Acute Illness Flashcards
Describe the normal physiological RR, HR and BP in a child
RR - high
HR - high
BP - low
How does child anatomy vary from adult anatomy?
Larger head and more prominent occiput in children
Large surface area of skin compared to volume (important if burned)
High anterior larynx/floppy epiglottis (different intubation)
More flexible ribs
Blood volume 80mls/kg
What respiratory noise is usually heard in Croup and why?
Stridor (inspiratory noise)
As Croup affects upper respiratory tract
What respiratory noise would be heard if the child had a lower respiratory tract infection?
Wheeze (on expiration)
How is Croup usually treated?
Steroids
Under what age can children NOT attempt a peak flow reading?
2 years
What CNS problems usually affect children acutely?
Meningitis: bacterial and viral
Encephalitis: commonly viral
How are CNS infections investigated?
Lumbar puncture and imaging
What does the purpuric rash often seen in meningitis confirm?
A meningococcaemia
=> present in bloodstream and is a different (and more severe) disease than meningitis which is limited to the CNS
What are the most common causes of fits/faints/seizures in children?
- Febrile seizures
- Vasovagal episode
- Reflex anoxic seizures
- Breath holding attacks
- Epilepsy
- Arrhythmias
What are the most common types of accidents/trauma that children will present with to the GP?
RTA Trampoline, sports injuries Burns Ingestion Drowning, near-drowning Choking
What does a rib fracture in a child create suspicion of?
NAI
as childrens ribs are flexible, so fracture would take a lot of force
What GI problems cause children to present acutely ill?
- Viral gastroenteritis
- GI obstruction
(congenital pyloric stenosis, volvulus, intussusception
and malrotation) - Acute abdomen [in older children] - appendicitis
- UTI (OR abnormal renal tract)
- Testicular torsion
What cardiovascular conditions are most common in children?
Congenital heart disease – cyanosis, heart failure
Arrhythmias (SVT)
Bacterial endocarditis (rare but severe)
What manoeuvre can be performed to make a child’s airway as patent as possible?
NOT head tilt, chin lift (due to high larynx)
Return to neutral position
How do you manage Breathing when carrying out ABCDE on a child?
High flow O2 if breathing
Not breathing – rescue breaths
Hypertension in a child is a pre-terminal sign. TRUE/FALSE?
FALSE
HYPOtension is a pre-terminal sign
How much fluid should be given if a child presents in shock?
20mls/kg of 0.9% saline
How can you see if a child is dehydrated?
Mucous membranes visibly dry
Skin turgor decreased
Urine output decreased
What postures during fitting can indicate a severe problem in the child?
decorticate (back of wrists together in front)
decerebrate (hands inturned by side)
