General Flashcards
What are the 5 greatest causes for mortality in children below the age of 5?
Pneumonia
Diarrhoea
Malnutrition
Malaria
Measles
What are general danger signs in children 2months - 5 years?
Lethargy/unconscious
Vomiting everything
Convulsions
Inability to drink
What factors cause an infant to be high risk?
-low birth weight
-Born pre/postterm
-under/overweight for GA
-wasted
-1min APGAR low
-born with complicated pregnancy/delivery/labour
-one or more clinical problems since delivery
-Sick but now recovered
Define shock
Circulatory failure with inadequate tissue perfusion resulting in impaired oxygen and substrate delivery as well as impaired excretion of waste products
What equipment do you need to transport a sick neonate?
Transport incubator
Ventilator
Handheld devices -glucose, Hb, electrolytes
Airways - pro/NG tube
Full ICU monitoring
Blood gases (prior and at receiving hospital)
Power source in ambulance
Battery for transfers
What does ACCEPT stand for with regards to transport of neonate?
Assessment
Control
Communication
Evaluation
Preparation
Transfer
How do you check for general danger signs in a child 2months - 5 years?
Ask:
-is the child able to eat?
-Does the child vomit everything?
-has the child convulsed during the illness?
Look:
-lethargic/unconscious?
-convulsing?
Into what categories do you triage a child?
Emergency - immediate care (ABC)
Priority - ahead of normal queue
Queue - non-urgent
What can cause absent resp distress signs when a child is in resp distress?
-exhausted
-severe resp failure
-neurologically depressed
-intrinsic neuromuscular disorder eg Guillian Barre
What are signs of circulatory compromise in a child?
Cold hands
Increased cap refil
Weak and fast pulse
What is a formula for expected systolic BP in children?
80 + age x2
How do you treat a shocked child?
NO MALNUTRITION:
-rapid IV fluids RL/ NS
20ml/kg bolus
-reassess
-2-3 boluses
HAS SEVERE MALNUTRITION:
-assess if child can drink
-rehydrate fluid orally/ NG 5-10ml/kg/hr
-reassess
How can you rapidly assess LOC?
AVPU
Alert
Voice response
Pain response only
Unresponsive to all stimuli
How do you treat severe dehydration?
NO MALNUTRITION:
-treat for shock if shocked
-No shock = 1/2 DD 5-10ml/kg/hr
-drink as soon as possible
- ORS 5ml/kg/hr
-encourage breastfeeding
HAS SEVERE MALNUTRITION:
-treat for shock if shocked
- no shock = no IV fluids
- ORS5-10ml/kg/hr oral/NG
-check blood glucose and treat if <3
What are the priority signs?
3 TPR
-MOB
Tiny baby <3months
Temperature very high/low
Trauma or other urgent surgical condition
Pallor
Poisoning
Pain
Resp distress
Restless, irritable, lethargic
Referral (urgent)
Malnutrition
Oedema of both feet
Burns (major)
