Childhood Illness Flashcards
AIRWAY
What is epiglottis?
- Bacterial infection = causes inflammation of epiglottis
- Hib vaccine
Signs & symptoms
- Stridor
- low SpO2
- high fever
- Peripherally shut down - inflammatory process, cardiovascular compromised
- Tachycardia
- Tachyphnoea
- TRIPODING
- DROOLING
Treatment
- High flow O2
- DO NOT AGITATE
- Needs ENT & senior anaesthetist
BJM
AIRWAY
What is tonsillitis?
Acute infection of parenchyma of the palatine tonsils
Signs & Symptoms
- Pain on swallowing
- fever >38 C
- Tonsillar exudate
Treatment
- Paracetamol
- Fluids
- Rest
BJM
AIRWAY
What is anaphylaxis?
- Type 1 allergic response = histamine release = oedema of mucus membranes
Treatment
- 1 in 1,000 IM into large muscle
- IV access
- Hydrocortisonse
- Chlorphenamine
- Fluids
BJM & JRCALC
AIRWAY
What is CROUP?
The underlying pathology is inflammation of the pharynx, larynx, trachea or bronchi.
6months - 6 years
Signs & Symptoms
- Sudden onset of seal-like Barry cough
- Stridor
- Resp distress
- Voice hoarseness
Treatment
- Dexamethasone (corticosteroids)
- Nebulised adrenaline
- O2
- Humidifier
BJM or RCEM Learning
What is the Westly Croup Score?
Children with croup can be divided into four levels of severity:
- Mild (croup score 0-2)
- Moderate (croup score 3-5)
- Severe (croup score 6-11) and
- Impending respiratory failure (croup score 12-17)
RCEM Learning
AIRWAY
What is an URTI?
- viral infection
Signs & Symptoms
- Runny / blocked nose
- Ear ache - often pull ear (eustation tube)
- Sore throat
Treatment
- Fluids
- Rest
- Ibuprofen / paracetamol
- Ice cream - cooling on throat
BMJ
AIRWAY
Foreign body - treatment
- effective cough?
- No - up to 5 back slaps
- No - up to 5 abdominal thrusts
Inhaled FB
- Anterior & posterior chest x-ray (CXR)
- Lateral neck for soft tissues if FB suggestive to be in neck, irrespective of whether FB is radio opaque or not
Hazardous
- CXR
Foreign body in nose
- unilateral offensive discharge strongly suggestive of long standing FB
- parental ‘magic kiss’
DON’T MISS….
- Foreign body in upper eye lid
- Non accidental injuries
AIRWAY
Identifying teething
3-5 months
Signs & symptoms
- Drooling
- Fever
- Not sleeping
- Crying
- Crysal symptoms
- Can get rash around mouth = can lead to impetigo (yellow)
- red & sore gum
- rubbing they’re ear
- chewing on things
Treatment
- Paracetamol / ibuprofen
NHS
BREATHING
Bronchiolitis
Acute viral infection of the lower respiratory tract
Signs & Symptoms
- Cough
- Wheeze
- Laboured breathing
- Tachypnoea
- Retractions, grunting & nasal flaring
- oedema
- Tugging & intercostal recession (lungs far more compliant, more elastic = recession) - children have a smaller tidal volume
BREATHING
Asthma
> 5 y/o
Signs & symptoms
- wheezing episode triggers
- increased WOB
- features of atopic disease
Treatment
- salbutamol - beta 2 agonist
- oxygen
- dexamethasone (steriod)
- ibratropium
- adrenaline
BMJ
BREATHING
Lower Respiratory Tract Infections / pneumonia
Secondary infections e.g. from bronchiolitis
Signs & Symptoms
- Productive cough (thick & green)
- Tachycardia
- Fever
- Pneumonia = exudate on lungs (decreased air sounds, bronchial breathing), dull percussion
Treatment
- Oxygen
- Fluids
- Hospital - if suspect pneumonia in under 5 need to go in, may be another cause
BMJ
CIRCULATION
Gastroenteritis
Causes;
- Infection e.g. bacterial
- Autoimmunue disorders e.g. chrones
- Metabolic e.g. DKA
Signs & Symptoms
- Dehydration e.g. vomiting = lose potassium, can cause arrthymias
- Decreased urine output
- Sunken fontella
- Dry mucus membranes
- cold extremities
- Altered responsiveness e.g. irritable, lethargic
- deteriorating
- diarrhoea causes loss of sodium
NICE CKS
CIRCULATION
Causes of dehydration?
- Not swallowing e.g. infection - URTI
- Neglect
- N&V
- Insensible loss e.g. sweat
- Haemorrhagic
- Distributive e.g. Sepsis or Anaphylaxis - AKI
- Renal failure
CIRCULATION
What are the signs & symptoms of shock and dehydration?
Clinical Dehydration
- Deteriorating *
- Altered responsiveness *
- Decreased urine output
- skin colour unchanged
- warm extremities
- sunken eyes
- Dry mucous membranes
- Tachycardia
- Tachypnoea
- reduced skin turgor
Clinical shock
- decreased LOC
- Pale or mottled skin
- Cold extremities
- Tachycardia
- Tachypnoea
- Weak peripheral pulses
- Prolonged CapRefil
- Hypotension
- = red flag symptoms - risk of progression to shock
NICE
CIRCULATION
Treatment pathways for dehydration - red flags?
Emergency transfer if:
- Features of shock
- Features suggestive of alternative life-threatening diagnosis e.g. non-blanching rash
Face-to-face assessment if:
- episode of bloody diarrhoea
- signs of dehydration
- Risk factors increasing risk of dehydration:
- < 1y/o
- low birthweight
- stoped breast feeding while ill
- 6+ diarrhoea stools in 24h
- 3+ vomiting in 24 h
Treatment
- 20 mls fluid per kilo
JRCALC
NICE
