics and vasodilators

Meningeal signs are possible
Pallor
Mramornost of integuments
Crocq's disease
The symptom of a white spot keeps several minutes
Increase of a muscle tone
The sharp tachycardia which is replaced bradycardia
Lowering of arterial pressure

397 Neurotoxicosis, trunk coma

The consciousness is absent
The rare spasms arising against hypoxemic attacks
Cyanosis
Sharp decrease in a muscle tone
Hyporeflexia
Expansion of pupils with a weak photoharmose
Bradycardia
Lowering of arterial pressure

398 Neurotoxicosis, terminal coma

The consciousness is absent
There are no spasms
There is no deglutitory reflex
Sharp decrease in a muscle tone
Cyanosis
Bradipnoe
Respiratory arrhythmia
Bradycardia
Sharp lowering of arterial pressure

399 Syncope

The increasing weakness
Dizziness
Sonitus
Numbness of extremities
Blackout
Loss of consciousness

400 Acute adrenal
insufficiency

1 Nausea

2 Vomiting

3 Tachycardia

4 Deafs cardiac sounds

5 Pulse of weak filling

6 Breath like Cheyn-Stokes

7 Sharp hypotonia

8 Falling of arterial pressure

9 Preparetichesky state, intestines paresis

401 Acute renal failure, initial stage

1 Emergence of symptoms against a basic disease

2 Slackness

3 Loss of appetite

4 Pallor

5 Considerable decrease in diuresis

6 Hyposthenuria

7 The accruing azotemia

8 Hyperpotassemia

9 Hypernatremia

402 Acute renal failure, oligoanurichesky stage

1 Decrease in diuresis by 75% and more in relation to norm

2 Anorexia

3 Nausea

4 Headache

5 Skin itch

6 Spasms

7 Noisy, toxic breath

8 Unstable chair

9 Pallor with an ikterichny shade

10 Arrhythmia

11 Lowering of arterial pressure

12 Hyposthenuria

13 Increase of level of residual nitrogen, urea, creatinine in blood
Acidosis
Hyperpotassemia, gipermagniyemiya, hyperphosphatemia
Hyponatremia, hypocalcemia

403 Acute vascular insufficiency

Sharp weakness
Dizziness
Pallor
Skin Mramornost
Fall of skin veins
Cold snap of extremities
Cold sweat
Lowering of arterial pressure
Tachycardia
Pulse of weak filling and tension
Priglushennost of cordial tones
Mydriasis
Oliguria

404 Fluid lungs

Forced position of the child with the raised upper half of a trunk
Concern
Cardialgias
Asthma
Plentiful allocation of a foamy phlegm of pink or yellowish color
The bubbling noisy breath
Grayish and cyanotic color of integuments
Wet rattles in lungs
The speeded-up pulse of small filling
Shift of the left border of heart of a knaruzha
Tachycardia
Dullness of the I tone at a top, accent of the II tone over a pulmonary artery

412 Potassium poisoning with permanganate

Morbidity when swallowing
The raised sialosis
Pains in an anticardium
Vomiting with streaks and clots
Chair with blood
Cardiovascular insufficiency
Hepatomegalia
Oliguria
Increase of level of transaminases, residual nitrogen, creatinine, urea in blood

413 Poisoning with acids

Motive and hyperphrenia
The expressed morbidity of the struck mucous
Repeated vomiting with blood
Liquid chair with blood impurity
Sharp hyperemia, puffiness and bleeding mucous mouth, pharynx, almonds
The scab is dense, superficial, not getting deeply into fabrics
Hoarse voice, up to a full aphonia
The expressed exophthalmos
The tachycardia reaching degree paroxysmal
Priglushennost of cordial tones
Increase of arterial pressure

414 Poisoning with xanthines

 

Increase of a physical activity
Spasms
Orientation disturbance
Expansion of pupils with the kept photoharmose
Hallucinations, nonsense
Vomiting

Emetic masses in the form of a coffee thick
The speeded-up, deep breath
Tachycardia
Lowering of arterial pressure

