Introduction to paediatric surgery Flashcards
How is a childs weight estimated based on their age?
Weight (kg) = 2 x (age + 4)
How is a childs blood volume estimated?
Blood volume (mls) = 80mls/kg
What is the normal amount of urine output in children?
0.5-1ml/kg/hour
What is the amount of insensible fluid loss from a child per day?
20ml/kg/day
How is a childs systolic blood pressure estimated?
Systolic BP = 80 + (2 x age)
What is the maximum dose of paracetamol allowed for a child?
20mg/kg 4-6 hourly
What is the maximum dose of ibuprofen allowed for a child?
10mg/kg 8 hourly
What fluids should be given to a child for resuscitation?
20ml/kg bolus 0.9% NaCl
At what should a childs maintenance fluids be delivered?
4ml/kg for 1st 10kg
2ml/kg for 2nd 10kg
1ml/kg every kg thereafter
If a child is 10 years old, how much fluid per hour should they be given?
Weight = 2 x (age + 4)
= 2 x 14
= 28kg
1st 10kg = 4mls/kg
= 4 x 10 = 40mls
2nd 10kg = 2mls/kg
= 2 x 10 = 20mls
Last 8kg = 1ml/kg
= 1 x 8 = 8mls
Total = 40 + 20 + 8
= 68mls/hour
What are important points to watch out for in a history of a child with abdo pain?
1 - Pain closer to umbilicus = less chance of pathology
2 - Colicy pain vs constant pain
3 - Pain initiated by movement (e.g. car trip/speed bumps)
4 - Has there been vomitting
5 - Have they produced bile (green)
What are some common surgical problems associated with childhood?
Appendicitis
Pyloric stenosis
Malrotation
Intussusception
Exomphalos
What is Murphy’s triad and with which condition is it associated?
Murphy’s Triad:
- pain
- vomiting
- fever
Appendicitis
Over which area is there tenderness in appendicitis?
McBurney’s point
What can be the possible diagnoses in non-specific abdo pain?
1 - Mesenteric adenitis
2 - Pneumonia
Is Pyloric stenosis more likely to occur in boys or girls?
Boys
What are the signs of pyloric stenosis?
Projectile vomiting (without bile)
Weight loss
What should be the first step in treating a child with pyloric stenosis?
IV fluids
How is paediatric pyloric stenosis diagnosed?
Ultrasound
What is the main treatment for fixing pyloric stenosis?
Surgery - periumbilical pyloromyotomy
What is malrotation and volvulus?
Malrotation - intestines are not formed in the correct position
Volvulus - Intestines become twisted
How does a child with malrotation and volvulus present?
Bile vomiting - green colour
How is malrotation and volvulus investigated?
Upper GI contrast study
How is malrotation managed?
Laparotomy
