Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr4: Child Health > Paediatric Emergencies > Flashcards

Paediatric Emergencies Flashcards

1
Q

State some common paediatric emergencies

A
  • Cardiac arrest
  • Croup
  • Sepsis
  • Meningitis
  • Dehydration
  • Febrile convulsions
  • Anaphylaxis
  • Overdose
  • Hypothermia & hyperthermia
  • Hypoglycaemia
  • Respiratory arrest
  • Poisoning of unknown origin
  • Pneumothorax
  • Peripheral nerve injuries/palsies

*NOTE: some emergencies covered here, some covered in other clases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The outcome following cardiac arrest in children is often poor; true or false?

A

True; problem is usually with respiratory system therefore even if get heart going again it doesn’t solve the problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Management of paediatric emergencies is A-E approach as it is with adults; gauge the normal RR for children of different ages

*don’t need to know off by heart, just idea

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of paediatric emergencies is A-E approach as it is with adults; what could the following clinical findings indicate in a child:

  • Bubbling sound
  • Harsh stridor & barking cough
  • Soft stridor, drooling, fever, looks sick
  • Sudden onset stridor with history of inhalation
  • Stridor following allergen exposure
  • Wheeze
  • Bronchial breathing
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of paediatric emergencies is A-E approach as it is with adults; gauge the normal HR for children of different ages

*don’t need to know off by heart, just idea

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of paediatric emergencies is A-E approach as it is with adults; gauge the normal BP for children of different ages

*don’t need to know off by heart, just idea

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

During CPR, what position do you want the head of children:

  • <1yr
  • >1yr
A
  • <1yr: neutral position
  • >1yr: sniffing morning air
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the pattern of rescue breaths and compressions in child CPR

A
  • Start with 5 rescue breaths
  • 15 chest compressions
  • 2 rescue breaths

… repeat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the pattern of rescue breaths and compressions in child CPR

A
  • Start with 5 rescue breaths
  • 15 chest compressions
  • 2 rescue breaths

… repeat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How should you position your hands for CPR in:

  • Infants (<1yr)
  • Toddlers/children
A
  • Infants (<1yr): two fingers in centre of chest or two thumbs in centre with hand encircling chest
  • Toddlers/children: heel of one hand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How should you assess a child who is choking?

A

A-E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you manage a choking child?

A
  • Encourage to cough
  • Infants:
    • 5 back blows
    • 5 chest thrusts
  • Children:
    • 5 back blows
    • Heimlich manoeuvre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common overdose in paediatrics?

A

Paracetamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

State common clinical features of paracetamol overdose

A
  • None
  • Nausea/vomiting
  • History of risk factors (self-harm, depression, regular pain relief medications, glutathione deficiency, long term treatment with CYP P450 inducers)
  • Uncommon: abdo pain, jaundice, hepatomegaly,loin pain, altered conscious level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigations would you do in paracetamol overdose?

A
  • Paracetamol level: treatment
  • LFTs: monitor ALT for hepatotoxicity
  • Clotting screen: functioning of liver
  • U&Es: baseline, risk of AKI
  • Glucose: hypoglycaemia common in liver necrosis
  • Venous gas: acidosis in 10% acute liver failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Discuss the management of paracetamol overdose

A
  • If staggered overdose or timing unclear, start N-acetylcysteine straight away
  • If not staggered, >150mg/kg, been <8hrs since ingestion and can get blood results back (and act on them) within 8hrs: do bloods and wait to see if need NAC
  • If not staggered, >150mg/kg and been >8hrs since ingestion or cannot get blood results back (and act on them) within 8hrs start NAC

Use graph to determine if need treatment

17
Q

State some potential causes of pneumothorax in:

  • Infants
  • Children
A

Infants

  • Prematurity (fragile lungs)
  • Meconium aspiration syndrome (idea that meconium is thick, when in airways allows air to pass through during inspiration but doesn’t allow air to flow out during expiration)
  • RDS

Children

  • Primary spontaneous (rupture subpleural blebs tall, thin, adolescent males)
  • Secondary spontaneous: CF, asthma, Marfan’s syndrome
  • Trauma
18
Q

Discuss the management of pneumothorax in children

A
19
Q

What is meant by:

  • Biochemical hypoglycaemia in a neonate
  • Biochemical hypoglycaemia for children older than neonate
  • Clinical hypoglycaemia
A
  • Biochemical neonate: 2.6mmol/L
  • Biochemical older than neonate: 3mmol/L
  • Clinical: glucose low enough to cause symptoms and/or signs of impaired brain function

(according to UHL guidelines gluocse <2.6mmol/L in infant <6months and <3mmol/L in children > 6 months)

20
Q

Discuss the management of hypoglycaemia in children (not neonates)