415 Poisoning with arsenic

Headache
Nonsense
Repeated vomiting
Emetic masses with bile and blood
Difficulty when swallowing
Polydipsia
Tetanic spasms
Megalgias in a stomach
The frequent chair reminding rice broth
Calves pains
Decrease in body temperature
Dryness of integuments
Decrease in turgor of fabrics
Frequent pulse of weak filling
Lowering of arterial pressure

416 Poisoning
narcotic analgetics

Stupor
Bradipnoe
Periodically arising an apnoea
Spasms
Sharp narrowing of pupils
Loss of reaction of pupils to light
Oliguria and obstipatsio

417 Poisoning with mercury vapors

Cough
Asthma
Cyanosis
Fever
Frequent liquid chair
The drowsiness which is replaced a hyperexcitability
Radiological — emphysema, atelectases, pheumothorax

418 Poisoning with mercury drugs

Nausea
Repeated vomiting with blood impurity
Stomatitis
Abdominal pains
Tenesmus
Frequent liquid chair with blood impurity
Priglushennost of cordial tones
Tachycardia
Systolic noise
Hepatomegalia
Oliguria
The hypochromia anemia, leukocytosis increased by SOE
Proteinuria, hamaturia, hyaline and granular cylindruria

419 Poisoning with iron preparations

Repeated vomiting
The emetic mass of brown color with blood impurity
Chair with blood impurity
Cyanosis
Frequent pulse of small filling
Sharp falling of arterial pressure
Black-out

420 Poisoning with antihistaminic means

Slackness
Block
Hypomyotonia
Hyperkinetic syndrome
Kloniko-tonichesky spasms

421 Poisoning with helminthicides

Concern, sensation of fear
Cephalalgia
Ataxy
Nausea
Vomiting
Diarrhea
Hypomyotonia
Spasms
Urtikarny rash

422 Poisoning protivo-epileptic means

Vomiting
Dysphagy
Photophobia
The expressed ataxy
Dysarthtia
Dizziness
Hallucinations
Diplopia
Tremor
Mydriasis
Lateral and vertical nystagmus
Increase of deep tendon jerks
Temperature increase
Skin rashes

423 Poisoning with Reserpinum

Slackness
The child quickly falls asleep, but he can be woken easily
Dermahemia, persons, necks, trunks
Injetsirovannost of scleras
Puffiness and hyperemia of a mucous mouth, pharynx, nose
Difficulty of nasal breath
The child speaks "very softly"
Bradycardia
Decrease in systolic arterial pressure

424 Poisoning with salicylates

Vomiting in the form of "a coffee thick"
Unstable chair with blood impurity
Hyperpnea
Hyperthermia
Sonitus
Hyperemia of integuments
Hyperhidrosis
Hyperglycemia
Glucosuria

425 Poisoning
lead

Hyperexcitability
Spasms
Nape muscle tension
Mydriasis
Strabismus
Nystagmus
Persistent vomiting
Anemia
The increased content of lead in blood (more than 0,03 mg of %)
Increase of content of lead in urine more than 0,08 mg/l
Increase of content of coproporphyrin and delta and aminolevulinic acid more than 0,09 mg of %
Radiological — "lead strips" (cross more dense tapes in zones of preliminary calcification of tubular bones)

426 Poisoning with cardiac glycosides

Nausea
Vomiting
Cephalalgia
Decrease in visual acuity
Bradycardia
Ekstrasistoliya
ECG — disturbance of processes of conductivity, excitability, repolarization

427 Poisoning with tranquilizers

Drowsiness
Muscular relaxation
Sinus arrhythmia
Lowering of arterial pressure up to a collapse
The phenomena of a collapse precede respiratory depression and a mental depression

428 Poisoning with carbon monoxide

 

Decrease in attention
Disturbance of ability to distinguish short intervals of time
Weakening of perception of light

The accruing headache
Dizziness
Sonitus
Nausea
Vomiting
Blue-crimson color of integuments
Crimson-red shade of mucous
Hypomyotonia
Discontinuous breath
Falling of arterial pressure

429 Poisoning with fenotiazinovy derivatives

Dizziness
Drowsiness
Xeroderma and mucous
Hypomyotonia
Tachycardia
Intestines paresis
On ECG disturbance of processes of conductivity, excitability, repolarization

