Paediatric Medicine Flashcards
Anaphylaxis
Immediate hypersensitivity 5-30 mins post exposure
IgE mediated
Give adrenaline 10mcg/kg (0.01ml/kg of 1:1000 - minimum 0.1ml, max 0.5ml) then observe 4-6 hours.
Give nebulised adrenaline and IV fluid bolus then IV adrenaline if worsening
Steroids, H1 and H2 blockers are optional extras
If 2 doses adrenaline given admission is required.
Afebrile seizure
Review and plan
Careful history including:
-any focal features?
-awareness?
-at night or with exercise? (consider arrhythmia)
-FHx of sudden death, epilepsy or arrhythmia
-BSL and Ca check
-12 lead ECG
-OP EEG
-OP FU
Febrile seizure criteria
Fever
6 months to 5 years
1x seizures <15 mins only per day
GTC, not focal
No prev neuro issues
Seizure types
Simple partial
-awareness maintained
-can be with motor signs, sensory signs, autonomic signs or psychic symptoms
Complex partial
-with or without automatisms
-awareness not maintained either from the beginning or during the seizure event
General (whole of brain involved)
-absence
-myoclonic
-tonic
-clonic
-tonic-clonic
-atonic (drop attack)
Asthma exacerbation - red flags for admission
Severe/life threatening
Ongoing sats <92%
Inability to space to 2 hours
Live far from hospital
Carer unlikely to cope at home/learning difficulties
Poor socioeconomic status
Hx brittle asthma
Hx intubations/ICU with asthma
Night
Repeat presentation with the same illness
Presentation despite steroids at home
1 pill can kill
Medical and non-pharmaceuticals
Ca channel blocker
Sulphonylureas
TCAs
Opiates
Amphetamines
Theophylline
Chloroquine
Non-pharmaceuticals
Praquat
Organophosphates
Camphor
Naphthalene (mothballs)
Kerosene
Solvents
Eucalyptus oil
Hydrocarbons
Paediatric Chest Pain
Unknown cause = 99%
In known cause, usually pericarditis or arrhythmia.
Bronchiolitis - risks for more serious illness
Prematurity <37/40
Lower socioeconomic
Māori/PI
Smoking household
<10 weeks old
<2/12 breastfed
Comorbidities eg Downs/CF/congenital heart disease/CLD/ immunodeficiency
