Module 8a: paediatric

Question 1

When is an infant described as premature

Answer 1

<38 weeks

Question 2

How old is a neonate

Answer 2

0-28 days

Question 3

How old is an infant

Answer 3

1 month- 1 year

Question 4

How old is a todler

Answer 4

1-3 years

Question 5

How does an infant and an adult differ in CVS?

Answer 5

1. CO is less dependent on SV but more on HR because of poorly developed + non-complaint myocardium
2. Sympathetic innervation is little after birth so stress response=BRADYCARDIA due to vagal stimulation

Question 6

Differences between adults and infants in resp system?

Answer 6

Neonates and infants up to 6 months are obligate nasal breathers

1. Lung volumes are much less
2. Prone to desaturation
3. Immature alveoli
4. Use diaphragmatic breathing

Premature infants are prone to apnoea

Question 7

Haematological differences between adults and infants?

Answer 7

1. Blood volume is much less
2. Hb structure and quantity up to 1 year of age
3. Limited coagulation beause of immature liver

Question 8

Differences in liver and renal system?

Answer 8

immature-> neonates are prone to hypoglycemia

Question 9

Differences in CNS between adults and infants?

Answer 9

1. can accommodate raised ICP better

Question 10

what must you check in pre-operative assessment in infants?

Answer 10

URTI
Airway

Question 11

Which infants do not get pre-medication?

Answer 11

Infants younger than 6 months
Children with OSA
Children with possible airway obstruction

Question 12

What are options for pre-medications?

Answer 12

Midazolam
Clonidine
Droperidol

Question 13

How do you determine the correct diameter for endotracheal tube?

Answer 13

3-3.5mm (4 + age/4)

Question 14

How do you determine the correct length

Answer 14

12 + age/2

Question 15

what size jelco should be used in pediatric patients

Answer 15

22(blue), 24(yellow)

Question 16

What is the most common induction method in SA?

Answer 16

Inhalational: use volatiles like halothane or sevoflurane

Question 17

Why is muscle relaxants not used in in paediatric patients

Answer 17

After sufficient levels of inhalational agents, adding 2% lignocaine and/or dose of propofol abolishes reflexes appropiately

Question 18

What is the maintenance dose for a 25 kg infant

Answer 18

65ml/hr

(10x4) + (10x2) + (1x5)

For the first 10 kg: 4 ml/kg/hr
For the next 10-20 kg: 2 ml/kg/hr
For each kg above 20 kg: 1 ml/kg/hr

Question 19

What are the options for analgesia in infants?

Answer 19

paracaetamol, NSAIDS, opiates, ketamine, clonidine