Paediatric Medical

Question 1

1. What is the Rx for N/V Paeds?

Answer 1

Ondansetron ODT orally
Small - 2mg
Medium - 4mg
If n/v tolerated, basic care and Tx is only required Rx

Question 2

2. What is the Rx for Hypoglycaemia Paeds?

Answer 2

BGL <4 and responding:
Glucose 15g, repeat after 15min (max 30g) or Glucagon IM

Not responding to commands:
<25kg Glucagon 0.5 IU (0.5mL) IM
≥25kg Glucagon 1 IU (1mL) IM

Question 3

3. What is the Rx for GCSE Paeds?

Answer 3

Mx airway and ventilation, if airway patent - high flow O2
Midazolam IM
- Medium child: 2.5-5mg
- Small: 2.5mg
- Infant: 1mg
- Newborn: 0.5mg
Repeat once only after 10mins, consult for further
Continue to monitor airway, ventilation, CS and BP

Question 4

4. What is the Rx for Anaphylaxis Paeds?

Answer 4

• Do not sit/walk if possible
• Adrenaline 10mcg/kg (max 500mcg), repeated 5/60
• Request MICA if risk factors
• High flow O2
  Additional therapies:
• Stridor: Adrenaline 5mg nebulised, consult RCH for repeat dose, notify receiving hospital
• Bronchospasm: Salbutamol 6-11yrs 2.5-5mg or 4-12 pMDI; 2-5yrs 2.5mg or 2-6 PMDI
  + IB 250mcg + Dex 600mcg/kg (Max 12mg)

Question 5

5. What is the Rx for Opioid OD Paeds?

Answer 5

Assist and maintain airway and ventilation
Naloxone 10mcg/kg (max 400mcg) IM
Repeat dose after 10/60

Question 6

6. What are some risks for refractory anaphylaxis or deterioration?

Answer 6

• Expected clinical course e.g. Hx of refractory, ICU admission
• Hypotensive
• Medication precipitating cause
• Respiratory Sx
• Hx of asthma or multiple co-morbidities
• No response to initial dose of IM adrenaline

Question 7

7. What is the Rx for Paed Meningococcal Septicaemia?

Answer 7

• PPE
• Confirm S/S
• Ceftriaxone 50mg/kg IM (max 1000mg), dilute 1000mg with 3.5mL Lignocaine 1%