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Paramedicine > CLS 202 > Flashcards

CLS 202 Flashcards

1
Q

What are the steps for the paediatric assessment

A
  1. Scene safety
  2. PAT
  3. Primary Survey DRABCDE
    Any critical interventions
  4. Secondary Survey
    History and Vital signs
  5. Management and treatments
  6. Differential and provisional diagnosis
  7. Transport decision
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2
Q

What are the three sides to the PAT

A
  1. Appearance
  2. Work of breathing
  3. Circulation
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3
Q

Describe TICLS

A
  1. Tone- floppy lethargic or moving spontaneous.
  2. Interactions- do they interact normally interested in objects and sounds or uninterested.
  3. Consolabilty- can they be consoled or are they agitated
  4. Look- make eye contact or vacant glazed stare.
  5. Speech- sound strong and spontaneous or weak and muffled.
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4
Q

Four things to look for in Work of Breathing

A
  1. Listen for sounds, strider, wheeze grunt.
  2. Patients position
  3. Accessory muscle use.
  4. Nasal flaring
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5
Q

Three things to look for in circulation

A
  1. Pale
  2. Mottling
  3. Cyanosis
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6
Q

5 signs of respiratory distress

A
  1. Intercostal retraction
  2. Nasal flaring
  3. Sternal retraction
  4. Pallor
  5. Tracheal tug
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7
Q

Why do kids grunt to breath

A

Trying to generate PEEP to splint the alveolar.

Typically seen in pneumonia

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8
Q

What is the ratio for CPR and what age does it change?

A

15:2

Changes to 30-2 at 9 years

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9
Q

Drug protocols for cardiac arrest in shockable rhythms

A
  1. Adrenaline after second shock. Then every second shock
    - 10mcg/kg 1:10,000
  2. Amiodarone after three shocks
    - 5mg/kg
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10
Q

Drug protocols for non shockable cardiac arrest

A

Adrenaline once IV access is obtained. Same as shockable.

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11
Q

What is the weight formula for patients less than 1 year of age

A

(0.5 x Age in months) + 4 = kg

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12
Q

What is the weight formula for patients 1-6 years

A

(2 x age in years) + 8 = Kg

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13
Q

What is the weight formula for patients 6-16 years

A

(3 x age in years) + 7 = Kg

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14
Q

How do you calculate the Joules for peads

A

Joules = weight x 4

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15
Q

What are the three types of breech birth?

A

1- complete
2- footling
3- frank

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16
Q

What’s the process for delivering a Breech birth?

A

1-POSTURE- get mum standing or on all fours to allow gravity to assist
2- BIRTH- HANDS OFF as much as possible to limit stimulation and breath.
Ensure foetal spine is opposite mums.
Ensure foetal head is in Flection (chin to chest)
Hands off allow gravity to deliver legs and torso.
Place pointers into groin and thumbs on sacrum.
Let the baby ease out until you visualise the scapula.
Gentler rotate in lovaetts manoeuvre. With same side pointer finger place over the shoulder into the antecubital fossa and flex arm out. Repeat for other arm
Once nape of the neck is visualised move to Mauriceau smellie veit
Place info at on forearm pointer an rude finger on cheek upper hand on occipital apply gentle pressure to maintain flextion
As the mother is pushing stand up, maintain flection deliver in a J shape.

17
Q

What is a cord prolapse

A

Cord drops through the open cervix before baby

18
Q

How to manage pt with prolapse cord

A

If visualised mum may be able to place the cord back in. If not
Walk mum to stretcher and get her to lay in the exaggerated sims position.
Urgent transport. Hi flow oxygen

19
Q

Signs of shoulder dystocia

A

Head fails to be delivered despite good effort
Foetal head fails to rotate
Face and chin of foetus may seem to be being pulled back into the vagina (turtle sign)
Anterior shoulder is not visible externally

20
Q

What does Gravidity mean

A

How many times the lady has been pregnant

21
Q

What does Parity mean

A

Total number of times a women has given birth.

22
Q

What does G1P1 mean

A

Been pregnant once given birth once

23
Q

Describe ECOLOGY in terms of history taking.

A

Estimated Date of delivery
Contractions
Obstetrics- previous pregnancies, ectopic, c sections, previous pregnancies.
Loss- colour and quantity
Observations-
Gynaecology history- contraception, ovarian cysts, endometriosis.
Y use of drugs- prescription non prescription.

24
Q

How to deliver shoulder dystocia

A

Posture supine
Attempt McRoberts
- push both legs to chest
- encourage the women to push apply gentle downwards traction max 30seconds.
Apply supra public pressure to the anterior shoulder
Move to gaskin
- all fours position
- when pushing apply gentle traction delivering anterior shoulder
If unsuccessful transport in mcroberts
Attempt supra pubic pressure

25
Q

Paediatric treatment of anaphylaxis is?

A

Position pt
Adrenaline (1:100) 10mcg/kg every 5 minutes whilst indicated
Oxygen target 94%
Salbutamol Neb over 5= 5mg under 5= 2.5mg whilst indicated
Fluids IV 20ml/kg
Hydrocortisone IV 4mg/kg once

26
Q

Clinical manifestations of epiglottis

A 
Fever 4-8 hours prior 
Acute onset of upper airway obstruction 
Lethargy
Drooling 
Dysphagia
27
Q

What is the asthma treatment?

Both life threatening and non life threatening

A

O2- 94-98%
Salbutamol- under 5= 2.5 mg over 5= 5mg whilst indicated
Ipatropium Bromide- 2-6years 250mcg, max dose = 500mcg

Life threatening start with
Adrenaline- 10mcg/kg every five minutes
Then as above

28
Q

Croup Manifestations

A

1 history of common cold

  1. Low grade fever
  2. Seel bark
  3. Strider on inspiration
29
Q

What is treatment for severe croup

A
  1. O2 94-98
  2. Adrenaline
    - Neb
    - 500mcg/kg
    - every 30 minutes
30
Q

Seizure treatment whilst actively fitting

A
  1. Protect Pt by removing objects
  2. Consider backup
  3. Consider cause. Eclampsia etc.
  4. Midazolam
    - IM 0.15mg/kg
    - every 5 minutes
    - 0.45mg/kg max dose

No contra indications.

31
Q

What things to find out with History taking of a seizure patient

A 
1- Time of onset 
2- Mechanism of injury 
3- fever, aloc 
4- past Med Hx
5-meds
6- Allergies
32
Q

Treatment of Hypoglycaemia

A

1- glucose get if able to swallow
-entire tube 15grams

If unable to swallow 
2- glucose 10% 
-IV 
15g bolus greater then 10 years 
0.2g/kg less than 10

Glucagon

33
Q

Treatment for hyperglycaemia

A

1-administer compound sodium lactate

  • 10ml/kg
  • max dose 10ml/kg

Paramedicine (11 decks)

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