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Paeds > Emergency > Flashcards

Emergency Flashcards

1
Q

cMost common cause of death in 4-52 weeks

A

SIDS

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2
Q

Most common cause of death 1-5 years old

A

Congenital abnormality

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3
Q

Most common cause of death 5-14

A

Neoplasm

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4
Q

Causes of cerebral depression resulting in reduced resp drive

A

Raised ICP
Poisoning
Encepahlopathy

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5
Q

Causes of NM disease leading to reduced effort of breathing

A

Poison
Drugs
Spinal muscular atrophy
Muscular dystrophy

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6
Q

What is the triad of shaken baby syndrome

A

Encephalopathy
Retinal haemorrhages
Subdural bleeds

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7
Q

How to assess consciousness in a child

A

AVPU
Alert
Responds to VOICE
Responds to PAIN
Unresponsive

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8
Q

Difference in compression technique in children

A

For infants- 2 thumb encircling technique
Children over 1- 1 hand compressing lower half of sternum

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9
Q

Most common fracture in physical child abuse

A

Humeral

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10
Q

What are the life threatening red signs of febrile illness

A

CNS infection signs
Severe dehydration
pneumonia

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11
Q

Traffic light system for feverish child, actvity criteria

A

Amber

Not responding normally to social cues
Walking only with prolonged stimulation
Decreased activity
Not smiling

Red

No response to social cues
Appears ill to healthcare worker
Unable to rouse
Weak high pitched crying

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12
Q

Traffic light system for feverish child, respiratory criteria

A

Amber

Nasal flaring
O2 less than 95
Crackles
Tachypnoea

Red

Grunting
Tachypnoea over 60
Moderate or severe chest indrawing

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13
Q

Traffic light system for feverish child, circulatory and and hydration

A

Amber

Poor feeding
Dry mucous membranes
CRT over 3s
Reduced urinary output
Tachycardia

Red
Reduced skin turgor

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14
Q

Traffic light system for feverish child, tachycardia amber criteria

A

Infant- over 160
1-2 years- over 150
2-5 years- over 140

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15
Q

Traffic light system for feverish child, tachypnoea amber criteria

A

6-12 months- over 50
Over 12 months- over 40

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16
Q

Traffic light system for feverish child, ‘other’ amber criteria

A

Fever for 5 days or more
Rigors
Temperature over 39 in children 3-6 months
Swelling of limb or joint
Non-weight bearing or not using a limb

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17
Q

Traffic light system for feverish child, ‘other’ red criteria

A

Non-blanching rash
Bulging fontanelle
Neck stiffness
Focal neurology
Seizures

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18
Q

Major risk factors for SIDS

A

Prone sleeping
Bed sharing
Parental smoking
Hyperthermia and head covering
Prematurity

19
Q

Meningitis organisms if neonate-3 months

A

Group B Streptococcus: usually acquired from the mother at birth. More common in low birth weight babies and following prolonged rupture of the membranes
E. coli and other Gram -ve organisms
Listeria monocytogenes

20
Q

Meningitis organisms if 1 month -6 years

A

Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
Haemophilus influenzae

21
Q

Meningitis organisms if over 6 years

A

Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)

22
Q

BLS for choking

A

Get them to cough- if coughing effective don’t get them to stop
5 back blows and then 5 chest (infant)/abdo (child) thrusts but ONLY when they are conscious
If lose consciousness do 5 rescue breaths

23
Q

When would you continue CPR but they have a pulse

A

If pulse below 60 and peripheral cyanosis

24
Q

Differences between early and late shock

A

Hypotension is a late sign of shock.In early shock it is compensated for by tachycardia and tachypnoea, the BP can be normal. In late shock will be hypotensive, acidotic so kussmal breathing, blue skin as opposed to pale and absent urine output

25
Q

When asssessing hydration status what categories should be used

A

Normal
Dehydrated
Shock

26
Q

What factors inficate dehydration as opposed to shock

A

Warm extremities
No pallor
Sunken eyes
Dry mucous membranes
Normal cap refill
Normal peripheral pulses

