Intro week-PPRAPID

Question 1

What are the airway manovers for children

Answer 1

• Infant - neutral position: face parallel to the surface
• Between these ages (2-5) might need to assume the ‘sniffing the morning air position’
• Child over 5 will tolerate the head-tilt chin-lift
• Jaw thrust (if your worried about C spine)

Question 2

contraindication to nasopharyngeal airway?

Answer 2

Basal skull fracture (CSF out of ears)

Question 3

What GCS requires incubation?

Answer 3

GCS <8 (equivalent of ‘P’)

Question 4

What is high PAWS for all children ages?

Answer 4

> 40

Question 5

Organ perfusion considerations for ‘Circulation’ in ABCDE

Answer 5

BREATHING
URINE OUTPUT -wet nappy?
BRAIN-drowsey

Question 6

Fluid bolus in adult vs child

Answer 6

adult 500ml/15 mins 0.9% saline

child 20ml/kg 0.9% saline *(however if suspicion of underlying heart problem half it to 10ml/kg)

Question 7

Causes of bilateral fixed dilated pupils?

Answer 7

• brain herniation due to raised ICP
• can also be a sign of severe hypoxia, hypothermia
• can occur during and post seizure as well

Question 8

causes of bilateral pinpoint pupils?

Answer 8

• sign of opiate overdose or organophosphate ingestion

Question 9

three signs of Cushings triad? what are they signs of?

Answer 9

CUSHINGS TRIAD IS SIGNS OF RAISED ICP

• Bradycardia
• Hypertension
• Irregular respirations

Question 10

what age can adult GCS be used?

Answer 10

aged 5+

Question 11

RAPID treatment of siezures?

Answer 11

STEP 1-if seizing for >5 mins BUCCAL MIDAZOLAM 0.5mg/kg
STEP 2-if they continue to seize for 10 minutes after this then give them IV LORAZEPAM 0.1mg/kg (if you can get access) and seek senior help
STEP 3 -might need to prescribe phenytoin IV/IO over 20min

Question 12

treatment of meningitis in the neonate?

Answer 12

CEFTRIAXONE or CEFOTAXIME 50mg/kg
+amoxicillin in children under the age of 3 months to cover for listeria

Ceftriaxone notto be used in premature babies or in babies with jaundice, hypoalbuminaemia or acidosis, as it may exacerbate hyperbilirubinaemia JUST USE TAXIME

Question 13

DECORTICATE (core body) followed by DECEREBRATE posture can be sign of what?

Answer 13

brain herniation might be about to occur

Question 14

contraindications to lumbar puncture?

Answer 14

○ Local infection
		○ Unconscious or deteriorating
		○ MENINGOCOCCAL SEPTICEAMIA
		○ Bleeding disorder / BP high 
		○ Signs of raised ICP:Abnormal posture/respiratory abnormality/pupils
		○ Seizure 
		○ Neurological signs 
		○Extremis (shock)