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Paeds > Children are not Young Adults > Flashcards

Children are not Young Adults Flashcards

1
Q

What are the physiological differences and how do these relate to differing presentations in children? [6]

A

Large SA: volume = more cold

Smaller target = greater amount of energy absorbed

Reduced metabolic reserves = hypoglycaemia and dehydration

Smaller mass = drug dose and fluid differ

Skeleton not calcified = deforms and less protection Less elastic tissue =degloving

Less type 1 respiratory fibres

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2
Q

What is the most common form of hypoglycaemia in <5

A

Ketotic hypoglycaemia

Common in skinny 1-2 y/o with intercurrent illness

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3
Q

What are CVS differences in children [5]

What cardiovascular differences happen as children grow older? [3]

A
  • Faster pulse (110-160)
  • Faster RR (30-40) Lower BP - can maintain until very shocked (60-70)
  • Sats threshold <92%
  • Smaller circulating volume

SV increases as increase size

Pulmonary resistance decreases as get older

Systemic resistance increases

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4
Q

What are conditions that are not seen in adults [10]

A
  • Febrile convulsion
  • Abdominal migraine
  • Bronchiolitis, Croup Viral induced wheeze
  • Glue ear
  • IVH
  • Toddler diarrhoea
  • VUJ reflux
  • NAI
  • Sudden unexplained death of infants
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5
Q

What are chronic conditions with childhood onset [7]

A

Asthma

Autism

Cerebral palsy

CF

Gastroschisis

Hirschsprung

Spina bifida

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6
Q

What accounts for reduced mortality in children

A
  • Obstetric care
  • Better housing
  • Better nutrition
  • Immunisations
  • Antibiotics
  • NHS
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7
Q

Who most commonly presents to inpatient and how long do they stay [3]

A
  1. <2 years
  2. Respiratory illnesses
  3. <48 hours
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8
Q

What are other causes of acute admission [5]

A
  • Asthma, Wheeze
  • Acute LRTI, URTI
  • Bronchiolitis, Croup
  • Febrile convulsion, Fever
  • Gastroenteritis, Vomiting
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9
Q

What is decreased birthweight associated with [6]

A
  • Impaired glucose tolerance / DM
  • Hypertension
  • CHD
  • Stroke
  • Renal failure
  • Asthma
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10
Q

How does metabolism differ in children

A

Brown fat

Immature shivering

Hypoglycaemia as little glycogen stores which exacerbates hypothermia

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11
Q

How do you assess paed

A

ABCDE

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12
Q

When do you start oxygen / neb

A

Sats <92%

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13
Q

What do you do for viral wheeze

A

SABA

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14
Q

What do you do if child deteriorates [5]

A
  • ABCDE
  • IV access
  • Fluid Increase
  • O2
  • Nebulised SABA / steroid ABG / CXR
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15
Q

What are respiratory differences children vs adults [7]

A
  • RR higher
  • Higher O2 requirement
  • Smaller airway
  • Diaphragmatic / accessory muscles to breath
  • Easily fatigued
  • Soft bones = compliant chest wall so indrawing and recession can be seen
  • Can tolerate lower sats
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16
Q

Airway differences in babies [5]

A

Large head to body ratio

Large tongue, Large adenoids

Nasal breather so obstruct easily

Narrow airway, Short neck

17
Q

Pediatric vital signs

A

Look at this table and try to identify patterns in the numbers

18
Q

State HR and RR ranges:

  • Age <1
  • Age 2-5
  • Age >12
A

<1: HR 110-160, RR 30-40

2-5: HR 90-140, RR 25-30

>12: HR 60-100, RR 15-20

19
Q

Now fill in the blanks! State HR and RR ranges:

Age 1-2

Age 5-12

A

1-2: HR 100-150, RR 25-35

5-12: HR 80-120, RR 20-25

20
Q

The Apgar score is used to assess the health of a newborn baby. What are the parameters? [5] What is the scoring system like? [1]

A

Parameters:

  • Pulse
  • Respiratory effort
  • Colour
  • Muscle tone
  • Reflex irritability

Scoring: each parameter can be scored from 0, 1, 2

21
Q

Apgar score 0

A
  • Pulse: absent
  • Respiratory effort: nil
  • Colour: blue all over
  • Muscle tone: flaccid
  • Reflex irritability: nil
22
Q

Apgar score 1

A
  • Pulse: <100
  • Respiratory effort: weak, irregular
  • Colour: body pink, extremities blue
  • Muscle tone: limb flexion
  • Reflex irritability: grimace
23
Q

Apgar score 2

A
  • Pulse: >100
  • Respiratory effort: strong crying
  • Colour: pink
  • Muscle tone: active movement
  • Reflex irritability: cries on stimulation/sneezes coughed
24
Q

What does the calculated apgar score indicate about the newborn [3]

A
  • A score of 0-3 is very low score
  • between 4-6 is moderate low
  • between 7 - 10 means the baby is in a good state
  • Assess at 1 and 5 minutes
25
Q

Neonatal resuscitation guidelines

A

Birth: - Dry the baby, remove any wet towels and cover - start the clock or note the time.

Within 30 seconds:

  • Assess tone, breathing and heart rate.

Within 60 seconds:

  • If gasping or not breathing
  • open the airway and give 5 inflation breaths

When the chest is moving: If heart rate is not detectable or slow (< 60 min-1) - start chest compressions with 3 compressions to each breath.

Paeds (33 decks)

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