Clinical relevance: Week 2 Flashcards
Croup common features
barking cough
hoarse voice
stridor
worse in evening and at night
gradual onset 12-48h
coryza
febrile
Croup key differentials
acute epiglottitis
bacterial tracheitis
foreign body - inhaled or aspirated
allergic reaction/anaphylaxis
Croup management
keep child warm
keep parents calm
mild/moderate = PO dexamethasone or PO prednisolone
a period of observation
severe = adrenaline (nebulised 5ml of 1:1000), IM/IV dexamethasone 0.6ml/kg (max 12mg)
admit + observe
Features of febrile convulsions
benign in nature
6months-6years
simple or complex
What is a complex febrile seizure?
duration >15 mins
multiple seizures over a 24h period
focal neurology
Risk of developing epilepsy following a febrile convulsion
low
higher with complex febrile seizures
What features of febrile seizures would make you consider meningitis?
under 18 months
multiple seizures
focal features
prolonged (>15min)
drowsy >1h post-seizure
How long does bronchiolitis typically last?
7-10 days
days 2-3 usually most severe
Risk factors for severe bronchiolitis infection
age <1y, especially <6w
congenital heart disease
neurological conditions
chronic resp illness
pulmonary htn
ex-premature infants
inborn errors of metabolism
trisomy 21
cystic fibrosis
immunodeficiency
prev severe bronchiolitis needing CPAP or PICU admission
Bronchiolitis management
oxygen
feeding support (NG preferred)
high flow humidified oxygen
CPAP
ventilation
When do you admit patients with bronchiolitis?
sats <90%
feeding <50% of normal
What suggests decompensation in acute asthma?
normal or raised pco2
suggests tiring
Paediatric acute asthma management
back to back salbutamol nebulisers
IV hydrocortisone
IV fluids
IV aminophylline and magnesium sulphate
Viral-induced wheeze management
salbutamol
little evidence for steroids
