Paediatric Assessment Flashcards

1
Q

Paediatric Assessment Triangle

Appearance

A

Appearance:

  • Tone.
  • Interactiveness.
  • Consolability.
  • Look/ Gaze.
  • Speech/ Cry.
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2
Q

Paediatric Assessment Triangle

Appearance Explained

A

Well Child:

  • Tone: Active, reaching, moving, strong grip.
  • Interactivity: interested in environment, looking, smile.
  • Consolability: Easily comforted/ consoled.
  • Look/ Gaze: Looks at caregivers or items of interest.
  • Speech/ Cry: Cries.

Unwell Child:

  • Tone: Still, floppy, quiet.
  • Interactivity: No interest in surroundings.
  • Consolability: Inconsolable.
  • Look/ Gaze: Staring, not engaging in eye contact.
  • Speech/ Cry: Moaning, grunting or quiet.
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3
Q

Paediatric Assessment Triangle

WOB

A

Work of Breathing:

  • Abnormal breath sounds.
  • Abnormal posturing.
  • Retractions.
  • Nasal flaring.
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4
Q

Paediatric Assessment Triangle

Skin

A

Circulation to the Skin:

  • Pallor.
  • Mottling.
  • Cyanosis.
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5
Q

Paediatric Age & Weight

Newborn

A

Newborn:

  • Birth- 24hrs
  • 3.5kg.
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6
Q

Paediatric Age & Weight

Small Infant

A

Small Infant:

  • < 3 months.
  • 3 months = 6kg.
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7
Q

Paediatric Age & Weight

Large Infant

A

Large Infant:

  • 3-12 months.
  • 6 months = 8kg.
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8
Q

Paediatric Age & Weight

Small Child

A

Small Child:

  • 1-4 years.
  • 1-9 years = Age x2 + 8kg
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9
Q

Paediatric Age & Weight

Large Child

A

Large Child:

  • 5-11 years.
  • 10-11 years = Age x 3.3kg
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10
Q

Paediatric Perfusion Assessment

Newborn

A

Newborn (< 24hrs):

  • HR = 110-170 bpm.
  • SBP = > 60 mmHg.
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11
Q

Paediatric Perfusion Assessment

Small Infant

A

Small Infant (< 3mth):

  • HR = 110-170 bpm.
  • SBP = > 60 mmHg.
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12
Q

Paediatric Perfusion Assessment

Large Infant

A

Larger Infant (3-12 mth):

  • HR = 105-165 bpm.
  • SBP = > 65 mmHg.
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13
Q

Paediatric Perfusion Assessment

Small Child

A

Small Child (1-4 yrs):

  • HR = 85-150 bpm.
  • SBP = > 70 mmHg.
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14
Q

Paediatric Perfusion Assessment

Large Child

A

Large Child (5-11 yrs):

  • HR = 75-135 bpm.
  • SBP = > 80 mmHg.
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15
Q

Paediatric Respiratory Assessment

Newborn

A

Newborn (< 24hrs):

- 25-60 breaths/min.

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16
Q

Paediatric Respiratory Assessment

Small Infant

A
Small Infant (< 3mth):
   - 25-60 breaths/min.
17
Q

Paediatric Respiratory Assessment

Large Infant

A
Larger Infant (3-12 mth):
   - 25-55 breaths/min.
18
Q

Paediatric Respiratory Assessment

Small Child

A
Small Child (1-4 yrs):
   - 20-40 breaths/min.
19
Q

Paediatric Respiratory Assessment

Large Child

A
Large Child (5-11 yrs):
   - 16-34 breaths/min.
20
Q

Paediatric GCS
< = 4

Eyes

A

Spontaneous: 4
Reacts to speech: 3
Reacts to pain: 2
None: 1

21
Q

Paediatric GCS
< = 4

Verbal

A
Words or smile:              5
Cries/console:                4
Persistent Irritable:         3
Moans to pain:                2
None:                              1
22
Q

Paediatric GCS
< = 4

Motor

A
Spontaneous:                    6
Localises to pain:              5
Withdraws to pain:            4
Flexion:                              3
Extension:                          2
None:                                  1
23
Q

AVPU

A

Alert.
Voice (responds to).
Pain (responds to).
Unresponsive.

