Assessment of the acutely unwell child

Question 1

What are some of the common anatomical differences between a child and an adult?

Answer 1

Smaller face
Narrow nostril
Large teeth
FUNNEL SHAPE LAYRNX
HORSE SHOE SHAPE EPIGLOTIS
LARGER PROMINENT OCCIPUT

Question 2

Is the blood volume in a child higher or lower

Answer 2

Higher

Question 3

What three things are included in the paediatric assessment triangle

Answer 3

Appearance
Work of breathing
Circulation

Question 4

Do children deteriorate progressively or suddenly

Answer 4

Suddenly

Question 5

Bronchiolitis in children. What is it, and what are the symptoms

Answer 5

Inflammation of the bronchioles, often in winter and autumn.

Reduced sats
Increased RR
Irregular breathing
Inspiratory crackles
Low fever

Question 6

Is salbutamol indicated for bronchiolitis?

Answer 6

No, take to hospital

Question 7

What are some upper respiratory tract infections in children (URTIs)

Answer 7

Tonsilitis
Otitis media
Cold
Rhinosinusitis
Acute cough/bronchitis

Question 8

What are is a respiratory tract infection that is found in children

Answer 8

Pneumonia

Question 9

What is croup

Answer 9

Inflammation around the larynx
Usually self limiting
Follows after a cold usually, however can appear out of the blue
Croup cough
Can present with resp failure and resp arrest

Question 10

What drugs should we consider giving a child suffering with croup

Answer 10

Oxygen as per jrcalc
Dexamethasone

Question 11

What is epiglotitis in children

Answer 11

Inflammation of the epiglottis which left untreated can be fatal

Question 12

What are the symptoms of epiglotitis in children

Answer 12

Fever
Unwell/distressed
Stridor
Difficulty swallowing
Sitting up/drooling/chin forward

Question 13

What is Febrile illness in children

Answer 13

Most common medical problem in childhood
Suggests an underlying infection

Question 14

What should look for and ask for in assessment for febrile illness in children

Answer 14

Temp
Duration of illness
Other symptoms
Are they dehydrated
Medications
Family history and travel

Question 15

What are some dehydration red flags in children

Answer 15

Appearing unwell or deterioating
Altered level of responsivness
Sunken eyes
Tachycardia
Tachypnoea

Question 16

Causes of convulsions in children

Answer 16

Febrile - sudden rise in temperature
Brain insults
Epilepsy
Convulsive staus epilepticus

Question 17

What is the treatment of convulsing for children

Answer 17

100% oxygen
95% oxygen in post ictal phase
Diazepam
Buccal midazolam
BVM ventilate sometimes

Question 18

What are the signs of childhood gastroenteritis

Answer 18

Sudden onset of diarrhoea and vomitting

If there are any other symptoms such as rash or temperature or abdominal pain, consider other diagnosis

Question 19

What should we do for childhood gastroenteritis

Answer 19

Encourage fluid intake

Question 20

What are the blood sugar levels for hypoglycaemia in children

Answer 20

<4.0 in diabetic children
<3.0 in non diabetic children

Question 21

What is the management required for children having an overdose/poisoning

Answer 21

Oxygen
NEVER induce vomitting
12 Lead ECG
Hopsital

Question 22

Meningitis and septicaemia in children management

Answer 22

High flow 02
Full set of obs on way to hopsital
Give benzylpenicillin
Priority call to A&E

Question 23

Should all under 2 year olds be transferred to hospital

Answer 23

YES

Question 24

Where should children between ages 2-5 be transferred to

Answer 24

GP

Question 25

Children age 5-12 should be considered referring to GP and hospital, True or False

Answer 25

True