Acutely ill child Flashcards
children have a higher/lower HR and higher/lower BP than adults
higher HR
lower BP
respiratory causes of an acutely ill child
bronchiolitis
croup
pneumonia
asthma
features of bronchiolitis
viral - respiratory syncytial virus
supportive management
may become apnoeic and require CPAP
grunting
features of croup
laryngotracheobronchitis
viral
stridor
barking cough
treatment for croup
steroids
PO dexamethasone
if a small child has a fever, treat it as??
meningitis
CNS causes of acutely unwell child
meningitis
encephalitis
causes of faints or seizures
febrile seizures from raised temperature arrhythmias - all get ECG vasovagal reflex anoxic - after getting a fright breath holding attacks behavioural epilepsy
causes of abdominal pain in acutely unwell child
gastroenteritis UTI malrotation pyloric stenosis volvulus intussusception appendicitis mesenteric adenitis DKA IBD flare
CVS causes of acutely unwell child
congenital heart disease
infective endocarditis
arrhythmias: SVT, WPW
how do you do CPR in a child, >1 and <1yo
15 compressions : 2 breaths
>1yo - 1 hand
<1yo - 2 fingers
crying in babies is a good sign, true or false
true, means they are breathing
what is the commonest cause for acute illness in children
sepsis
what is the paediatric sepsis 6
- give high flow O2
- gain IV access: blood cultures, glucose, lactate
- IV/IO antibiotics
- fluid resuscitation
- early inotrope support e.g. adrenaline
- senior HELP!!
when performing an ABCDE assessment, what should you look for
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
decorticate posturing involves flexion/extension of limbs
decerebrate posturing involves flexion/extension of limbs
decorticate - flexion
decerebrate - extension
fluid volume for children resuscitation
20ml/kg bolus in 10 min
what is stridor
high pitched inspiratory noise of the upper airway
causes of stridor
croup
epiglottitis
foreign body
narrowed airway following intubation
what is wheeze
lower pitch expiratory sound from airway obstruction
wheeze is always due to asthma, true or false
false
https://ihub.scot/media/2063/pews-education-pack-updated-july-17.pdf
PEWS link
file:///Users/hibaalhasso/Downloads/Guidelines%20Paediatric%20basic%20life%20support.pdf
/Users/hibaalhasso/Downloads/Guidelines%20Paediatric%20advanced%20life%20support.pdf
Paed BLS and ALS algorithm
causes of fluid loss
blood loss
gastroenteritis
burns
which is more common in children, resp or circulatory failure
resp failure happens first leading to arrest
systematic approach to a sick child
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
how to assess airway?
infant - crying
verbal child - assess voice
how do you measure Cap refill
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
cardiac arrest is harder to bring a child back from the resp arrest, true or false
true, if hypoxic you can correct their O2 and breathing
kids have low glycogen storage and burn through it very quickly in stress, true or false
true
why do you give 5 initial breaths in BLS
to reverse hypoxia
causes of worldwide mortality
infectious diseases
neonatal - congenital/prematurity
maternal
Causes of fluid loss
haemorrhage
burns
gastroenteritis
causes of fluid maldistribution
anaphylaxis
septic shock
cardiac disease
causes of respiratory distress
croup
pneumonia
foreign body
asthma
causes of respiratory depression
drugs - poisoning
^ICP
convulsions
what does the septic screen involve
lumbar puncture
urine MC+S
how do you prescribe paediatric maintenance fluids
1st 10kg - 100ml/kg
2nd 10kg - 50ml/kg
for every kg above 20kg, prescribe 20ml/kg
what fluids are used in maintenance fluids
0.9% saline / 5% dextrose
calculate the dose of maintenance fluid in a 5.24kg baby
100ml/kg
5.24 x 100 = 524ml/day
