Paediatircs Flashcards
What are concerning HR’s for children? (Amber flag)
<1yr - >160bpm
1-2yrs - >150bpm
2-5yrs - >140
What are concerning RR for kids? (Amber)
6-12 months - >50bpm
>1yr - >40bpm
What are the reassuring features in Brief Resolved Unexplained Events?
> 60 days old
Born >32 weeks
No CPR
1st event
<1min duration
What are the red flags for paediatric dehydration? (6)
- appears unwell/deteriorating
- Reduced level of consciousness (irritable, lethargy)
- sunken eyes
- tachycardia
- tachypnoea
- reduced skin turgor
What are the three levels of dehydration?
- mild <5% loss of body weight
- moderate 5-10% loss of body weight
- severe >10% loss
Consider hypernatraemic dehydration if: (4)
- child <6 months old
- doughy skin
- tachypnoea
- jitteriness
Other neuro signs include increased muscle tone, hyperreflexia, convulsions, coma
Stool culture should not be routine but consider if: (6)
- Recent travel to at-risk area
- Diarrhoea not improved for 7 days
- uncertainty re: Dx
- septic
- blood/mucus in stool
- immunocompromised
Weight from Age calculations for 0-1, 1-5, 6-12.
- (0.5 x age(months)) + 4
- (2x age) + 8
- (3 x age) + 7
Febrile seizures are simple if:
Febrile seizures are considered “simple” providing they last less than 15 mins, don’t recur within 24 hours or within the same illness, have a complete recovery within an hour, and if they are generalised (as opposed to focal). They are most common up to the age of 2 years, but can range from 6 months to 6 years. Tell the parents that 1 in 3 children will have another febrile seizure, they reduce with age and are not harmful.
What are the ventilatory rates in children in arrest once ETT in situ?
Infant (<1yr) - 25 breaths/min
1-8 - 20bpm
8-12 - 15bpm
12-18 - 10-12bpm
What is the adrenaline dose for children in cardio-respiratory arrest?
10mcg/kg or 0.1ml/kg of 1 in 10,000
Other than the femoral a, where should you feel for a pulse in a child in arrest?
If infant (<1yr) then brachial
If child (1-18) carotid
What is the dose of Amiodarone in paediatric arrest?
5mg/kg - give after 3rd shock and again after 5th shock or if re-enters shockable rhythm after cardio version if second dose not already given.
Give over 3 mins in neonates, and over 5 mins in other ages.
N.b it is mildly negatively inotropic
What is the alternative to amiodarone in paediatric arrest? And what is the dose?
Lidocaine, 1mg/kg.
What is the initial fluid bolus in paediatric arrest? What is the maximum total you can give?
10ml/kg
40-60ml/kg
When should you initiate oxygen therapy in an unwell child?
<94% sats or 3% drop from usually level in children with known chronic resp ds.
What are the first line vasopressors in paediatrics?
Adrenaline and noradrenaline.
Dopamine is only used if these are unavailable
What are the doses of adenosine in paediatric SVT?
Neonate (<1m) 150mcg/kg - increase by 50-100mcg with each attempt (max 300)
Infant 150mcg/kg - max 500mcg
1-11yrs 100mcg/kg - max 12mg
12-17 - 6mg, then 12mg.
What is the paediatric dose of Mg for torsades de pointes?
25-50mg/kg - max 2g - over 10-15mins
What is the weight calculation for Paeds?
Age 1-10yrs
(Age + 4) x 2
What is the paediatric dose of atropine?
20mcg/kg if 1-11yrs
300-600mcg if 12-18
What is the dose of calcium gluconate in paediatric hyperkalaemia?
0.11mmol/kg over 5-10mins
Max doses:
Neonates - 2ml
Child - 20ml
What are the 5th centiles for SBP in Paeds?
1m - 50
1yr - 70
5yr - 75
10yr - 80
What are the signs of acute severe asthma in Paeds?
PEFR 33-50%
O2<92%
Mod to marked accessory muscle use
Can’t complete sentences
Agitated, distressed
