Acutely Unwell Child Flashcards
Low blood pressure is a late or early sign in the acutely unwell child
Late
Resuscitation, initially how many rescue breaths? Then what ratio : chest compressions?
5 rescue breaths
Then 15:2 compressions
What are the emergencies for same day referral from primary care to hospital?
T1DM
No meconium past 24hr
Bile stained vomit
For resuscitation for the acutely unwell child, how much fluid is given initially? What % of their circulating vol does this replace?
20ml/kg bolus
Replaces 25%
Then reassess + repeat
In appendicitis is there a mildly elevated or very high WCC? Mildly elevated or very temperature? What age group is commonest? Other than bloods what investigation is done first?
Mildly elevated WCC
Low grade pyrexia
10–20yr
US
What diagnosis shouldn’t be messed in boys with abdominal pain?
Torsion
Describe the nature, location and exacerbating features of the pain in appendicitis
Poorly localised colicky periumbilical pain migrates to RIF, exacerbated by movement – pain on speed bump
Do all children with appendicitis get a CT scan?
No, only if diagnostic uncertainty
“explosive passage of stool following PR exam”
Hirschsprung’s disease
“absent innovation to large bowel”
Hirschsprung’s disease
At what age does intussception present?
6mth
At what age does pyloric stenosis present?
2-8wk
“Projectile vomiting 30-60min after a feed, hungry baby, weight loss, visible peristalsis”
Pyloric stenosis
Is the vomit bilious or non-bilious in pyloric stenosis?
Non-bilious
What test is done for diagnosis of pyloric stenosis?
US
What is the management of pyloric stenosis?
Pyloromyotomy
red current jelly stool … caused by?
Intussception
there may also be no stool
What is seen on US in intussusception?
Target sign/kidney bean
What is the management of intussusception?
XR guided air reduction
What is the basic mechanism of intussusception?
Terminal ileum/ileocecal junction telescoping folds in on self
Sausage shaped mass in the right upper quadrant is a sign of?
Intussusception
Where is volvulus in the paediatric age group?
Caecal
Is the vomit bilious or non-bilious in volvulus malrotation?
Bilious green - yellow
What condition is meconium ileus associated with?
CF