Gastroenteritis Flashcards
1
Q
Important DDx gastroenteritis?
A
- UTI
- Appendicitis
- Other infections
- Surgical causes of acute abdo
2
Q
What are the red flags requiring careful consideration of Ddx in children presenting with ?gastro?
A
- severe pain / ado signs
- persistent diarrhoea 10d+
- blood in stool
- Very unwell
- bilious vomiting
- vomiting without diarrhoea
3
Q
When should stool micro investigation be considered in gastro?
A
- diarrhoea not improving by D7 (esp if recent travel Hx)
- septicaemia suspected
- blood / mucous in stool
- immunocompromised child
4
Q
When are blood Ix (UEC / glucose) required for children presenting with gastro?
A
- severe dehydration
- renal disease / diuretic Rx
- altered conscious state
- ‘doughy’ skin (suggesting hypernatremia)
- home therapy with excessively hypertonic solutions
- profuse or prolonged losses
- ileostomy
5
Q
Acute Mx gastro?
A
- Ondansetron (1 dose)
- Oral rehydration
- NGT if significant ongoing losses
- IV if severe, NGT fails
- Monitor rehydration
6
Q
Oral rehydration approach?
A
- Methods to help children drink: cup, icy pole etc
- Continue breast feeding
- Suggest ORS
- Early feeding
- Usual diet once rehydrated
- Temp lactose free formula (2w) if diarrhoea worse
7
Q
What is the preferred method of rehydration in children refusing oral intake?
A
NGT - even if vomiting. Most children stop vomiting after NGT started.
8
Q
How should rehydration be monitored?
A
- Bare weigh 6hrly in mod - severe dehydration receiving NGT / IV
- Reasess in 4-6h; then 8hrly to guide fluid therapy;
Assess: - weight change
- signs dehydration
- UO
- ongoing losses
- signs of overload
