Immunisations, Paediatric milestones and Paediatric CPR Flashcards

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1
Q

What percentage of the UK population is children?

A

30-40%

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2
Q

What age group is a; neonate?

A

Birth to 1 month

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3
Q

What age group is an; infant?

A

1 month to 2 years

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4
Q

What age group is a; young child?

A

2-6 years

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5
Q

What age group is a; child?

A

6-12 years

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6
Q

What age group is an; adolescent?

A

12-18 years

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7
Q

Why should you not use closed questions in a child history?

A

A child will often say yes to closed questions as they think this will please the questioner e.g. “does your tummy hurt?” they will often say yes, even if untrue

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8
Q

Which vaccinations are given to children at; 8 weeks old?

A
  • Diphtheria, tetanus, pertussis (whooping cough) , polio, Haemophilus Influenzae type b and hepatitis b
  • Meningococcal group B
  • Rotavirus gastroenteritis
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9
Q

Which vaccinations are given to children at; 12 weeks old?

A
  • Diphtheria, tetanus, pertussis, polio, H.Influenzae b, HepB
  • Pneumococcal
  • Rotavirus
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10
Q

Which vaccinations are given to children at; 16 weeks?

A
  • Diphtheria, tetanus, pertussis, polio, H.Influenzae B, HepB
  • Meningococcal B
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11
Q

Which vaccinations are given to children at; 1 year (on or after their first birthday)?

A
  • H.Influenzae B, Meningococcal C
  • Pneumococcal
  • Measles, mumps and rubella (MMR)
  • Meningococcal B
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12
Q

Which vaccinations are given to children at; 3 years 4 months?

A
  • Diphtheria, tetanus, pertussis and polio

- MMR

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13
Q

Which vaccinations are given to children at; 12-13 years (boys and girls)?

A
  • HPV (types 16 and 18 for cancers)
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14
Q

Which vaccinations are given to children at; 14 years old?

A
  • Tetanus, diphtheria and polio

- Meningococcal A, C, W and Y

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15
Q

What are the social/emotional milestones achieved by a 2 month old?

A
  1. Begins to smile at people
  2. Can briefly calm themselves - e.g. putting hand to mouth
  3. Tries to look at parent(s)
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16
Q

What are the language/communication milestones expected at 2 months old?

A
  • Cooing and gurgling sounds

- Turning head towards sounds

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17
Q

What are the cognitive milestones we expect from a 2 month old?

A
  • Pays close attention to faces
  • Begins to follow things/faces with their eyes
  • Recognises people at a distance
  • Begins to act ‘bored’ (crying/fussy) if their activity or position doesn’t change
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18
Q

What are the social/emotional milestones expected for a 4 month old?

A
  • Smiles spontaneously, especially at people
  • Likes to play with people and may cry when playing stops
  • Copies some facial expressions - smiling and frowning
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19
Q

What are the language/communication milestones expected for a 4 month old?

A
  • Begins to babble
  • Babbles with expression and copies sounds they hear
  • Cries differently when they are hungry, tired or in pain
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20
Q

What are the cognitive milestones expected for a 4 month old?

A
  • They let you know when they are happy or sad (expressions)
  • They respond to affection
  • They reach for a toy with 1 hand (using hand-eye coordination
  • They follow things from side to side with their eyes
  • They watch faces closely
  • They recognise familiar things and people at a distance
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21
Q

What are the movement/physical milestones expected in a 4 month old?

A
  • Hold their head steady and unsupported
  • Push down their legs when their feet are on a hard surface
  • May be able to roll over from tummy to back
  • Can hold and shake a dangling toy
  • Brings hands to their mouth
  • When lying on their stomach they can push up on their elbows
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22
Q

What are the social/emotional milestones expected in a 6 month old?

A
  • Know familiar faces and whether someone is a stranger
  • Likes to play with others, especially parents
  • Responds to other people’s emotions and often seems happy
  • Likes to look at themselves in the mirror
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23
Q

What are the language/communication milestones expected in a 6 month old?

A
  • They respond to sounds by making sound
  • They string vowels together when they are babbling (ah, eh, oh)
  • They respond to their own name
  • They make sounds to show joy and displeasure
  • They begin to jabber (mmm, bbb, ddd)
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24
Q

What are the cognitive milestones we expect from a 6 month old?

A
  • They look around at things nearby
  • They bring things to their mouth
  • They become curious and reach out for things
  • They begin passing things from one hand to the other
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25
Q

What are the movement/physical milestones expected in 6 month olds?

A
  • They roll over in both directions (tummy to back and back to tummy)
  • Begin to sit without support
  • Standing with aid - support weight on legs and may bounce when held
  • Rocking back and forth (sometimes backward crawl comes before a forward crawl)
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26
Q

What are the social/emotional milestones we expect to see in a 9 month old?

A
  • Afraid of strangers
  • Clingy with familiar adults
  • Has a favourite toy
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27
Q

What are the language/communication milestones we expect to see in a 9 month old?

A
  • Understanding the word ‘no’
  • Making lots of babbling words e.g. ‘mamamama’ ‘dadada’
  • Copies the sounds and gestures of others
  • Uses their finger to point at things
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28
Q

What are the cognitive milestones we expect to see in a 9 month old?

