Emergency Flashcards
What is a ALTE a combination of? (4)
Apnoea
Colour change
Altered tone
Choking and gagging
Common causes ALTE (4)
Infection - RSV, pertussis
Seizures
GOR
Upper airway obstruction
Uncommon causes ALTE (6)
Cardiac arrhythmia Breath-holding Anaemia Heat stress Central hypoventilation syndrome Cyanotic spells form intrapulmonary shunting
Common Ix ATLE (3)
O2 sats Resp ECG All overnight Ix \+ baseline Ix
Immediate Mx acute illness (6)
Detailed Hx
Thorough exam
Admit to hospital
Episode = usually brief w/ rapid recovery
Overnight sats, resp, ECG to be norm for discharge
Teach parents RE follow-up + resus
PS Anaphylaxis (6)
Angiodema bronchospasm bronchorrhea laryngospasm Incr vascular perm Decr vascular tone
Common agents anaphylaxis (7)
Food ABx - penicillin NSAIDs Opiates Biologicals - venom Preservatives - MSG Latex
RF for more serious anaphylaxis attack (5)
Younger (smaller airway) Asthma Chronic GI Sx HoTN FH
EpiPen regime anaphylaxis
Adrenaline 1:1000 IM Repeat every 5 mins if needed Removed lid (blue to sky) Place into upper outer thigh Swing + insert until it clicks Hold in place for 3 s Massage area for 10s
Mx anaphylaxis - A (2)
Establish airway
Intubate if needed
Mx anaphylaxis - B (3)
15L high flow O2
Wheeze? Neb salbutamol
O2 sats
Mx anaphylaxis - C (5)
IV fl 20ml/kg saline IV chlorphenamine IV hydrocortisone ECG BP
Ix anaphylaxis (4)
Mast cell tryptase test
Skin prick test
Serum specific IgE
PO food challenge
What is non-accidental OD?
Child abuse
Which children are at greatest risk of accidental poisoning? (3)
Poor parental input
Risk of abuse or neglect
Toddlers who can walk but don’t understand consequences ingestion
What % adolescents self harm?
7%
What are the most common forms of self harm? (2)
Cuts
Burning
Poison - alcohol - effect (3)
Hypoglycaemia
Coma
Resp failure
Mx alcohol poisoning (3)
Measure blood level for severity
Monitor blood gluc
IV dextrose
Poison - paracetamol - effect (2)
Gastric irritation Liver failure (3-5 days)
Mx paracetamol poisoning (3)
Check plasma conc 4hrs after
If >150 - IV acetylchristine
Monitor PTT, LFT
Poison - NSAIDs - effect (4)
Abdo pain/ vomiting
Gastric ulcer/haematemesis
AKI
Seizures/coma
Mx NSAIDS poisoning - (2)
<2hrs - activated charcoal
Orogastric lavage
Poison - methadone - effect (6)
Resp depression Constricted pupils Constipation N + V HoTN Confusion/coma
Mx - methadone poisoning (2)
IV Naloxone
Activated charcoal <2hrs
Poison - detergents - effects
Inflamm + ulcers UGI
Mx detergents poisoning
Gastric emptying + decontamination by NGT
RF in adolescents who OD (6)
Men Decr social class Isolation Psychiatric/physical illness Prev Hx Alcohol/Dx abuse
What is SIDS
No cause of death on post-mortem
At what age is SIDS most common
2-4 months
RF SIDS (10)
LBW/Premature Male Multiple births Parents - low income Poor housing Single mother Young maternal age Maternal smoking during/after preg Baby sleeping face down Infant overheats
Advice to parents RE SIDS (5)
Sleep on back _ feet to foot position Keep baby in your bedroom Avoid sleeping with them on sofa/arm chair Avoid overheating them Don't smoke
RF Burns + scalds (6)
Majority occur in low SE status Low education levels High pop density Psycho stress Single parents Young mothers
PS Burns/scalds (5)
Damaged skin; blisters,peels Shock Airway obstruction Wheezing Swelling
Features of superficial burn
Skin epithelialized from surviving cells
Features of partial thickness burn
Damage to dermis, blistering, pink
Features of full thickness burn
Skin + dermis destroyed, white + charred, painless
Tx scalds/burns - initial
Run under cold water at least 5 mins
Wrap in cling film
Mx scalds/burns
IV morphine
Tx shock - fl
Tentanus booster if needed `
Which burns should be investigated for safeguarding concerns (3)
Recurrent
Severe
Hx not reasonable
Preventative measures for parents for burns (7)
Smoke alarms Education Stop drop + roll Close supervision High chairs Keep electrical chords out of reach Careful placement of hot items
Drowning - M:F
M:F = 3:1
Immediate Mx drowning (4)
M2M resus + CHx compression
Cover + warm
If water inhaled - hospital - pulm oedema - resp distress
Pneumonia may develop