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Paediatrics > Emergency > Flashcards

Emergency Flashcards

1
Q

Why are five rescue breaths and a ratio of 15:2 used in paediatric BLS?

A

Because children are much more likely to be suffering from a respiratory arrest than cardiac

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2
Q

How do you give chest compressions to a small child?

A

Use the heel of one hand in the middle of a line joining the nipples. Compress the lower half of the sternum to a third of the chest’s depth.

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3
Q

What is the preferred site for an IO?

A

Anteromedial surface of the proximal tibia, 1-2cms medial to and 1-2cms distal to the tibial tuberosity

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4
Q

What are the contraindications for an IO?

A
  • Osteoporosis
  • Osteogenesis imperfecta
  • Infection at target site
  • Vascular injury proximal to insertion site
  • Fracture in target bone
  • Previous insertion at site within last 48 hours
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5
Q

What is the ideal position for a child suffering anaphylaxis when they are not comatose?

A

On their back with their legs raised

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6
Q

What position do you put a comatose child suffering anaphylaxis in? Why?

A

Left-lateral position to prevent caval compression

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7
Q

What are the three drugs used to treat anaphylaxis?

A

1) Adrenaline 1:1000
2) Chlorphenamine
3) Hydrocortisone

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8
Q

What are the IM doses of the drugs used to treat anaphylaxis for a baby aged <6 months?

A
  • Adrenaline = 0.15ml
  • Chlorphenamine = 25mcg/kg
  • Hydrocortisone = 25mg
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9
Q

What are the IM doses of the drugs used to treat anaphylaxis for a child aged 6 months to 6 years?

A
  • Adrenaline = 0.15ml
  • Chlorphenamine = 2.5mg
  • Hydrocortisone = 50mg
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10
Q

What are the IM doses of the drugs used to treat anaphylaxis for a child aged 6-12 years?

A
  • Adrenaline = 0.3ml
  • Chlorphenamine = 5mg
  • Hydrocortisone = 100mg
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11
Q

What are the IM doses of the drugs used to treat anaphylaxis for an adolescent?

A
  • Adrenaline = 0.5ml
  • Chlorphenamine = `10mg
  • Hydrocortisone = 200mg
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12
Q

How do you calculate IV fluid bolus in a child?

A

20ml/kg

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13
Q

What does an infant <3 months old with a fever of unknown cause require?

A

Full septic screen including lumbar puncture

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14
Q

What medication do you give in a febrile child with suspected herpes simplex encephalitis?

A

IV aciclovir

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15
Q

If a febrile child is >3 months old and bacterial meningitis is confirmed, give __ _____________.

A

IV corticosteroids

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16
Q

Children with a fever lasting 5 days or more should be assessed by a paediatrician for _________ _______.

A

Kawasaki disease

17
Q

What fractures are indicative of NAI?

A
  • Rib # in very young children, particularly posterior, multiple or same location on adjacent ribs
  • Humeral # in non-mobile children
  • Spiral fracture on humerus of any age
  • Femoral # in non-mobile children
  • Spinal # of any age
18
Q

What investigations should children have if physical abuse is suspected?

A
  • Skeletal survey and ophthalmology review (<2 years)
  • Head CT (<1 year)
  • Coag, FBC and film in patients with bruising
  • Bone profile, vit D and PTH in patients with #
  • Urine toxicology for poisoning
  • Medical photography
19
Q

What are the differential diagnoses for NAI/child abuse?

A
  • Osteogenesis imperfecta
  • Immune thrombocytopenic purpura (ITP)
  • Leukaemia
  • HSP
  • Coagulation disorders
  • Scurvy
  • Blue spots (congenital dermal melanocytosis)
  • Osteoporosis
20
Q

What mental health disorder is associated with child sexual assault and abuse?

A

Conversion disorder

21
Q

What is encephalitis?

A

Inflammation and swelling of the active tissues of the brain caused by an infection or an autoimmune response

22
Q

What are the signs of encephalitis in children?

A
  • Altered behaviour, cognition or consciousness
  • Fever or recent febrile illness
  • Seizures
  • Focal neurological signs
  • Vomiting
  • Meningism
23
Q

What is meningism?

A

The clinical syndrome of headache, neck stiffness and photophobia, often with nausea and vomiting. It is most often caused by inflammation of the meninges, but other causes include raised intracranial pressure.

24
Q

What are the infective causes of encephalitis?

A
  • HSV
  • Mumps
  • Varicella zoster (chickenpox)
  • Rabies
  • Parvovirus (slapped cheek syndrome)
  • Influenza
  • Toxoplasmosis
  • TB
  • Mycoplasma
  • Malaria
  • Dengue
  • Rickettsia
  • Lyme disease
25
Q

What is acute disseminated encephalomyelitis?

A

An acute demyelinating process which usually follows a non-cns infection that causes encephalitis.

26
Q

What are the differentials for encephalitis?

A
  • Hypoglycaemia
  • DKA
  • High ammonia
  • Sepsis
  • Meningitis
  • Brain abscess
  • Lead or other poisoning
  • Subarachnoid haemorrhage
  • Malignancy
  • Lupus
27
Q

What is the first line treatment for infective encephalitis?

A

IV aciclovir

28
Q

How do children with meningitis commonly present?

A
  • Poor feeding
  • Fever
  • Lethargy
  • Irritability
  • Vomiting
  • Headache
  • Myalgia
  • Arthralgia
29
Q

What are the clinical signs and symptoms of meningitis?

A
  • Neck stiffness
  • Kernig’s sign (resistance to extending knee when hip flexed)
  • Brudzinski’s sign (hips flex on neck flexion)
  • Photophobia
  • Opisthotonos
  • Bulging fontanelle
  • Altered consciousness
  • Seizures
  • Focal neurological deficit
  • Abnormal pupils
  • Non-blanching rash
  • Fever
  • N&V
30
Q

What is opisthotonos?

A

The spasm of the muscles causing backward arching of the head, neck, and spine

31
Q

What is the correct location for a lumbar puncture in a child?

A

Just above a line joining the spinous processes between the iliac crests

32
Q

What is the treatment for meningitis with unknown cause in a child < 3 months?

A

IV cefotaxime plus amoxicillin/ampicillin

33
Q

What is the treatment for meningitis with unknown cause in a child > 3 months?

A
  • IV ceftriaxone

- IV dexamethasone (when not meningococcal septicaemia or TB)

34
Q

What is the benefit of treating children with meningitis steroids?

A

Reduces the chance of deafness

Paediatrics (9 decks)

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