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Vaccinations (Peds) (Active (Passive (Herd Immunity :cow2::cow2: (How we…

- - - - How we eradicate disease
        
        everyone should (not must) get vaccinated
        
        nobody can carry the disease, but some immunocompromised ppl can still get disease.
        
        so not everyone has small pox vaccination, but they won't get it because we eradicated it
- - - - anaphylaxis is worse than getting the virus.
        
        :no_entry:Yellow Fever
        
        :check:MMRV (can give, no longer egg based)
        
        (changing) Influenza (will no longer be used w/ egg. For the test, be careful and check to see if our flu vaccine is made w/ egg
        
        not a restriction, just need to check
    - - :no_entry:MMRV
        
        :check:Influenza IM (not live, safe)
        
        :no_entry:Influenza Nasal
  - - - :forbidden:
        
        Hi temp :fire::thermometer: ≥104ºF
        
        inconsolable child :sob:
        
        frank Anaphylaxis
        
        :pencil2:not a contraindication for other vaccines, just contraindicated in that specific vaccine in the future.
        
        :pencil2:Sickness is not a contraindication for giving a vaccine.
        
        baby sick? give vaccine
        
        :pencil2:Fam Hx of a bad reaction to vaccine? Give the vaccine. Irrelevant history.
        
        only personal hx, or known allergy is contraindication.
        
        :pencil2:Autism?????
        
        nope, don't mention it
        
        may want to chastise the parent
        
        Vaccines are good, end of story.
- - - - DTaP = kids :boy::skin-tone-2: (5x as child)
        
        Tdap = adults :man::skin-tone-4: (1x after 11yo, & q10years)
        
        Td = tetanus booster; can be given instead of Tdap (preferred).
        
        :pencil2:Never miss an opportunity to give a Tdap
        
        especially :pregnant_woman::skin-tone-2:, every pregnancy
        
        Adults >65 :older_woman::skin-tone-4: (for pertussis)
      - Hib
        
        Give vaccine when pt has epiglotitis
        :warning:Hib infx doesn't give immunity
        
        MMRV
        
        everyone gets it
        
        :forbidden::pregnant_woman::skin-tone-2:
        
        (Pretest): Pts born before 1957 (62yo now) are considered immune to measles.
        
        Pneumococcal
        
        mostly adults, but also kids: :boy::skin-tone-2:
        
        sick or asplenic kids :boy::skin-tone-2:
        
        (Pretest)
        
        1 before, 1 after age 65
        
        must space out by 5 years
        
        Meningococcal
        
        Everyone should get
        
        College/military :warning: must get :camping::boot:
        
        HBV/HAV
        
        3x dose for HAV
        
        3x dose for HBV
        
        if theres a lapse, continue where you left off.
        
        Flu
        
        2 more items...
      - Pertussis
        
        Diptheria
        
        Tetanus
        
        focus on studying this
        
        Pt: Dirty wound :hammer:
        
        metal puncture w/ rust
        
        also muddy swamp :crocodile:
        
        Lock Jaw :lock:
        
        Spastic paralysis (every muscle contracts; 10% of people die)
        
        Dx: Clinical
        
        Tx: ABCs
        
        intubate & sedate :sleeping:
        
        Muscle relaxers & Paralytics (prn) to get thru acute
        
        IV ABx (metronidazole is right answer)
        
        1 more item...
        
        Pt: Fever :thermometer::fire:
        
        Dysphagia
        
        Dyspnea (pseudomembrane: see in mouth)
        :warning:don't peel it off, it will bleed/pt dies :skull:
        
        Dx: Clinical
        
        Tx: ABCs
        
        Secure airway: Intubate
        
        Anti-toxin
        
        IV Abx
        
        :pencil2:Will not see any of these, IF they get the vaccine!
        
        :pencil2: immunity wanes in adulthood
        
        Pt:
        
        Cattaral phase: infectious, nonspecific syndrome "cold-like": low grade :thermometer: Temp, rhinorrhea :sneezing_face:, cough
        
        Paroxysmal (bad for kids :boy::skin-tone-2:) Paroxysms of coughs w/ large inspiratory effort *wheezing
        
        Resolution
        
        Dx: Clinical
        
        Tx: Supportive
        
        may need airway support
        
        Azithromycin
    - - :pregnant_woman::skin-tone-2: is HBV negative.
        Tx: HBV HAV vaccine series w/in 2mo
        
        :pregnant_woman::skin-tone-3: doesn't know carrier status :shrug::skin-tone-3:
        Tx: HBV vaccine now, test HBsAg