APLS Flashcards
How does adrenaline work on the alpha adrenoceptors
- increases peripheral vascular resistance
- reverses peripheral vasodilatation
- reduces angiodema
How does adrenaline work on the B1 adrenoceptors
positive inotropic and chronotropic cardiac effects
How does adrenaline work on the B2 adrenoceptors
causes bronchodiltation
reduced inflammatory mediator release
what are considered shockable rhythms
VF
pulseless ventricular tachycardia
How long should you observe a child with an anaphylactic reaction
6-12 hours as there is a possiblity of a biphasic reaction
What blood test should you take if not sure of an anaphylactic reaction
mast cell tryptase
1-2 hours after symptom onset and again at 24hours
What shock should you give a child in a shockable rhythem
4J/kg
What are the 4Hs of reversable cardiac arrest
hypothermia
hypoxia
hypovolaemia
hypo/hyperkaemia
What are the 4Ts of a reversible cardiac arrest
Thrombosis
Toxins
Tamponade (cardiac)
Tension pneumothorax
What is the algorhythm in children for BLS
15:2
management of anaphylaxis
Im adrenaline
IV chlorenphenamine
IV hydrocortison
What dose adrenaline is given in anaphylaxis
12-17 500mcg 0.5ml 1:1000
6-11: 300mcg 0.3ml 1:1000
1 months-6: 150mcg 0.15ml 1:1000
What dose chlorenphenamine is given in anaphylaxis
> 12: 10mg
6-12: 5mg
6 months - 6 years: 2.5mg
<6 months: 250 mcg/kg
What does hydrocortisone is given in anaphylaxis
> 12: 200mg
6-12: 100mg
6 months - 6 years: 50mg
<6 months: 25mg
What are the most common food allergies
cows milk egg peanut treenut soya wheat seeds fish/shellfish
What constitutes a mild allergic reaction
itchy lips/mouth/throat erythema/urticaria angiodema lump in throat - no voice change conjunctivitis/rhinitis nausea abdo pain
What constitutes a severe allergic reaction
impending doom stridor/voice change wheeze dizziness/hypotension severe abdo pain impaired conciousness
What is the Cushing’s triad
hypertension
bradycardia
irregular breathing
what occurs when tentorial herniation begins
decorticate posturing:
- upper limbs flex
- legs extend and rotate inwards
What is hydrocephalus
- increased volume of CSF in the cerebral ventricles
- usually as a result of impaired absorption but it may occasionally be due to excessive secretion
What are the features of hydrocephalus in an infant
- rapidly growing head circumference/circumference in 98th centile
- Increased limb tone
- dysjunction of sutures
- tense fontanelle
- Setting-sun sign
What is the setting sun sign
both ocular globes are deviated downward, the upper lids are retracted and the white sclerae may be visible above the iris
what are the acute features of hydrocephalus in an older child
vomiting
headache
papiloedema
impaired upward gaze
what are the gradual features of hydrocephalus in an older child
- Unsteady gait: spasticity in the legs.
- Large head
- Unilateral or bilateral sixth nerve palsy secondary to increased ICP.
What are the risk factors for ischaemic stroke in young children
- cardiac disorders
- infection
- head and neck trauma
- sickle cell disease
- vascular malformations
- genetic disorders
- autoimmune diseases
What is the imaging of choice in patients with ?ischaemic stroke
MRI
What are the features benign idiopathic infantile dyskinesia
hip flexion and adduction
distant expression
flushed
followed by sleepiness
What is sandifer syndrome
combination of gastro-oesophageal reflux disease with spastic torticollis and dystonic body movements with or without hiatal hernia
How long do episodes of dystonic body movements in Sandifer’s syndrome occur
1-3 mins up to 10x a day
Usually associated with food but can be whenever