27
Q

Which children are at greater risk of dehydration

A

Children younger than 1 year, especially those younger than 6 months
infants who were of low birth weight
children who have passed six or more diarrhoeal stools in the past 24 hours
children who have vomited three times or more in the past 24 hours
children who have not been offered or have not been able to tolerate supplementary fluids before presentation
infants who have stopped breastfeeding during the illness
children with signs of malnutrition

28
Q

When should do stool sample in gastroenteritis

A

suspect septicaemia
blood and/or mucus in the stool
immunocompromised

Can also consider if
- recently been abroad
- not improved by day 7
- uncertain about the diagnosis of gastroenteritis

29
Q

Management of gastroenteritis

A

Depends if normal, dehydrated or in shock

Normal
- continue breastfeeding
- encourage fluid intake
- discourage juices and carbonated drinks

Dehydrated
- 50ml/kg/hr ORS over 4 hours
- continue supplementing with usual fluids

Shock
- admit for intravenous rehydration

Take stool sample in specific scenarios

30
Q

Management of gastroenteritis fluids

A

Depends if normal, dehydrated or in shock

Normal
- continue breastfeeding
- encourage fluid intake
- discourage juices and carbonated drinks

Dehydrated
- 50ml/kg/hr ORS over 4 hours
- continue supplementing with usual fluids

Shock
- admit for intravenous rehydration

Take stool sample in specific scenarios

31
Q

What is infantile colic

A

At age of 3 months roughly babies start crying uncontrollably and bring knees up to chest or arch back
Typically worse in the evening

32
Q

CT scan guidelines for head injuries- immediate CT

A

Immediately do head CT if
- NAI suspected
- post traumatic seizure
- GCS less than 14 on assessment, GCS less than 15 in under 1 YO
- focal neurology
- 2 hours after injury GCS less than 15
- suspected skull fracture
- tense fontanelle
- for children under 1 a bruise or laceration over 5 cm

33
Q

CT scan guidelines for head injuries- observation or do in under 1 hour

A

If one of following then observe for 1 hour, if MORE than 1 have to do in less than 1 hour
- LOC over 5 mins
- high velocity impact (RTA, over 3m fall)
- 3 or more vomiting episodes
- amnesia over 5 mins
- abnormal drowsiness

If develop either abnormal drowsiness, vomits again or abnormal drowsiness with 1 of above RFX then do CT in less than 1 hour

34
Q

What are different ways of opening airway in paeds BLS

A

Head tilt-chin lift
Jaw thrust with cervical spine control- do if evidence of potential trauma

35
Q

Anaphylaxis management

A

Legs elevated
Im adrenaline
Highflow O2
IV fluids
IV chlorphenmaine
IV hydrocortisone
FLACOS
look up doses

36
Q

What is rate of chest compression in all children

A

100-120

37
Q

Features suggesting hypernatraemic dehydration

A

Jittery movements
Increased muscle tone
Hyperreflexia
Convulsions or coma

38
Q

Risk factors for non-accidental injury

A

Domestic violence
Previous history of child maltreatment
Mental health disorders
Drug or alcohol misuse in the carers
Disability or long-term chronic illness

39
Q

Where feel for pulse in an infant vs child

A

Child- carotid
Infant- Brachial and femoral

40
Q

When do chest or abdo thrusts in choking BLS

A

Infant- chest
Child- abdo

41
Q

How deep do you go in chest compression on a child

A

1/3 chest

42
Q

What do if clinical dehydration but cant tolerate oral rehydration solution

A

NG rehydration

43
Q

When consider admission to PICU in sepsis

A

Need for ionotrope or vasopressins
Lactate high

44
Q

If on own attending paediatric resus what do

A

Check danger
Give 1 minute of BLS
Then put out a 2222 call

Paeds (17 decks)

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