Emergency Paediatrics Flashcards

Question

What are causes of hypovolaemia?

Answer 1

Dehydration - gastroenteritis DKA Blood loss -trauma

Answer 2

Septicaemia | Anaphylaxis

Answer 3

Arrhythmias | Heart failure

Answer 4

``` Upper airway obstruction: causes stridor Croup/epiglottitis Foreign body Congenital malformations Trauma ``` Lower airway disorders e.g. asthma, bronchiolitis, pneumonia, pneumothorax

Answer 5

Acute abdomen - appendicitis, peritonitis Intestinal obstruction - intussusception, malrotation, bowel atresia/stenosis

Answer 6

15 compressions, 2 breaths | 100-120 compression/min

Answer 7

Ventricular fibrillation VF | Pulseless ventricular tachycardia

Answer 8

Give adrenaline every 3-5 mins after 3 shock and then at alternate cycles if shockable rhythm If unshockable rhythm, CPR and adrenaline every 3-5 mins ie every other cycle

Answer 9

4Hs and 4Ts Hypoxia Hypovolaemia Hypo/hyperkalaemia Hypothermia Tension pneumothorax Toxins Tamponade Thromboembolism

Answer 10

``` Tachypnoea, tachycardia Decreased skin turgor Sunken eyes and fontanelle Delayed CRT Mottled pale cold skin Core peripheral temp gap Decreased urinary output ``` Late - acidotic, bradycardia Confused, blue peripheries Hypotensive Absent urine output

Answer 11

``` Fever, poor feeding, misery Lethargy History of focal infection Predisposing conditions Tachycardia, tachypnoea Purpuric rash Shock, multi-organ failure ```

Answer 12

Opiates, barbiturates | Pontine lesion

Answer 13

Severe hypoxia During/post seizures Anticholinergic drugs Hypothermia

Answer 14

Expanding ipsilateral lesion Tentorial herniation Third nerve lesion Seizures

Answer 15

Combination of apnoea, colour change, alteration in muscle tone, choking or gagging Most common in infants less than 10 weeks old May occur on multiple occasions Can be presentation of deadly serious disorder, or no cause identified

Answer 16

Infection - fever, rash, seizures, neck stiffness Do FBC, cultures, CSF, PCR Status epilepticus or post-ictal - hx of seizures, neurocutaneous lesions on skin, developmental delay, ongoing seizure activity Do blood glucose, electrolytes, drug levels, EEG, CT Trauma - RTA, bruising, haemorrhage, fractures Do x-rays, CT, MRI Diabetes - DKA, diabetes Blood glucose, plasma electrolytes, urine, blood gas Hypoglycaemia Inborn errors of metabolism Hepatic failure - do LFTs, PT Acute renal failure - creatinine Poisoning - toxicology, FBC Shock - FBC, cultures, urea, blood gases HTN - left ventricular hypertrophy on ECG or echo Resp failure - chest x ray, arterial blood gas - hypoxia, hypercarbia

Answer 17

A-E, check blood glucose If <3, give glucose IV If no vascular access - diazepam or midazolam buccal ``` If IV access lorazepam Repeat if no response in 5-10 mins Paraldehyde PR Phenytoin if no response Rapid sequence induction and mechanical ventilation if still no response ```

Answer 18

``` Infections - RSV, pertussis Seizures GORD Upper airways obstruction No cause identified ``` ``` Uncommon - Arrhythmias Breath holding Anaemia Heavy wrapping/heat stress Central hypoventilation syndrome Cyanotic spells from intrapulmonary shunting ```

Answer 19

``` Fever Refusal to weight bear or use affected joint Constant severe pain Night pain Weight loss Unexplained bruising ```

Answer 20

Infection - septic arthritis, osteomyelitis Viral arthritis Trauma - fracture, dislocation, soft tissue injury, child abuse, NAI Reactive arthritis Haemophilia - family history, unexplained bruising ``` Juvenile idiopathic arthritis Kawasaki disease Acute rheumatic fever Henoch-Schonlein purpura Serum sickness ``` Leukaemia Soft tissue malignancy IBD Ehlers-Danlos

Answer 21

URTI Toddlers and infants Stridor due to laryngeal oedema and secretions Parainfluenza virus cause

Answer 22

Stridor Barking cough - worse at night Fever Coryzal symptoms

Answer 23

<6 months of age Known upper airway abnormalities e.g. laryngomalacia, Down's Uncertainty about diagnosis Moderate or severe croup

Answer 24

Clinical diagnosis | CXR - PA view subglottic narrowing - steeple sign

Answer 25

Single dose oral dexamethasone regardless of severity Or prednisolone High flow oxygen Nebulised adrenaline

Answer 26

``` Day 5-9 Hypothyroidism PKU Metabolic diseases CF MCADD ```