Acutely ill child Flashcards
what is the most common reason for acutely ill children
infection
what are the 6 things to do in an hour in the paediatric sepsis 6
1) high flow oxygen
2) IV access and take bloods
3) Give IV or IO antibiotics
4) fluid resuscitation (20ml/kg)
5) consider inotropic support (adrenaline)
6) involve senior clinicians early
why do children tend to arrest
due respiratory arrest then leading to cardiorespiratory arrest
can sometimes also be due to circulatory failure
what can cause circulatory failure in infants
fluid loss (blood loss, gastroenteritis, burns)
fluid maldistribution (septic shock, cardiac disease, anaphylaxis)
what can cause respiratory failure in infants
respiratory distress (foreign body, croup, asthma)
respiratory depression (convulsions, raised intracranial pressure, poisoning)
In child CPR what is the compression: breaths ration
15:2
depth of compressions for child CPR
1/3 of the chest size eg. 5 cm
what position do babies <1 need to be in to receive rescue breaths
neutral - in older children do head tilt chin lift
what to do for B in an child ABCDE scenario
asses if they are breathing, if not:
5 rescue breaths reassess high flow O2 reassess -do they need airway support and ventilation
what to do for C in an ABCDE child scenario
look for signs of life HR + rhythm Pulse volume Cap refill BP skin perfusion - temp, colour Urine output
what do you do if a child is shocked
give 20ml/kg of 0.9 saline reassess, if not better repeat, if still not better send to ICU
what do children grunt when they can’t breath
giving yourself CPAP - forcing air against to a closed epiglottis to raise the pressure in the lungs to help breath
how to tell the efficacy of a Childs breathing
Expansion
Additional noises
Pulse oximetry
Effects on end organs - conscious level, pallor, tachycardia