430 Poisoning with organophosphorous connections

Adynamia
Accommodation spasm
Expiratory asthma
Hypersalivation
Vomiting
Diarrhea
Pollakiuria
Abdominal pains
Tachycardia
10 Increase of arterial pressure

431 Poisoning with organochlorine compounds

Cephalalgia
Dizziness
Weakness
Extremity pains
Fever
Numbness of language
Tremor of distal departments of extremities
Sharp pallor
Cold clammy sweat
Conjunctivitis
Hypostasis of a mucous mouth and throat
Ekstrasistoliya

432 Poisoning with alkalis

Sharp morbidity of the struck mucous
Cough with an otkhozhdeniye of a mucous, bloody phlegm
Dispnoe
Hoarse voice
Cyanosis
Friable, deep scab in the place of defeat
Tachycardia
Priglushennost of cordial tones

433 Pancreatitis is acute

Sharp abdominal pain of the surrounding character
Nausea
Vomiting
Subfebrile condition
Obstipatsio
Pallor of integuments
Dryness of language, oblozhennost its whitish or dirty-gray plaque
The speeded-up, shallow breathing
Tachycardia
Priglushennost of cardiac sounds
Meteorism
Testovatost of fabrics in the left upper half of a stomach and in the field of the left costovertebral corner
At a stomach palpation — muscular La Défense
Positive symptoms of Kerte, Kacha, Mayo-Robsona, Of St. George at the left
Hyperamilasemia
Hyperamilasuria

434 Bouveret's disease

Dizziness
Feeling of a pulsation in temples
Impossibility of a full breath
Sensation of fear
Feeling of the strengthened heartbeat
Pains in an anticardium
Nausea
Excitement of the child
Asthma
The strengthened pulsation of cervical vessels
Pallor
Hyperhidrosis
Pulse is frequent, small filling
Heart rate more than 150 in a minute at children of advanced age and more than 200 in a minute at children of younger age
The loud, clapping tones
Polyuria
ECG myocardial dystrophy

435 Pheumothorax is spontaneous

Sharp aggravation of symptoms
Concern of the child
Frequent, shallow breathing
Dry, pristupoobrazny cough
Pallor
Participation in the act of breath of auxiliary muscles
Lag in the act of breath of the struck party
Percussion sound with a bandbox shade on the party of pheumothorax
Auskultativno — on the party of pheumothorax the weakened breath
Tachyarrhythmia
Radiological — mediastinum shift aside, opposite to pheumothorax

436 Diabetes mellitus, prekomatozny state

Apathy
Drowsiness
Appetite loss
Headache
Abdominal pains
Vomiting
Oliguria
Dryness of integuments and mucous
Tachypnea
Tachycardia
Hyperglycemia
Glucosuria
Ketonuria

437 Saturinizm

Pallor with an earthy-grayish shade
Lead border at a neck of teeth
Dispepsichesky frustration
Astheno - a vegetative syndrome
Hypochromia anemia, anisocytosis, tendency to a microcythemia
Basophilic and polychromatophilous stippling of erythrocytes
Miyelogramma — eritroblastoz, basphilic normotsitoz, an oxyphilic normotsitopeniya

438 Heart failure, coronary

Sharp concern of the child
The expressed cardialgias
Frequent shallow breathing
Pallor, Crocq's disease
The tachycardia reaching the level of paroxysmal
Degree of tachycardia does not correspond to degree of an asthma and a hyperthermia in the presence of the last
The expressed dullness of cardiac sounds
Meteorism
On an ECG — symptoms of ischemia of a myocardium

439 Heart failure, left ventricular

Forced situation with the raised upper half of a trunk
Asthma
Cardialgias
Cough
Grayish and cyanotic color of integuments
Wet rattles in lower parts of lungs with the subsequent their distribution to average and upper parts of lungs
Expansion of relative dullness of heart to the left
Dullness of the I tone at a top
Emphasis of the II tone on a pulmonary artery
The tachycardia which is not corresponding to temperature
The speeded-up pulse of small filling

