Intro to Paeds Surgery Flashcards
what should weight of children be
2x(age+4)
approximate blood volume children
80mls/kg
urine output children
0.5-1ml/kg/hour
rough insensible fluid loss children
20ml/kg/day
systolic blood pressure children
80+(2xage)
over what age should vital signs be approximately the same as adults
> 10
WHO pain ladder for kids
paracetamol -> ibuprofen -> weak opiod -> strong opiod
what opiod not recommended children <12
codeine
fluid resuscitation recommendation
20ml/kg bolus 0.9%NaCl
maintenance fluid children
0.9% NaCl / 5% Dextrose +/- 0.15% KCl
4ml/kg 1st 10kg
2ml/kg 2nd 10 kg
1ml/kg every kg thereafter
important examination techniques for kids with abdominal pain/ vomitting
- general appearance
- temp
- guarding
- rebound
investigations kids with abdominal pain/ vomitting
- urine (always)
- FBC (if diagnostic doubt)
- electrolytes (if dehydrated)
- rarely x-ray
Murphy’s triad of appendicitis
- pain (McBurneys point)
- vomitting
- fever
complications appendicitis
abscess
mass
peritonitis
features NSAP (non-specific abdominal pain)
- short duration
- central
- constant
- not made worse by movement
- no GIT disturbance
- no temperature
- site and severity of tenderness may vary
where is pneumonia normally in kids
right LL
mesenteric adenitis
condition that more often affects children and teenagers. It causes inflammation and swelling in the lymph nodes inside the abdomen
presentation mesenteric adenitis
- high temp
- URTI often
- not ‘unwell’
presentation of pyloric stenosis
- non-bilious vomitting
- weight loss
- cap gas (alkalosis, hypocholraemia, hypokalaemia)
investigations pyloric stenosis
- test feed
- USS
- periumbilical pyloromyotomy
describe malrotation of gut
abnormality that can happen early in pregnancy when a baby’s intestines don’t form into a coil in the abdomen. the intestines are twisting, which can cause obstruction
presentation malrotation
- 3 day old baby
- bile vomitting
- fairy liquid green
management malrotation
- upper GI contrast study
- laparotomy
intussusception
condition in which one segment of intestine “telescopes” inside of another
presentation intussusception
- history viral illness
- intermittent colic and dying spells
- bilious vomitting
- delayed cap refill
- bloody mucous PR (red jelly)
intussusception investigations
- USS abdomen
‘target sign’ appearance
management intussusceptions
- pneumostatic reduction
- laparotomy
define gastroschisis
gut eviscerated and exposed through abdominal wall
management gastroschisis
- primary/ delayed closure
- TPN
examphalos
weakness of the baby’s abdominal wall where the umbilical cord joins it. This weakness allows the abdominal contents, mainly the bowel and the liver to protrude outside the abdominal cavity where they are contained in a loose sac that surrounds the umbilical cord
