Child

Question 1

Describe the NHS immunisation programme for babies, infants, children and adolescents

Answer 1

8 weeks: 6MR

• 6-in-1 (diphtheria, tetanus, polio, pertussis, Hib, HepB)
• MenB
• Rotavirus

12 weeks: 6PR

• 6-in-1
• Pneumococcal
• Rotavirus

16 weeks: 6M

• 6-in-1
• MenB

1 year: PMHM

• Pneumococcal
• MenB
• Hib/MenC
• MMR

2-10 years:
- Flu vaccine

3 years, 4 months:

• 4-in-1 preschool booster (diphtheria, tetanus, polio, pertussis)
• MMR

12-13 years:
- HPV (girls AND boys)

14 years:

• 3-in-1 teenage booster (diphtheria, tetanus, polio)
• MenACWY

Question 2

What are the components of the NICE traffic light guidance for assessing the febrile child?

Answer 2

AARCH + other

• Appearance
• Activity
• Respiratory
• Circulation and Hydration
  + other

Question 3

Describe the AMBER criteria of the NICE traffic light guidance for assessing the febrile child

Answer 3

Appearance:
- Pallor (reported by parent/carer)

Activity:

• Not responding normally to social cues
• Wakes only with prolonged stimulation
• No smile

Respiratory:
- Nasal flaring
- Tachypnoea:
> 50 breaths/min (6-12 months)
> 40 breaths/min (>12 months)
- O2 sats < 95%

Circulation and Hydration:
- Tachycardia:
> 160 bpm (<12 months)
> 150 bpm (12-24 months)
> 140 bpm (2-5 years)
- CRT > 3 seconds
- Dry mucous membranes
- Reduced oral intake/urine output

Other:

• Fever 5 days +
• Fever > 39 degrees (3-6 months)

Question 4

Describe the RED criteria of the NICE traffic light guidance for assessing the febrile child

Answer 4

Appearance:
- Pallor/cyanosis

Activity:

• No response to social cues
• Does not wake when roused
• Weak/high-pitched/continuous cry

Respiratory:

• Grunting
• Moderate/severe chest indrawing
• Tachypnoea (> 60 breaths/min)
• O2 sats < 92%

Circulation and Hydration:
- Reduced skin turgor

Other:
- Fever > 38 degrees (< 3 months)

Question 5

What is the FeverPAIN score used for?

Describe the criteria

Answer 5

Assessing the likelihood that sore throat is caused by a bacterial streptococcus infection (higher score = more likely)

Criteria:

• Fever (in the last 24 hours)
• Purulence (pus on tonsils)
• Attend rapidly (within 3 days of onset of symptoms)
• Inflamed tonsils (severely)
• No cough of coryza