childhealth treatment Flashcards
treatment criteria for NAS
-if feeding becomes a problem
-profuse vomit/diarrhoea
-baby remains unsettled after 2 consecutive feeds
medications used for NAS
oral morphine solution
breast thrush treatment
miconazole gel
if not going then oral as well
Always treat baby too!
Lactating Mastitis treatment
(and when to give antibiotics- 3 reason and what antibiotics to presribe)
1st line analgesia and resting and still breast feed from affected breast. rest and express is the alternative.
if there is a nipple fissure, symptoms not improving aftr 24hrs, (+) milk culture prescribe:
1st line: flucoxaxillin
2nd line: clindamycin
non lactating mastitis treatment
co-amoxiclav
if penicillin allergic: clarithomycin (or erythromycin)
does a women with breast abscess continue breastfeeding?
yes, including the affected breast. if they r struggling wiht breat fedding then express the milk.
intussusception treatment
1st line: reduction using floroscopy (blows air through)
(ileo-colic intussusceptions most reliably removed using ^this method)
2nd: surgery (for long ileo-ileal intussceceptions)
constipation in children treatment (no red flags)
1st: movical paediatric plain (using an escalating dose)
2nd: add stimulant laxative (senna) after 2 weeks if not improved
3rd: if movical not tolerated do a stimulant laxative with an osmotic laxative (lactulose)
hyposadias treatment
(include what must not occur before treatment)
refer to specialist, corrective surgery is around 12 months of age
the child must not be circumsised prior to surgery
in boys with very distal disease, no treatment may be needed
threadworms treatment
one dose of mebendazole to affected patinet and their whole household
meningitis in children <3months antibiotic treatment
IV cefotaxime and amoxicillin to cover for listeria
steroids contraindicted. do not prescribe.
meningitis in childresn >3months treatment
IV dexamethasone and IV cefotaxime
croup treatment
immedietley give a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
If severe give nebulised adrenaline as well
emergency croup treatment
single dose of oral dexamethasone + high flow oxygen and nebulised adrenaline
pertussis treatment (whooping cough)
oral macrolide (eg. azithromycin) if onset of cough is within the previous 21 days
household contacts should be offered antibiotic prophylaxis
should a child with pertussis be excluded? if so how long
yes, up until 48hrs after commencing antibiotic or
21 says from onset of symptoms if no antibiotics
undescended test in child management
review at 3 months old, if persistent then refer
hypoglycaemia in infant treatement
asymptomatic: bottle feed and monitor
symptomatic: admit to neonate ward and give IV 10% dextrose
when should a child with croup be admitted
if they have any evidence of a narrowed airway/ struggling to breathe at rest eg. stridor at rest
billiary atresia treatment
surgery (kasai procedure)
anaphlyaxis treatment in those <6 yrs old
150 micrograms IM adrenaline (1:1000)
then:
high flow oxygen
IV fluids if in shock
hydrocortisone
monitor for 12 hrs
anaphylaxis treatment in those >6 yrs old
300 migrograms IM adrenaline (1:1000)
then:
high flow oxygen
IV fluids if in shock
hydrocortisone
monitor for 12 hrs
when to stop phototherapy for hyperbilinurubia in babies
and what to do after
when levels fall to >50mmol/L
after stopping recheck bilurubin in 12-18 hrs time
if it remains the same then no further monitoring is needed however if it rises check another 12 hrs later and consider restarting phototherapy
acute epiglottitis treatment
Immediete senior ENT help
Do no examine throat
IV ceftriaxone + oxygen
pertussis Investigations
1st line: nasal swab for bordatella pertussis
PCR and serology increasingly used
chickenpox treatment
calamine lotion to stop itch
(Calamine Calms the itch)
UTI tx
<3 months IV Abx
>3months= po Abx
Developmental dysplasia treatment:
Dislocated/unstable hip
Pavlike harness 6 weeks
Developmental hip dysplasia:
Persistent dislocation >18months
Open surgical reduction/osteotomy
SUFE treatment
Pin femoral head
Pyloric stenosis treatment
Ramstedt pyloromyotomy
necrotising entercolitis tx
NIL BY ORAL, clindamycin and cefotaxime
immediete referral to neonate surgical team
child cows milk protein allergy tx
extensive hydrolysed formula (eHF)
if severe/persisting use: amino acid based formula
cerebral palsy spasticity treatment
oral diazepam & oral baclofen
Kawasaki disease treatment
high dose aspirin and a single dose of intravenous immunoglobulin
management for hirschsprungs disease
initially: rectal washouts/bowel irrigation
definitive: surgery rescection of colon
tx for nocturnal enuresis
1st line: enuresis alarm
iif reward system etc has been tried then pharmacological management: desmopressin
most important intervention for reducing likeliehood of hypoxia induced brain damage in baby
therapeutic cooling
patent ductus arteriosus tx
indomethacin (closes the duct)
what drug used to keep patent ductus arteriosus open
prostaglandins
Tx for NRDS
ventilate and intra-tracheal surfactant
transient tachypnoea of newborn tx
self limiting, resolves after 24 hrs
