Introduction to Paediatric Surgery Flashcards
How do you calculate average weight of a child per age?
Weight in kg = 2 x (age + 4)
->e.g. if child 1, they would weight approx 10kg
How do you calculate average systolic BP of a child?
Systolic BP = 80 + (2 x age)
As a child increases with age from birth, what happens to their RR?
Decreases
->higher is <1yrs
As a child increases with age from birth, what happens to their HR?
Decreases
As a child increases with age from birth, what happens to their systolic BP?
Increases
Can you give children:
a. morphine?
b. codeine?
A. Yes
B. No
What is the fluid bolus for resuscitation in children?
10ml/kg bolus 0.9% of Sodium chloride or crystalloid
What colour of vomiting is worrying in children?
Green- bilious vomit
Murphy’s triad?
Pain
Vomiting
Fever
->seen in appendicitis
Management of appendicitis in children?
Analgesia- do not withhold
Surgery
->note that medical management can work, during Covid- appendicitis was managed with antibiotics, and 70% got better
NSAP?
Non-specific abdominal pain
->most common type of abdominal pain in children, parents like a diagnosis
Features of NSAP?
Short duration
Central
Constant
Not made worse by movement
No GI disturbance
No temperature
Variation in site, even within same patient
Pneumonia can give referred pain to where?
Right iliac fossa, so can be missed
->will hear crackles of auscultation and seem more sick
What is intussusception?
A serious condition in which part of the intestine slides into an adjacent part of the intestine
Management of inttassusception?
Pneumostatic reduction with air enema (rectal catheter) to push the intestine out of the adjacent part.
Laparotomy if not successful
Umbilical swelling which gets worse with crying?
Umbilical hernia
Management of umbilical hernia?
Most get better by themselves, most spontaneously close by 4yrs
Gastroschisis?
Abdominal wall defect where gut is outside the abdomen when the child is born
Management of gastroschisis?
Primary/delayed closure
TPN- total parental nutrition, feeding via vein
->basically the gut is suspended in plastic tubing above the baby and slowly squeezed into the abdomen over a few days
Exomphalos?
Baby’s abdominal wall doesn’t close properly around the umbilical cord. This causes organs to protrude from the abdomen.
->suggestive of disordered embryogenesis
Associated anomalies of exomphalos?
25% cardiac
25% chromosomal - Trisomy13, 18, 21
15% renal, neurological
Beckwith-Weideman syndrome
Management of exomphalos?
Primary/delayed closure
->post-natal mortality rate is 25%, usually due to the associated anomalies
