Paediatrics Flashcards
What is different about the rate of deterioration in young patients and why?
Compensatory mechanisms tend to mask signs until illness is very advanced
In children reserve capacity is low
In children absolute volumes are low
In children metabolic rate is high
Signs of deterioration are often non-specific
How does respiratory rate respond to severe illness in children?
Usually with tip near however children often have a paradoxical response with depressed respiratory rate or apnoea
Other than nasal flaring intercostal recession and subcostal recession what are some signs of respiratory distress in children?
Head bobbing and grunting
How do you calculate the expected systolic blood pressure in children
Anything below 70+2a (a is age) is below 5 percentile for age.
Neurological features of an acutely unwell child
Lethargy, drowsiness, severe confusion or agitation
What is the first investigation that should be run in a child with abnormal mental state?
Glucose
What should be the minimum urine output for a child?
1ml/hour/kg
Formula for estimating weight in a child:
Weight = 2(a+4)
Differences between child airways and adult airways
Upper airway obstruction is anatomically more likely in children.
Infants are obligate nose breathers until 3-5 months age.
Large occiputs tends to cause neck flexion which causes obstruction.
How do you select a diameter of endotracheal tube?
Diameter should be same as little finger of infant.
Tidal volume for mechanically ventilating a child:
Aim for 6-8 ml/kg
Most common cause of shock in children
Hypovolaemia
Difference with how septic shock presents in infants
Less commonly associated with warm peripheries.
Site for intraosseous access
Anteromedial surface of tibia, 1-3cm below tibial tuberosity.
Volumes for fluid resuscitation in children
20-40ml/kg of lactated Ringer’s solution or saline.
Repeat with 10-20ml/kg as required.
