EAC Recognition of the Seriously Ill Child - Medical Flashcards
A and P differences in paediatrics compared to adults:
Airway
Narrow nostrils Large tongue Loose teeth Compressible floor of mouth Horseshoe-shaped epiglottis High anterior larynx
A and P differences in paediatrics compared to adults:
Cardiovascular
generally healthy hearts
minimum equipment required when attending a paediatric patient
O2 bag
Defib
PALS kit bag: contains various paediatric sized versions of normal kit - OP’s, NP’s, Suction catheters, Non rebreather O2 mask
importance of early recognition of S and S of a seriously ill or injured child
Good assessment allows the child with actual or potential life threatening illness or injury to be rapidly identified and managed.
Paediatric patients will suffer organ damage before their heart gives up making it important to recognise illness or injury early to prevent this. Once they do arrest they stand less chance then adults of successful resuscitation.
the two main pathways that lead to paediatric cardiac arrest
Circulatory failure
Respiratory failure
describe:
Paediatric Assessment Triangle
- Appearance
- Work of Breathing
- Circulation to Skin
All covered during primary survey. Helps to identify time critical illness or injury
Paediatric Assessment Triangle:
Appearance
Tone Interactiveness Consolability Look/gaze Speech/cry
Paediatric Assessment Triangle:
Work of Breathing
Effort: Respiratory effort Recession Accessory muscles Nasal flare Stridor/Wheeze Expiratory grunting
Efficiency ad Effort: Chest expansion Air entry (auscultate) Pulse oximetry Pulse rate Colour Mental status
Paediatric Assessment Triangle:
Circulation to Skin
Colour
Capillary refill
Warmth of Skin
describe:
Paediatric Primary Survey
Airway Breathing Circulation Disability -AVPU -Pupils -BM Expose Frequently Reassess
signs and symptoms of:
Deteriorating Paediatric Patient
Increasing recession Increasing RR Fatigue Altered mental state Cyanosis
respiratory illnesses that occur in paediatric patients
Croup Epiglottitis Asthma Bronchiolitis URTI's LRTI's/Pneumonia
signs and symptoms of:
Croup
Cough - harsh and barking Stridor - due to inflammation and narrowing of the airways Use of accessory muscles Runny nose Hoarseness Sore throat May follow a cold but can appear out of the blue -fever -feeling unwell -being off food -general aches and pains
signs and symptoms of:
Epiglottitis
Fever
Unwell/distressed
Stridor (all children with stridor must be transferred to further care)
Sitting up/ Drooling/ Chin out
management of:
Croup and Epiglottitis
DRcABCDE (time critical correct A and B then transport)
High flow O2 if required
Consider paramedic assistance
Keep child in position of comfort
Keep calm approach and assess the patient in a reassuring and not over-bearing manner
Place noting in the child’s mouth
Blue call if required (always epiglottitis)
REMEMBER:
Upper airway compromise can be made worse by any procedure that may distress the child. This includes measurement of blood pressure, administrations of nebulizers or the forced administration of medication.
