1.1 Paeds Emergencies Flashcards
How common is febrile convulsion?
3%
Febrile convulsions Family Hx link %?
20%
Chance of recurrence in febrile convulsion?
35%
Links with febrile convulsions?
Sodium channel proteins
Iron deficiency
Atopy
Age range for febrile convulsion?
6mo - 6years
Simple febrile convulsions lasts how long?
Less than 4min usually
No longer than 15 minutes
In febrile child we are looking for?
- Bacteraemia
- shock, sepsis
Approach to evaluation of sepsis?
A B C D
Alertness (AVPU)
Breathing
Colour
Dehydration
How to assess Alertness in septic child?
AVPU
Alert
Voice
Pain
Unresponsive
How to assess Breathing in septic child?
Rate
Effort
Noises
How to assess colour in septic child?
Cyanosis
Pallor
Mottling
CRT <2
How to assess dehydration in septic child?
Fluids in Fluids out (com, diarrhoea
Dose of BenPen in suspected meningitis if child is under 1?
300mg
Dose of BenPen in suspected meningitis if child is age 1-9?
600mg
Dose of BenPen in suspected meningitis if child is over 10?
1200mg
Ceftriaxone 50mg/kg up to 2G
Vomiting child DDx?
Gastro
O I M I
Vomiting DDx what is OIMI?
Obstruction
Infection
Metabolic
Injury
Vomiting child what kinds of obstruction?
Intussesception
Appendicitis
Hernia
Vomiting child what is in infection?
UTI
Meningitis
Vomiting child what kind of metabolic conditions?
Diabetic Ketoacidosis
HUS
Vomiting child, what is in injury?
Raised intracranial Pressure
Dehydrated child, ask about what 3 things?
Intake
Wet nappies
Losses
Dehydrated child, intake, when to worry?
Less than 50%
Dehydrated child, wet nappies when to worry?
> 8h
Dehydrated child, losses, when to worry?
> 5 vomiting and
>5 diarrhoea
Describe mild dehydration
Thirsty
Reduced wet nappies
Dry mucosa
Mild tachy
Describe moderate dehydration
Lethargy
Sunken Fontaine lies/eyes
Reduced skin turner
Describe severe dehydration
- Decrease level of consciousness
- shock: perfusion, hypotension
In mild dehydration, how to treat?
Frequent breast feeds
Oral rehydration
1/5 juice
If not tolerated
NGT fluids
IV fluids
Treatment of dystonic reaction to prochlorperazine in <1?
Anticholinergic antihistmine, diazepam
Treatment of dystonic reaction to prochlorperazine in >1?
Benztropine (Cogentin)
Near drowning child. PRevention?
Watch child
Fence around pool
Education
Swimming programs
