Acutely ill child

Question 1

children have a higher/lower HR and higher/lower BP than adults

Answer 1

higher HR

lower BP

Question 2

respiratory causes of an acutely ill child

Answer 2

bronchiolitis
croup
pneumonia
asthma

Question 3

features of bronchiolitis

Answer 3

viral - respiratory syncytial virus
supportive management
may become apnoeic and require CPAP
grunting

Question 4

features of croup

Answer 4

laryngotracheobronchitis
viral
stridor
barking cough

Question 5

treatment for croup

Answer 5

steroids

PO dexamethasone

Question 6

if a small child has a fever, treat it as??

Answer 6

meningitis

Question 7

CNS causes of acutely unwell child

Answer 7

meningitis

encephalitis

Question 8

causes of faints or seizures

Answer 8

febrile seizures from raised temperature 
arrhythmias - all get ECG 
vasovagal 
reflex anoxic - after getting a fright 
breath holding attacks 
behavioural 
epilepsy

Question 9

causes of abdominal pain in acutely unwell child

Answer 9

gastroenteritis 
UTI 
malrotation 
pyloric stenosis 
volvulus 
intussusception 
appendicitis
mesenteric adenitis 
DKA 
IBD flare

Question 10

CVS causes of acutely unwell child

Answer 10

congenital heart disease
infective endocarditis
arrhythmias: SVT, WPW

Question 11

how do you do CPR in a child, >1 and <1yo

Answer 11

15 compressions : 2 breaths
>1yo - 1 hand
<1yo - 2 fingers

Question 12

crying in babies is a good sign, true or false

Answer 12

true, means they are breathing

Question 13

what is the commonest cause for acute illness in children

Answer 13

sepsis

Question 14

what is the paediatric sepsis 6

Answer 14

1. give high flow O2
2. gain IV access: blood cultures, glucose, lactate
3. IV/IO antibiotics
4. fluid resuscitation
5. early inotrope support e.g. adrenaline
6. senior HELP!!

Question 15

when performing an ABCDE assessment, what should you look for

Answer 15

A - careful not to extend the neck as this can compress the airway
B - nasal flaring, grunting, recession, accessory muscle use, wheeze, stridor
C - CRT, HR, BP, skin colour, urine output, fluids 20ml/kg
D - hypoxic fits, AVPU, pupils, GLUCOSE, decorticate, decerebrate
E - temp, rash, bruising

Question 16

decorticate posturing involves flexion/extension of limbs

decerebrate posturing involves flexion/extension of limbs

Answer 16

decorticate - flexion

decerebrate - extension

Question 17

fluid volume for children resuscitation

Answer 17

20ml/kg bolus in 10 min

Question 18

what is stridor

Answer 18

high pitched inspiratory noise of the upper airway

Question 19

causes of stridor

Answer 19

croup
epiglottitis
foreign body
narrowed airway following intubation

Question 20

what is wheeze

Answer 20

lower pitch expiratory sound from airway obstruction

Question 21

wheeze is always due to asthma, true or false

Answer 21

false

Question 22

https://ihub.scot/media/2063/pews-education-pack-updated-july-17.pdf

Answer 22

PEWS link

Question 23

file:///Users/hibaalhasso/Downloads/Guidelines%20Paediatric%20basic%20life%20support.pdf
/Users/hibaalhasso/Downloads/Guidelines%20Paediatric%20advanced%20life%20support.pdf

Answer 23

Paed BLS and ALS algorithm

Question 24

causes of fluid loss

Answer 24

blood loss
gastroenteritis
burns

Question 25

which is more common in children, resp or circulatory failure

Answer 25

resp failure happens first leading to arrest

Question 26

systematic approach to a sick child

Answer 26

ABCDE A - pink or blue, noises B - rate, recession, accessory muscle, grunting, flaring, additional noises, saturations, consciousness C - rate, rhythm, pulse volume, perfusion, CRT, skin colour, BP, confusion, urine output D - conscious level, AVPU, GCS, pupils, posture, behaviour and interaction E - temp, rash, injury DEFG - GLUCOSE H - hypoxia, hypothermia, hypotension, hypoglycaemia

Question 27

how to assess airway?

Answer 27

infant - crying | verbal child - assess voice

Question 28

how do you measure Cap refill

Answer 28

``` press on fingers or sternum, nose or forehead want to know central then peripheral 5 sec blanches then time how long <3s normal >3s abnormal ```

Question 29

cardiac arrest is harder to bring a child back from the resp arrest, true or false

Answer 29

true, if hypoxic you can correct their O2 and breathing

Question 30

kids have low glycogen storage and burn through it very quickly in stress, true or false

Answer 30

true

Question 31

why do you give 5 initial breaths in BLS

Answer 31

to reverse hypoxia

Question 32

causes of worldwide mortality

Answer 32

infectious diseases neonatal - congenital/prematurity maternal

Question 33

Causes of fluid loss

Answer 33

haemorrhage burns gastroenteritis

Question 34

causes of fluid maldistribution

Answer 34

anaphylaxis septic shock cardiac disease

Question 35

causes of respiratory distress

Answer 35

croup pneumonia foreign body asthma

Question 36

causes of respiratory depression

Answer 36

drugs - poisoning ^ICP convulsions

Question 37

what does the septic screen involve

Answer 37

lumbar puncture | urine MC+S

Question 38

how do you prescribe paediatric maintenance fluids

Answer 38

1st 10kg - 100ml/kg 2nd 10kg - 50ml/kg for every kg above 20kg, prescribe 20ml/kg

Question 39

what fluids are used in maintenance fluids

Answer 39

0.9% saline / 5% dextrose

Question 40

calculate the dose of maintenance fluid in a 5.24kg baby

Answer 40

100ml/kg | 5.24 x 100 = 524ml/day