440 Heart failure, right ventricular

Cyanosis
Pulsation of vessels of a neck
Expansion of cordial dullness
Easing of the II tone over a pulmonary artery
The tachycardia which is not corresponding to temperature
Increase in the sizes of a liver, its morbidity at a palpation
Decrease in diuresis
Increase of body weight
Positive reaction of Makklyura-Aldrich

441 Scalded skin syndrome

1 The acute beginning of a disease connected with reception of medicines (antibiotics, streptocides, analgetics, blood preparations) or with infectious, more often staphylococcal process
Fever
Burning and moderate dermatalgia
Pharyngalgia
Back pains
Existence of the large erntematozny spots on skin which are often merging and within several hours extending on all body
Forming on site spots of large, flat, flabby bubbles or hemorrhages
Positive symptom of Nikolsky

442 Ray's syndrome

Repeated vomiting
Convulsive syndrome
Pallor
Hyperhidrosis
Hemorrhagic syndrome
Hepatomegalia
Giperammoniyemiya
Increase of activity of transaminases in blood serum
Hypoglycemia
Metabolic acidosis
Prothrombinopenia

443 Stephens-Johnson's syndrome

The acute beginning of a disease against reception of streptocides, antibiotics or derivatives of pyrazyl ketone
Fever
Hyperemia and morbidity of mucous
Emergence during the first hours diseases of an enanthesis of the person, a neck, a breast, extremities, palms, soles in the form of the dark red spots, papules, vesicles inclined to merge
Obligatory localization of rashes in the field of natural foramens


444 A syndrome of chemical intoxication with a diffusion alopecia

The catarral phenomena from respiratory tracts
Intoxication
Increase of excitability of the central nervous system
Hallucinations are possible
Acute diffusion alopecia

445 The stenosing laryngotracheobronchitis

Quickly arises, usually, in the evening or at night against a SARS
The barking cough
Rough deep voice
The complicated noisy breath
Tachypnea
Participation in the act of breath of auxiliary muscles
Auskultativno — in lungs rigid breath
Tachycardia

446 Uraemia

The consciousness is absent
Motive concern
Clonic spasms
Began to smell urea from a mouth
Fall of temperature of a body
Breath like Cheyn-Stokes or the Biota
Anury
Dryness of integuments
Hemorrhagic rash on skin
Pulse is firm, it is intense
Arterial pressure is increased
Pericardial rub
Mydriasis
Positive symptom of Babinsky
The anemia, leukocytosis increased by SOE
Sharp increase of level of residual nitrogen, urea, creatinine in blood
Hypocalcemia

447 Favism

Rapid development of symptomatology in a few minutes after inhalation of pollen of flowers of a plant of Vicia Fava or within a day after the use in food of horse beans
High temperature
Nausea, vomiting
Headache
The accruing jaundice
The progressing gepatosplenomegaliya
The progressing anemia, anizo-and a poikilocytosis, a polychromatophilia, formation of little bodies of Heinz
Increase of level, indirect bilirubin in blood
Gemoglobinouriya
Deficit of enzyme glucose — 6 — fosfatdegidrogenaza

448 Cholecystitis is acute

Sudden beginning of a disease
Colicy pains in right hypochondrium, amplifying in situation on the right side
Temperature increase to febrile figures
Nausea
Vomiting
Pallor
Dryness of mucous
Language Oblozhennost ochroleucous plaque
Meteorism
Lag of upper parts of a stomach in the act of breath
Muscle tension of a front abdominal wall, especially, in right hypochondrium
Positive symptom of Kerr
Neutrophylic leukocytosis
Ultrasonography — consolidation, a thickening of walls of a gall bladder

449 Eclampsia
renal

Headache
Drowsiness
Vomiting
Amblyopia
Toniko-klonichesky spasms
Breath like Cheyn-Stokes
Increase of arterial pressure
Oliguria
Hamaturia
Confusion of consciousness

According to Ostropolets S. S., V. N. Beet, Diagnostic syndromes of diseases of children's age.

 
"Diagnosis of disbolism at children   Diagnosis of nervous diseases"