24
Q

Paediatric TCG Trauma

Vital Signs

0-3 months

A
HR:        < 100 or > 180
RR:         > 60
SBP:       < 50mmHg
SpO2:    < 90%
GCS:      < 15 or < A

Tx Highest Level of Trauma service w/i 45 mins

25
Q

Paediatric TCG Trauma

Vital Signs

4-12months

A
HR:        < 100 or > 180
RR:         > 50
SBP:       < 60mmHg
SpO2:    < 90%
GCS:      < 15 or < A

Tx Highest Level of Trauma service w/i 45 mins

26
Q

Paediatric TCG Trauma

Vital Signs

1-4yrs

A
HR:        < 90 or > 160
RR:         > 40
SBP:       < 70mmHg
SpO2:    < 90%
GCS:      < 15 or < A

Tx Highest Level of Trauma service w/i 45 mins

27
Q

Paediatric TCG Trauma

Vital Signs

5-11yrs

A
HR:        < 80 or > 140
RR:         > 30
SBP:       < 80mmHg
SpO2:    < 90%
GCS:      < 15 or < A

Tx Highest Level of Trauma service w/i 45 mins

28
Q

Paediatric TCG Trauma

General Injuries

A

Penetrating Injury:
- All except isolated
superficial limbn
injuries.

Blunt Injuries:
   - Serious injury to a 
     single region such 
     that specialised 
     care or intervention 
     may be required or 
     such that life, limb 
     or long-term quality 
     of life may be at  
     risk.

Tx Highest Level of Trauma service w/i 45 mins

29
Q

Paediatric TCG Trauma

Specific Injuries

A
- Limb amputations or 
  limb threatening 
  injury.
- Serious crush injury.
- Suspected spinal 
  cord or spinal #
- Burns > 10% TBSA or 
  suspected resp tract 
  burns.
- High voltage burn 
  injury.
- Major compound # or 
  dislocation.
- # to 2 or > of Femur/ 
  Tibia/ Humerus.
- # Pelvis.

Tx Highest Level of Trauma service w/i 45 mins

30
Q

Paediatric TCG Trauma

High Risk

A
- Motor/ cyclist impact 
  > 30km/h.
- High speed MCA > 
  60km/h.
- Pedestrian impact.
- Ejection from vehicle.
- Prolonged 
  extrication.
- Fall from height > 3m.
- Struck on head by 
  object falling > 3m.
- Explosion.

Tx Highest Level of Trauma service w/i 45 mins

31
Q

Clinical Red Flags

General.

A
- Obs outside of normal 
  range.
- GCS < 15 or not Alert 
  (AVPU).
- Unexplained pain.
- Secondary 
  presentation w/i 48hrs 
  to AV or GP related 
  complaint.
32
Q

Clinical Red Flags

Specific Conditions.

A
- Febrile > 38*C in 
  small infant.
- Stridor.
- First presentation 
  seizure.
- Anaphylaxis (incl. 
  resolved).
- Unable to walk 
  (usually able).
- Post-tonsillectomy 
  bleeding.
- Testicular pain.
- Ingestion/ inhalation 
  of toxic substances.
- Inhalation of foreign 
  body.
- Non blanching rash.

Mandatory Tx to hospital via Ambulance.

33
Q

Clinical Yellow Flags

A
- Ongoing parental 
  concern.
- Asymptomatic 
  ingestion of a 
  dangerous foreign 
  body.
- Surgical procedure in 
  last 14/7.

&

  • Capability to attend
    hospital/GP.
  • Be read Referral
    Advise Script.

Must be advised to attend hospital or GP w/i 2hrs.

34
Q

Croup Mild

A
Behaviour: normal
Accessory muscles: none, minimal
Stridor: barking cough, stridor only when upset.
Resp Rate: normal
Oxygen: none
35
Q

Croup moderate

A

Behaviour: some irritability
Accessory muscle: moderate chest wall retraction
Resp rate: increased RR. Nasal flare, trachael tug
Stridor: some at rest
Oxygen: none

36
Q

Croup severe

A

Behaviour: increased irritability
Accessory muscle: marked chest wall retraction
Resp Rate: marked increased or decreased. Tracheal tug, nasal flare
Stridor: present at rest
Oxygen: hypoxaemia late sign