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Paediatrics > Anaphylaxis / emergency > Flashcards

Anaphylaxis / emergency Flashcards

1
Q

What type of reaction is anaphylaxis

A

Type 1 IgE

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2
Q

What is acute symptoms

A 
Facial swelling
Tight throat
Breathing issue
Urticaria
Oedema
Itch 
Wheeze
Stridor
Laryngeal obstruction
Collapse
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3
Q

How do you monitor

A

Pulse
Sats
ECG
BP

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4
Q

What can tell if had allergic reaction

A

Serum tryptase

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5
Q

How do you assess

A

A - swelling / stridor
B - RR / wheeze / fatigue / cyanosis / sats
C - pale / clammy /low BP / low HR / coma

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6
Q

How do you treat

A 
Remove allergen + raise legs 
ABCDE
IM adrenaline 
High flow O2 trauma mask
IV acesss
Fluid
IV Hydrocortisone
IV Chlorophenamine
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7
Q

When do you intubate

A

If obstruction

Call anaesthetist early

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8
Q

How much adrenaline and how often and what dose for children

A

1 in 1000
Every 5 minutes
Can still detioriate after so keep giving

<6 = 0.15ml
6-12 = 0.3ml
>12 = 0.5ml
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9
Q

How much fluid

A

20ml / kg 0.9% saline bolus

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10
Q

How much hydrocortisone

A

200mg >12
100mg >6-12
50 mg >6 months-6
25mg <6 months

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11
Q

How much chlorophenaimine

A

10mg >12
5mg 6months-12
2.5mg <6months

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12
Q

When do you discharge

A 
Diet review
Avoid nuts if unclear trigger
Skin prick test
Epipen 
Train how to use
Anti-histamine
Emergency plan
Allergic clinic referral
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13
Q

What is most common cause of arrest

A

Respiratory

Hypoxia due to choking

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14
Q

What do you do

A 
Airway
Breathing
5 rescue breaths
Check pulse
CPR 15:2
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15
Q

What is agonanl breathing

A

Occurs first few minutes of cardiac arrest

Brain stem reflex

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16
Q

What is most common cause of death

A

SIDS

17
Q

What are major RF

A 
Prone sleeping
Smoke during pregnancy 
Premature / LBW
Bed sharing
Hyperthermia
18
Q

What are minor RF

A

Male
Social class
Drugs

19
Q

What is protective

A 
Breast
Room sharing
Dummies
Keep babies lying on back
Don't cover head 
Avoid smoking / co-sleeping
20
Q

What do you screen for siblings for

A

Sepsis

Errors of metabolism

21
Q

What causes non-blanching rash

A

Bleeding under skin

22
Q

What is petechiae

A

<3mm non blanching spot caused by burst capillary

23
Q

What is purpura

A

> 3mm non blaching rash due to bleeding from vessel

24
Q

What is differential

A 
Meningococcal septicaemia= main
HSP
ITP
Acute leukaemia
HUS
Trauma / NAI 
VIral illness
- Most likely cause even if non-blanching 
- Esp if child well
25
Q

How do you investigate

A 
Refer and admit for observation +- bloods 
FBC
- Will detect cytopenia 
- ITP / leukaemia 
U+E
- If think HSP or HUS 
- HSP more purpura on buttock
- HUS if recent diarrhoea 
CRP / ESR
- If think sepsis 
Coag screen
- DIC from sepsis 
Blood culture
Meningococcal PCR
LP
BP
Urine dip
26
Q

How do you manage

A

Any child with non-blanching rash needs urgent referral

27
Q

Child vitals

A

OK

See surgery

28
Q

Assessment

A

ABCDE

29
Q

If unwell baby coming in, <3 months, with resp distress and off vitals what are your DDX

A 
Sepsis = top of list
Bronchiolitis / pneumonia
Duct dependent cardiac
Metabolic 
NAI - head
Congenital
30
Q

What happens

A 
SENIOR HELP
ABCDE 
- Oxygen, airway or breathing
- May get RSI + intubate
- IV or IO 
- Take bloods and gas
- Fluid volus
- Inotrope
- Ax 
- CXR / USS / CT
31
Q

What is rare but think

A

Cardiology

- Prostaglandin infusion will keep the duct open

32
Q

Child fallen onto abdo, bruised and very unwell what is Dx

A

Ruptured spleen until proven otherwise as big blood supply and less protection
Could be anything

33
Q

What are red flags in children to refer

A 
Parental concern
Co-morbid 
Cold hand / feet 
Decreased urine
No fluid intake 
No source of fever
Cold / clammy / patchy
Non-blanching rash
Lethargic

Paediatrics (35 decks)

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