A
  • Watching something as it falls
  • Looks for things they see you hiding
  • Playing ‘peek-a-boo’
  • Puts things in their mouth
  • Moves things smoothly from one hand to the other
  • Picks things up with their thumb and forefinger (smaller items e.g. piece of cereal)
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29
Q

What are the movement/physical milestone developments we expect to see in a 9 month old?

A
  • Stands holding onto something
  • Can get themselves into a sitting position
  • Sits up without support
  • Pulls up to stand
  • Crawling
30
Q

What are the social/emotional milestones we expect to see in a 12 month old?

A
  • Shy or nervous with strangers
  • Cries when mum or dad leaves
  • Has their favourite things
  • Has favourite people
  • Shows fear in some situations
  • Hands you a book when they want to hear a story
  • Repeats sounds/actions to get attention
  • Help with dressing by putting arms or legs out
  • Plays ‘peek-a-boo’
31
Q

What are the language/communication milestones we expect to see in a 12 month old?

A
  • Responds to simple, spoken requests e.g. pass me the book
  • Uses simple gestures - shaking head for no, waving goodbye
  • Makes sounds with changes in tone (this sounds more like speech)
  • Says “mama”, “dada” and things like “uh-oh!”
  • They try to say words you say
32
Q

What are the cognitive milestones we expect to see in a 12 month old?

A
  • Exploring items in different ways like shaking, banging and throwing
  • Finds hidden things easily
  • Looks at the right thing when it is named
  • Copies gestures
  • Starts using things correctly e.g. drinks from a cup, uses comb to brush hair
  • Bangs 2 things together
  • Puts things into a container and takes them out
  • Lets things go without any help
  • Pokes with index finger
  • Follows instructions such as “pick up the toy”
33
Q

What are the movement/physical development milestones expected at 12 months old?

A
  • Gets into sitting position without any help
  • Pulls up to stand and can walk holding onto furniture (cruising)
  • May take a few steps without holding on
  • May stand alone
34
Q

What are the social/emotional milestones expected from an 18 month old?

A
  • Likes to hand toys to other as a method of play
  • May have temper tantrums
  • May be afraid of strangers
  • Shows affection to familiar people
  • Plays simple pretend games e.g. feeding a doll
  • May be clingy with caregivers in new situations
  • Pointing is used often
  • Explores alone but wants parents nearby
35
Q

What are the language/communication milestones expected for an 18 month old?

A
  • Says several single words (begin to build their vocabulary)
  • Says “no” and shakes their head
  • Points to show what they want
36
Q

What are the cognitive milestones expected in an 18 month old?

A
  • They know what ordinary things are e.g. shoe, brush, spoon
  • Points to get the attention of others
  • Shows interest in dolls/stuffed animal by pretending to feed them
  • Points to one body part
  • Scribbles on their own
  • Can follow a 1-step verbal command without any gestures e.g. wash your hands
37
Q

What are the movement/physical development milestones expected from an 18 month old?

A
  • They walk alone
  • May walk up stairs and run
  • Pull toys along when walking
  • Can help to undress
  • Drink from a cup
  • Eat with a spoon
38
Q

What are the social/emotional milestones we expect to see from a 2 year old?

A
  • Copies others, especially adults and older children
  • Gets excited when they see other children
  • Showing more and more independence
  • Shows defiant behaviour
  • Plays mainly besides other children
39
Q

What are the language/communication milestones we expect to see in a 2 year old?

A
  • Points to things or pictures when they are named
  • Knows the name of familiar body parts or people
  • Says sentences with 2-4 words “I kicked ball”
  • They can follow simple instructions
  • They repeat words overheard in conversation
40
Q

What are the cognitive milestones expected to be seen in a 2 year old?

A
  • Finds things, even when hidden under several covers
  • Begins to sort shapes and colours
  • Able to complete sentences and rhymes in familiar/favourite books
  • Plays simple make believe
  • Builds a tower of 4< blocks
  • Might use one hand more than the other (throwing, scribbling, pointing)
  • Follows 2-step instructions e.g. go and get your shoes and put them away
  • Names items in a picture books (animals etc)
41
Q

What are the movement/physical development milestones we expect to see in a 2 year old?

A
  • Standing on their tip-toes
  • Kicking a ball
  • Begins to run
  • Climbs up and down furniture without help
  • Walks up and down the stairs when holding on
  • Throws ball overhand
  • Copies straight lines and circles (or draws them independently)
42
Q

What are the social/emotional milestones expected to be seen in a 3 year old?

A
  • Copies adults and friends
  • Shows affection for friends (without prompting)
  • Takes turn with friends in games
  • Shows concern with a crying friend
  • Understands “mine”, “his” or “hers”
  • Shows a wider range of emotions
  • Separates easily from mum and dad
  • Dresses and undresses self
  • May get upset with major change in routine
43
Q

What language/communication milestones would be expected from a 3 year old?

