Common Acute Illnesses COPY Flashcards
Normal HR, RR and systolic BP in a child <1 year?
HR: 110-160 bpm
RR: 30-40 breaths/min
Systolic BP: 70-90 mmHg
Normal HR, RR and systolic BP in a child 1-2 years of age?
HR: 100-150 bpm
RR: 25-35 breaths/min
Systolic BP: 80-95 mmHg
Normal HR, RR and systolic BP in a child 2-5 years of age?
HR: 95-140 bpm
RR: 25-30 breaths/min
Systolic BP: 80-100 mmHg
Normal HR, RR and systolic BP in a child 5-12 years of age?
HR: 80-120 bpm
RR: 20-25 breaths/min
Systolic BP: 90-110 mmHg
Normal HR, RR and systolic BP in a child >12 years of age?
HR: 60-100 bpm
RR: 15-20 breaths/min
Systolic BP: 100-120 mmHg
Proportions of infants?
Infants have a relatively large head and a more prominent occiput
Sitting height is proportionately more
They have a relatively large surface area compared to volume - important when treating burns and considering fluid replacement
Structural differences of the respiratory tract between adults and children?
In children, there is a high anterior larynx with a floppy epiglottis
Rib structure in children compared to adults?
Ribs are more flexible so low risk of fracture when resuscitating
Blood volume differences between children and adults?
80 mls/kg (much lower than adults); this is important for fluid replacemet
Haemoglobin type at birth?
HbF - present for the first 1/2 months; it lasts less time before degrading
It also has a greater affinity for O2
What is the most common reason for acute illness in children?
Sepsis
Presentation of sepsis in children?
Variable - unlike adults, they may not have specific signs, e.g: fever, off of feeding, irritability and a non-specific rash
Treatment of sepsis?
Supportive and with anti-microbials
Describe bronchiolitis
Acute inflammation of the bronchioles, mainly caused by RSV but also by metapneumovirus
Usually occurs at ages 1-2 years
Treatment of bronchiolitis?
Supportive
Describe croup
Laryngotracheobronchitis - the cause is usually viral
X-ray signs of croup?
Hypopharynx distension
“Steeple sign” - narrowed sub-glottic air column
Treatment of croup?
Steroids aid recovery
Causes of pneumonia?
Normally bacterial but could be viral
Causes of meningitis?
Bacterial and viral
Causes of encephalitis?
An infection of the brain substance that commonly has a VIRAL causes
Ix for CNS conditions, e.g: meningitis or encephalitis?
Lumbar puncture
Imaging
Which test must always be done with a rash?
Tumbler test - menigococcal/haemorrhagic rash will be non-blanching
Potential causes of child fits and fainting?
- Febrile seizures
- Vasovagal episodes
- Reflex anoxic seizures
- Breath holding attacks
- Behavioural episodes
- Epilepsy
- Arrhythmias
What are reflex anoxic episodes?
Brief periods of asystole, usually due to a noxious stimulus, e.g: being frightened
They turn white and the heart stops; it is generally benign but frightening
What are breath holding attacks?
Often due to a noxious stimulus; they take a big breath, exhale, stop breathing and cannot take a breath in
They become unconscious and may have tonic movements; they go blue
Causes of arrhythmias in children?
Rare but SVTs are the most common; it is almost always a congenital abnormality and not due to degenerative atherosclerosis
Signs of NAI on thoracic X-ray?
Fractures posterior ribs from grabbing a child too hard; on X-ray, posterior ribs should be straight (anterior are curved), not lumpy
It is unlikely that these would occur by accident
GI/GU issues in children?
- Viral gastroenteritis, e.g: rotavirus (there is a vaccination for this)
- GI obstruction
- Acute abdomen (in older children) - appendicitis
- UTI
- Testicular torsion
Causes of GI obstruction in children?
Congential pyloric stenosis - presents at ~6 weeks
Volvulus
Intussusception
Malrotation (infants)
Potential cause of a UTI in a child?
Consider an abnormal renal tract
CVS issues that present in children?
Congenital heart disease (with cyanosis and heart failure)
Arrhythmias (rare but usually an SVT)
Bacterial endocarditis (usually due to a congenitally abnormal heart valve)