A

Depends on if acidosis & hypoglycaemia present. Options include:

  • Fast acting glucose (glucose tablets, glucose gel, fruit juice)
  • IV glucose bolus
  • IM glucagon
21
Q

State some ways you could assess hydration status of infant or child

A
  • CRT
  • Heart rate
  • Tachypnoea
  • Fontanelle (depression)
  • Skin turgor
  • Sunken eyes
  • Urine output
  • Dry mucous membranes
  • Altered responsiveness
22
Q

State some signs of clinical shock in a child

A
  • Decreased level of consciousness
  • Pale or mottled skin
  • Cold extremities
  • Pronounced tachycardia
  • Pronounced tachypnoea
  • Weak peripheral pulses
  • Prolonged capillary refill time
  • Hypotension

**Hypotension is sign of decompensated shock in children and is late sign!!!

23
Q

If a child comes into A&E and there are minor concerns about hydration/fluid intake, what can you do?

A

Fluid challenge

24
Q

What is the choice of fluids in children (and neonates who are not critically ill)

A

Sodium chloride 0.9% with 5% glucose

25
Q

Discuss how you calculate paediatric maintenance fluids

A

Children (>28 days of age)

Routine maintenance fluids for children are calculated by weight using the Holliday-Segar formula:1,5

  • 100 ml/kg/day for the first 10kg of weight
  • 50 ml/kg/day for the next 10kg of weight
  • 20 ml/kg/day for weight over 20kg
26
Q

Discuss how you calculate neonatal fluids

A

Neonates (<28 days of age)

Maintenance for term neonates is calculated according to their age and weight:

  • Birth to day 1: 50-60 ml/kg/day
  • Day 2: 70-80 mL/kg/day
  • Day 3: 80-100 mL/kg/day
  • Day 4: 100-120 mL/kg/day
  • Days 5-28: 120-150 mL/kg/day
27
Q

How can you calculate percentage dehydration by weight?

A
28
Q

What vol of fluid is used in resuscitation in paediatrics?

A

10-20ml/kg

Use smaller volume in situations such as cardiac failure, septic shock, diabetic ketoacidosis and major trauma.

**NICE CKS SAYS: 10ml/kg for children and young people over <10 minutes. 10-20ml/kg for term neonates over <10 minutes.

29
Q

Describe how you calculate a fluid deficit in children?

A
  • Fluid deficit (mL) = % dehydration x weight (kg) x 10
  • *NOTE: the fluid deficit is corrected over 48hrs*
30
Q

When correcting any hyper- or hyponatraemia you must ensure Na+ does not rise or fall more than ____ in 24hrs?

A

12mmol/L

31
Q

What should children on IV fluids have checked everyday?

A
  • Plasma glucose
  • U&Es
32
Q

What is the normal/acceptable urine output for the following ages:

  • Neonate
  • Infant
  • Child
  • Adolescent
A
  • Neonate (<28 days): 2-3mL/kg/hr
  • Infant (>28 days to <1yr): 2mL/kg/hr
  • Child: 1-2mL/kg/hr
  • Adolescent (10-18yrs): 0.5-1mL/kg/hr
33
Q

Define hypothermia

Discuss management

A
  • Temperature <35 degrees
  • Management:
    • Remove from sources of potential cooling e.g. remove wet clothes, bring inside
    • Warmed IV fluids
    • External warming e.g. Bair-Hugger
    • Humidified oxygen at 40 degrees (decrease heat loss through respiration)
34
Q

State some signs & symptoms of heat exhaustion

State some signs & symptoms of heat stroke

A

Heat Exhaustion

  • Hx exposure to high heat or strenuous exercise
  • Irritability
  • Lethargy
  • Headache
  • Nausea
  • Hyperthermia >38

Heat Stroke

  • Seizures
  • Anhidrosis
  • Impaired consciousness
  • Temp >40
35
Q

Discuss the management of heat stroke

A
  • ABCDE
  • Remove excessive clothing
  • Rapid acting cooling
    • Cold or iced water immersion (exertional heat exhaustion)
    • Wetting and fanning the skin
    • Wet ice packs
  • Supportive care (e.g. oxygen, IV fluids…)
36
Q

For iron poisoning, discuss:

  • Symptoms & signs
  • Investigations
  • Management
  • Complications
A
  • Nausea/vomiting, abdo pain, haematemesis, black bloody stools
  • Investigations: Fe level, FBC, U&E’s, LFTs, CBG,?axr (can sometimes see pills)
  • Management:
    • First line= bowel irrigation
    • If severe poisoning then IV chelation using deferoxamine
  • Complications:
    • Liver failure
    • GI scarring (leading to early satiety and/or nausea)

Yr4: Child Health (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions