A5 Recognition Of The Sick Baby Or Child

Question 1

Who does this protocol apply to?

Answer 1

Neonates, infants and children <16

Question 2

Key points in the recognition of the sick baby or child:

• _______ ________ should not be discounted: it is often of significance even if the baby or child does not appear especially unwell.
• Assessment of children and babies is sometimes difficult, as the signs and symptoms of illness may not be ___ ___ ___ ___ ______ ________ as those of the adult patient
• A ______ _______ is required including _____ ______ over time to ensure _____ _____ or ____ ____ _____ are detected. Due to ______ _______, the clinical severity may be greater than it first appears
• Assessment is not a single event, but a _____ and ______ process

Answer 2

Parental anxiety
As marked or as readily expressed
Structured assessment; repeated observations; subtle signs; cues of illness; compensatory measures
Continuous; dynamic

Question 3

Key points (contin.)

• Obtaining a good history of the illness and precipitating factors to the infant, child or adolescent’s presentation is fundamental to assessment and may help differentiate for example:
  
  • a child who was _____ _____ immediately prior to an acute onset of vomiting from the child who has been ____ for _____/_______
  • the baby who appears perfectly well but has a history of ____ ____ suggestive of conditions such as ____, ______, _____ or _______ _______
  • the child on ______ that may alter assessment, e.g. ______ that may cause _____

Answer 3

Perfectly well; unwell; days/weeks
Acute pallor; intussusception; seizure; sepsis; metabolic condition
Medication ; medication; drowsiness

Question 4

Key points (contin.)
- \_\_\_\_\_\_\_ can present with either \_\_\_\_\_\_ or \_\_\_\_\_\_\_ conditions. Babies born \_\_\_\_\_\_\_\_\_ are specifically a high risk group for \_\_\_\_ \_\_\_\_\_ such as \_\_\_\_\_\_ or \_\_\_\_\_\_ \_\_\_\_\_\_

Answer 4

Neonates; congenital; acquired; prematurely; congenital disorders; cardiac; metabolic disease

Question 5

Treatment

1. ____ _____ (__) - specific attention should be given to the assessment of:
   
   • ____ ____
   • ____
   • ____ _____ (Protocol __)
2. Obtain a thorough ______ , including patient’s normal _____ and look for any clinical signs of _____ or ______ ______
3. Manage per _____ _____
4. Determine appropriate _______ and ______ requirements:
   
   • A heightened level of concern should be applied to ____ _____ ____ with _____ for _____ ______/_______ recommended
   • _____ _____ ____ _____ (consider ____ _____) for any patient with any criteria outside the ____ ____ ____ (Reference ___) and/or is observed to be ______
5. Regularly ____ and ____ ____ ______ ______ and _____ _____ in order to identify _____ in _____ _____

Answer 5

1. Patient care (A2); respiratory distress; pain; traumatic injuries (T1)
2. History; presentation; sepsis; severe infection
3. Specific protocol/s
4. Disposition; transport requirements; all infants <=3 months; Transport; further assessment/treatments; minimise time on scene; urgent transport; paediatric white zone; R18; deteriorating
5. Repeat; document ABCD physical examinations; physiological observations; trends; clinical deterioration