Acute Flashcards
What would you assess when assesing a childs airway?
- Vocalisation
- Added sounds - stridor, secretions, snoring
- Consciousness
If there was soft tissue swelling around a childs airway, what could you give them to try to reduce the swelling?
Adrenaline nebuliser
What would you assess when assessing a childs breathing?
- SpO2 + oxygen requirements
- RR
- Inspection
- Palpation
- Percussion
- Auscultation
What are signs of respiratory distress in a child?
- Subcostal/intercostal recession
- Nasal flaring
- Tracheal tug
- Accessory muscle use
- Grunting
How might you treat hypoxia in a child?
- High-flow O2 through non-rebreath mask
- Consider non-invasive ventilation - Optiflow, CPAP, BiPAP
- Consider invasive ventilation
What signs might indicate that your treatment of hypoxia was not adequate?
- Increased RR
- Decreased Sats
- Increased CO2
- Child working hard
What would you assess on assessing circulation in a child as part of your ABCDE assessment?
- Colour
- Hydration
- Peripheral temperature
- CRT
- Radial pulse (+volume)
- BP
- Ausculatate Heart sounds
What might you look at to assess hydration status in a child?
- Nappy
- Mucous membranes
- Skin turgor
- Cap refill
- Urine output
What fluid challenge would you give a child if they were hypotensive?
20ml/kg 0.9% saline and monitor response
What might you assess when assessing disability as part of your primary ABCDE assessment of a child?
- Alertness/activity
- Fontanelles
- Pupils
- Limb tone
- Rashes
- Cap glucose
What might be the cause of a child that can’t be consoled (true irritability)?
Raised ICP
What might a bulging fontanelle indicate?
Raised ICP
What might cause sluggish pupillary resposes in a child?
- Post-ictal
- Drug overdose
What might asymmetrical pupils indicate in a child?
SOL
What might cause changing pupil size or abnormal gaze in a child?
Seizure
What would you assess as part of your “everything else” assessment when working through your primary ABCDE assessment of a child?
- Temperature
- Exposure - top-to-toe examination
- Focussed examinations - based on top-to-toe findings
What investigations might you want to do when assessing an acutely unwell child?
BOBIS - only do investigations which will change the management
-
Bedside
- Monitoring - ?ECG, PEWS
- Tests - Urine dipstick, cap glucose/ketones
- Orifices - MSSU and culture, stool culture
- Bloods - FBC, U+E’s, LFT’s, blood cultures, lab glucose, VBG
- Imaging - CXR
- Special tests - LP
What causes of respiratory obstruction could lead to respiratory failure in a child?
- Birth asphyxia
- Croup
- Epiglottitis
- Foreign body
- Bronchiolitis
- Asthma
- Pneumothorax
What causes of respiratory depression can lead to respiratory failure in a child?
- Poisoning
- Convulsions
- Raised ICP - Head injury, acute encephalopathy
What are the main causes of fluid loss seen in children?
- Gastroenteritis
- Bruns
- Trauma
What are the main causes of fluid maldistribution in children?
- Sepsis
- Anaphylaxis
- Heart failure
What is the average birth weight of a child?
3.5 kg
How could you calculate weight in a child under 1 year?
(0.5 x age in months) + 4
How could you calculate the weight of a child aged 1-5 years?
(2xAge) + 8
How might you calculate the weight of a child aged 6-10 years old?
(3xAge) + 7
Why can neonates tolerate lower oxygen saturations than older children?
Oxygen dissociation curve shifted left in neonates (HbF predominance)
What HR would you think of performing CPR in a child?
<60 bpm (bradycardia)
