acutely ill child Flashcards
what do children present with?
Bronchiolitis/URTI/Croup
Gastroenteritis
Seizures/epilepsy
Pneumonia/LRTI
Asthma
“Viral illness”
Head injury
Abdominal pain
UTI
describe bronchiloitis
acute inflammatory injury of bronchioles
viral, supportive treatment
describe croup
laryngotreacheobronchitis
viral
treat with steroids
what causes epiglottitis?
haemophilus influenzae type b
what causes stridor?
upper airway obstruction- look for noisy breathing
what causes wheeze?
lower airway problems e.g. asthma- difficult breathing out
what are common acute CNS illnesses in children?
meningitis- bacterial and viral
encephalopathy- commonly viral
how do you manage acute CNS illness in children?
ofetn give antibiotics and antivirals to be safe
how do you investigate acute CNS illness in children?
lumbar puncture and imaging
what causes a deep red non blanching rash in children?
Meningococcaeima- non blanching rash
Caused by neisseria meningitidis (does not necessarily indicate meningitis
what are the common GI & urogenital causes of acute illness in children?
viral gastroenteritis, UTI- consider abnormal renal tract
describe febrile seizures
short (5 mins or less) seizure seen in children under 6, caused by illness but not to do with brain
describe reflex anoxic seizures
Hit your head, don’t breathe, hr slows. Usually do not require treatment unless there is a history of them
what are the common surgical causes of acute illness in children?
GI obstruction, acute abdomen (appendicitis), testicular torsion
what is the most common arrhythmia in children?
SVT
what causes cardiac arrest in children?
respiratory failure –> respiratory arrest –> cardiac arrest
or circulatory failure caused by fluid loss or fluid maldistrubution
(respiratory arrest most common)
what is the primary and secondary assessment of the sick child?
primary assessment- do they need resuscitation?
secondary assessment- what emergency treatment to give of they do not need resuscitation
how do you do an airway manoeuvre on an under 1 year old
neutral neck (tilt head back in any other age)
how do you treat shock in children?
20ml/kg of 0.9% saline
repeat if still shocked
may need blood in trauma / haemorrhage
how does HIV present in babies and children?
Recurrent or severe common childhood illnesses eg otitis media, diarrhoea
Recurrent oral candidiasis not responding to treatment
Recurrent severe bacterial infections eg meningitis
Failure to thrive or growth failure
Generalised lymphadenopathy, hepatosplenomegaly
Persistent fever
Encephalopathy
Chronic parotitis
PJP, Kaposi sarcoma, TB, lymphocytic interstitial pneumonia….
what is the treatment for paediatric HIV?
HAART: Two NRTIs plus one NNRTI or protease inhibitor
Nucleoside reverse transcriptase inhibitors eg abacavir and lamivudine
Non-nucleoside reverse transcriptase inhibitors eg efavirenz for >3yr olds
Protease inhibitor eg kaletra for <3yr olds
