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MACHS > Misc > Flashcards

Misc Flashcards

1
Q

Reference FLACC

A

Merkel et al. 1997

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2
Q

Reference opioid guideline

A

Royal college of anaesthetics 2020

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3
Q

How do NSAIDs work?

A

Reduce inflammation

Block enzyme cycle-oxygenate

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4
Q

Reference analgesia ladder

A

WHO 2022

Use the more intense analgesia in conjunction with mid

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5
Q

Symptoms of neonates in pain

A
  1. unusual - cry, intake, nappies
  2. green vomits
  3. grows
  4. floppy
  5. reduced awareness
  6. pale
  7. wheeze
  8. blood in nails
  9. increased cap refill
  10. rash
  11. increased temperature
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6
Q

Psysiological differences neonates

A
  1. foremen ovals hole close - pressure in left and right atrium
  2. ductus arteriuosus close - increased O2 and maternal prostaglandin constrict - can be held open with prostin medication
  3. nose breathers - large epiglottis
  4. apnoea
  5. less fibres and chest wall compliance
  6. horizontal ribs
  7. poor elastic
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7
Q

Priorities of treating neonates

A

Golden triangle
1. hypothermia - humid incubator, dry and blankets
2. hypoglycaemia - IV access and TPN - commence feeds
3. hypoxia - O2 therapy and positioning prone try to prevent acidosis

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8
Q

normal neonate urine output

A

2ml/kg/hr

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9
Q

Reference PEWS

A

NHS england 2023

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10
Q

SBAR reference

A

Newman et al. 2023

Situation
Background
Assessment
Recommendations

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11
Q

Reference advance life support

A

Resuscitation council 2021

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12
Q

Reference Gilick competence

A

Scott et al. 2020

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13
Q

Reference of reasonable adjustments

A

Equality Act 2010

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14
Q

reference neonates pathophysiology

A

Glasper 2015

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15
Q

Priorities treatment trauma

A
  1. IV acccess
  2. Blood gas - eg. glucose (4-7)
  3. Fluid bolus - 500ml or 100ml for 10kg - 50ml for 20kg - 30ml
  4. blood transfusion - SBAR consult with medical staff - blood type
  5. manage major wounds
  6. tests - x-ray and CT
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16
Q

Reference resus fluids adults?

A

NICE 2013

Algorithm for IV fluids of adults

17
Q

Reference NEWS2

A

Royal College of Physicians

2022

18
Q

Child physiology airway

A
  1. large head and short neck with inability to support head
  2. large tongue
  3. easily compressible floor of mouth
  4. under 6 months - nose breathers
  5. small diameter airway
  6. epiglottis horseshoe shaped
  7. larynx high and anterior
  8. trachea short and soft - cricoid cartilage narrowest portion of neck
  9. increased secretions block airway easily
19
Q

Physiology of children effecting breathing

A
  1. diaphragmatic breathing
  2. ribs horizontal
  3. reduced chest expansion
  4. muscle easily fatigue
  5. sternum and ribs cartilaginous
  6. chest wall soft and intercostal muscles poorly developed
  7. increased metabolic rate
  8. increased resp demand for xylene compunction and CO elimination
  9. lung comp;i acne and. high chest wall compliance
  10. small amount of elastic and collagen tissue
20
Q

Physiology of children effecting circulation

A
  1. circulating blood volume higher per weight than adults
  2. stroke volume is small and relatively fixed in infants
  3. cardiac output is directly related t heart rate
  4. by 2 years myocardial function and response to fluid similar to adults
  5. after birth systemic vascular resistance starts rising until adulthood
21
Q

reference child vital signs

A

glasper et al. 2022

22
Q

Vital signs under 1 year old

A

RR - 30-40
HR - 110-160
systolic - 70-90

23
Q

Vital signs years 2-5

A

RR - 20-30
HR - 95-140
systolic - 80-100

24
Q

Vital signs 5-12 years

A

RR - 15-20
HR - 80-120
systolic - 90-110

GLASPER et al. 2022

25
Q

Vital signs children over 12

A

RR - 12-20
HR - 60-100
Systolic - 100-120

26
Q

Vital signs adults

A

RR - 12-20
HR - 60-100
Systolic - 100-139

Peate et al. 2021

27
Q

target Oxygen saturations

A

94-98% (88-92% COPD)

BTS 2017

92-96% Chu et al. 2018

28
Q

Priorities of fever found in children

A

NICE 2007 - last updated 2021

  1. Immediate IV fluid bolus of 10ml/kg of 0.9% sodium chloride (2007)
  2. Give immediate parenteral antibiotics if shocked, unrousable or show signs of meningococcal disease (2007)
  3. Give IV aciclovir if signs suggest herpes simplex encephalitis (2007)
  4. Oxygen if saturations under 92% in air (2007)
29
Q

Symptoms fever children need immediate attention

A

NICE traffic light - 2013
red
1. pa,le, mottled, ashen or blue
2. not responsive to social cues - not wake when roused or stay awake - weak, high pitched cry
3. grunting
4. tachypnoea - over 60bpm
5. moderate or serve chest indrawing
6. reduced skin turgor
7. temperature more than 38 degrees
8. non-blanching rash
9. bulging fontanelle
10. stiff neck
11. focal seizures - reduced LOC - (herpes simplex encephalitis)

30
Q

Reference traffic lights identify risk of serious illness in child

A

NICE 2013

31
Q

Normal temperature

A

normothermia

36.5-37.5 (adult and child with 38 being a fever - NICE 2023 - feverish child)

NICE 2013 - surgical site infection

32
Q

What NMC professional values to include?

A

NMC 2018

  1. respect and uphold human rights - convention on the rights of children - health care - 1989
  2. work in partnership with patient and family
  3. encourage and empower
  4. communicate clearly
33
Q

Reference - A-E

A

Resus council 2021

34
Q

reference NEWS2

A

NHSE 2017

35
Q

Adult fluid maintainance

A

25-30 ml/kg/day water
Include potassium, sodium or chloride and glucose as required.

Algorithm adult fluid - NICE 2013

MACHS (6 decks)

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