A
  • Can understand and follow instructions with 2 or 3 steps
  • Can name most familiar things
  • Understands words like ‘in’, ‘on’ or ‘under’
  • Names a friend
  • Says words like “I”, “me”, “we” and “you”
  • Understands plurals - cars, dogs, toys
  • Talks well enough for strangers to understand most of the time
  • Carries on conversation using 2-3 sentences
  • Knows first name, age and sex
44
Q

What are the cognitive milestones we expect to see from a 3 year old?

A
  • Can work toys with buttons, levers and moving parts
  • Plays make-believe with dolls, animals and people
  • Can complete a 3-4 piece puzzle
  • Understands what 2 (“two”) means
  • Copies a circle with a pencil
  • Turns book pages one at a time
  • Builds a tower of blocks of 6 or more
  • Screws and unscrews jar lids
45
Q

What are the movement/physical development milestones we expect to see from a 3 year old?

A
  • Climb well
  • Runs easily
  • Pedals a tricycle
  • Walks up and down the stairs
46
Q

What are the social/emotional milestones we expect to see in a 4 year old?

A
  • They enjoy trying new things/games
  • They play families - mum and dad
  • They become more creative with make-believe play
  • They would rather play with others than play on their own
  • Cooperates with other children
  • They often can’t differentiate between real and make-believe
  • Can identify their likes and dislikes
47
Q

What are the language/communication milestones expected from a 4 year old?

A
  • Knows basic rules of grammar, like using “he” and “she” correctly
  • Can sing a song from memory e.g. wheels on the bus
  • Tells stories
48
Q

What are the cognitive milestones we expect to see from a 4 year old?

A
  • Names some colours
  • Names some numbers
  • Understands the concept of counting
  • Starts understanding time
  • Remembers parts of a story
  • Understands the idea of same and different
  • Draws a person with 2-4 body parts
  • Uses scissors
  • Copies some capital letters
  • Plays board or card games
  • Tells you what they think will happen next in a book
49
Q

What are the movement/physical development milestones you would expect to see in a 4 year old?

A
  • Hops and stands on one foot for a few seconds
  • Catches a bounced ball most of the time
  • Pours, cuts and mashes food
50
Q

What are the social/emotional milestones expected to be reached by a 5 year old?

A
  • Wants to please their friends
  • Wants to be like their friends
  • More likely to agree with rules
  • Like to sing, dance and act
  • Is aware of gender
  • Knows what is real and what is make-believe
  • Shows more independence
  • Sometimes demanding, sometimes cooperative
51
Q

What are the language/communication milestones expected to be reached by a 5 year old?

A
  • Speaks very clearly
  • Tells a simple story using full sentences
  • Uses future tense “I will be going to the zoo this weekend”
52
Q

What are the cognitive milestones expected from a 5 year old?

A
  • Can count 10< things
  • Can draw a person with 6< body parts
  • Can write some letters and numbers
  • Copies a triangle and other geometric shapes
  • Knows everyday thing uses (e.g. money and food)
53
Q

What are the movement/physical development milestones expected to be seen in a 5 year old?

A
  • Stands on 1 foot for 10 seconds or longer
  • Hopping and skipping
  • Can somersault
  • Can use a fork and spoon, sometimes a knife
  • Swings and climbs
54
Q

Why is there more focus on breaths in paediatric CPR than adult?

A

Paediatric cardiac arrest is more commonly caused by asphyxia whereas adults is more likely to be a cardiac cause.

55
Q

What must we never do to check for a response in a baby?

A

Shake them - we do not want shaken baby syndrome

56
Q

How do we open the airways in an infant (<1)?

A

Lift in the neutral position (do not head tilt chin lift)

57
Q

How long do we look, listen, feel for in PaedsCPR?

A

10 seconds

58
Q

What should we do when we hear infrequent, noisy gasps?

A

Continue with CPR, this is not a sign of life

59
Q

What should you do before starting CPR?

A

Clear the airway

Give 5 rescue breaths

60
Q

How do we give breaths to an infant(<1)?

A

Your mouth over their mouth and nose

61
Q

How do we give breaths to a child?

A

Mouth to mouth (pinching their nose)

62
Q

What must you bear in mind when giving breaths?

A

A child’s lungs are much smaller than yours, only give enough breath to see their chest rise and fall
Give breath over 1-1.5 seconds

63
Q

If there is no chest rising and falling after 5 breaths, what must you consider?

A

Is there a blockage lower down in the airways?

64
Q

After 5 rescue breaths, how long do we check for signs of life?

A

For 10 seconds

65
Q

How do we check for signs of life in an infant/baby?

A

Feel for the brachial or femoral pulse

66
Q

How do we check for signs of life in a child?

A

Feel the carotid or femoral pulse

67
Q

What is the compression rate and depth needed in PaedsCPR? How many compressions do we do?

A

100-120/ minute
1/3 depth of the chest
15 compressions

68
Q

What do we use for the compressions in an infant/baby?

A

2 fingers or 2 thumbs

69
Q

What do we use to compress the chest in a child?

A

1 or 2 hands, all dependent on the size of the child and the size of you

70
Q

What is the ratio of compressions:breaths in an infant/child?

A

15:2