Paediatric Assessment Flashcards
Paediatric Assessment Triangle
Appearance
Appearance:
- Tone.
- Interactiveness.
- Consolability.
- Look/ Gaze.
- Speech/ Cry.
Paediatric Assessment Triangle
Appearance Explained
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.
Paediatric Assessment Triangle
WOB
Work of Breathing:
- Abnormal breath sounds.
- Abnormal posturing.
- Retractions.
- Nasal flaring.
Paediatric Assessment Triangle
Skin
Circulation to the Skin:
- Pallor.
- Mottling.
- Cyanosis.
Paediatric Age & Weight
Newborn
Newborn:
- Birth- 24hrs
- 3.5kg.
Paediatric Age & Weight
Small Infant
Small Infant:
- < 3 months.
- 3 months = 6kg.
Paediatric Age & Weight
Large Infant
Large Infant:
- 3-12 months.
- 6 months = 8kg.
Paediatric Age & Weight
Small Child
Small Child:
- 1-4 years.
- 1-9 years = Age x2 + 8kg
Paediatric Age & Weight
Large Child
Large Child:
- 5-11 years.
- 10-11 years = Age x 3.3kg
Paediatric Perfusion Assessment
Newborn
Newborn (< 24hrs):
- HR = 110-170 bpm.
- SBP = > 60 mmHg.
Paediatric Perfusion Assessment
Small Infant
Small Infant (< 3mth):
- HR = 110-170 bpm.
- SBP = > 60 mmHg.
Paediatric Perfusion Assessment
Large Infant
Larger Infant (3-12 mth):
- HR = 105-165 bpm.
- SBP = > 65 mmHg.
Paediatric Perfusion Assessment
Small Child
Small Child (1-4 yrs):
- HR = 85-150 bpm.
- SBP = > 70 mmHg.
Paediatric Perfusion Assessment
Large Child
Large Child (5-11 yrs):
- HR = 75-135 bpm.
- SBP = > 80 mmHg.
Paediatric Respiratory Assessment
Newborn
Newborn (< 24hrs):
- 25-60 breaths/min.
Paediatric Respiratory Assessment
Small Infant
Small Infant (< 3mth): - 25-60 breaths/min.
Paediatric Respiratory Assessment
Large Infant
Larger Infant (3-12 mth): - 25-55 breaths/min.
Paediatric Respiratory Assessment
Small Child
Small Child (1-4 yrs): - 20-40 breaths/min.
Paediatric Respiratory Assessment
Large Child
Large Child (5-11 yrs): - 16-34 breaths/min.
Paediatric GCS
< = 4
Eyes
Spontaneous: 4
Reacts to speech: 3
Reacts to pain: 2
None: 1
Paediatric GCS
< = 4
Verbal
Words or smile: 5 Cries/console: 4 Persistent Irritable: 3 Moans to pain: 2 None: 1
Paediatric GCS
< = 4
Motor
Spontaneous: 6 Localises to pain: 5 Withdraws to pain: 4 Flexion: 3 Extension: 2 None: 1
AVPU
Alert.
Voice (responds to).
Pain (responds to).
Unresponsive.
Paediatric TCG Trauma
Vital Signs
0-3 months
HR: < 100 or > 180 RR: > 60 SBP: < 50mmHg SpO2: < 90% GCS: < 15 or < A
Tx Highest Level of Trauma service w/i 45 mins
Paediatric TCG Trauma
Vital Signs
4-12months
HR: < 100 or > 180 RR: > 50 SBP: < 60mmHg SpO2: < 90% GCS: < 15 or < A
Tx Highest Level of Trauma service w/i 45 mins
Paediatric TCG Trauma
Vital Signs
1-4yrs
HR: < 90 or > 160 RR: > 40 SBP: < 70mmHg SpO2: < 90% GCS: < 15 or < A
Tx Highest Level of Trauma service w/i 45 mins
Paediatric TCG Trauma
Vital Signs
5-11yrs
HR: < 80 or > 140 RR: > 30 SBP: < 80mmHg SpO2: < 90% GCS: < 15 or < A
Tx Highest Level of Trauma service w/i 45 mins
Paediatric TCG Trauma
General Injuries
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
Paediatric TCG Trauma
Specific Injuries
- 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
Paediatric TCG Trauma
High Risk
- 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
Clinical Red Flags
General.
- Obs outside of normal range. - GCS < 15 or not Alert (AVPU). - Unexplained pain. - Secondary presentation w/i 48hrs to AV or GP related complaint.
Clinical Red Flags
Specific Conditions.
- 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.
Clinical Yellow Flags
- 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.
Croup Mild
Behaviour: normal Accessory muscles: none, minimal Stridor: barking cough, stridor only when upset. Resp Rate: normal Oxygen: none
Croup moderate
Behaviour: some irritability
Accessory muscle: moderate chest wall retraction
Resp rate: increased RR. Nasal flare, trachael tug
Stridor: some at rest
Oxygen: none
Croup severe
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
