Paediatrics Flashcards
(166 cards)
Symptoms of mild-moderate allergic reaction?
- Angioedema (swelling of lips, face, eyes).
- Itchy / tingling mouth.
- Sudden change in behaviour.
- Hives or itchy skin rash.
- Abdominal pain or vomiting.
Signs of anaphylactic reaction?
- Airway: swelling, hoarseness, stridor, difficulty swallowing.
- Breathing: tachypnoea, wheeze, fatigue (use of accessory muscles or indrawing of intercostal muscles), cyanosis, SpO2 <92%, confusion.
- Circulation: pale, clammy, hypotension, faint, drowsy, coma.
What does of adrenaline should be administered IM to a child over 12 in anaphylaxis?
500 micrograms (0.5mL - i.e. the same as an adult).
What dose of adrenaline should be administered IM to a child 6-12 years old who is in anaphylaxis?
300 micrograms (0.3mL).
What dose of adrenaline should be administered IM to a child less than 6 years old who is in anaphylaxis?
150 micrograms (0.15mL).
How would you fluid challenge a child after administering IM adrenaline for anaphylaxis?
IV crystalloid 20mL/kg.
If crystalloid is cause of anaphylaxis then stop the IV
What advice would you give to the parents of a child with a new diagnosis of asthma with regards to bathing?
- Don’t use soap, bubble bath or shower gel.
- Use an emollient soap substitute instead.
- Minimise the amount of time shampoo spends in contact with skin.
Describe what an emollient is in layman’s terms.
Used to moisturise the skin, they can be used liberally and often - which is when they work best.
Explain how to use an emollient for eczema.
- wash hands prior to using.
- if using a tub without a dispenser - use a spoon to take it out the tub (reduces risk of infection).
- use 1-2x day applying in the direction of hair growth (downward) and avoiding rubbing back and forth.
- continue to use even when skin looks okay.
What warnings should you advise parents of when using emollients for eczema?
ointments containing white soft paraffin and emulsifying ointment are easily ignited - avoid flame and smoking and warn friends/ relatives to be careful.
What advice should you give to parents when using topical steroids for eczema?
- Apply only on affected areas i.e. itchy, red, rough skin.
- Use once daily and only when needed.
- One fingertip unit (i.e. from finger top to first joint) is enough to cover an area the size of two adult hands.
Explain why steroids are used in eczema in layman’s terms.
Steroids act on affected areas to reduce the inflammation of the skin. They are safe when used correctly and benefits outweigh risks.
What is physical abuse?
Causing physical harm to a child or young person (e.g. hitting, shaking, burning, suffocating, poisoning, fabricating or inducing illness).
What is emotional abuse?
Persistent emotional neglect or ill treatment that has a severe and persistent adverse effect on a child’s emotional development.
What is sexual abuse?
Any act that involves the child in any activity for the sexual gratification of another person regardless of the child’s consent or assent.
What is neglect?
Persistent failure to meet a child’s basic physical and/or psychological needs - likely to result in serious impairment of the child’s health or development.
Name child-specific factors that make children more vulnerable to physical abuse?
- First child in a family.
- Unwanted pregnancy.
- Male.
- Disabled or congenital abnormality.
- <2 years old.
- History of neglect.
Name familial factors that make children more vulnerable to physical abuse?
- Low socioeconomic status.
- Family insecurity or instability.
- Mental health problems in family.
- Illicit drug abuse.
- History of violence in family.
What investigations might be arranged to investigate non-accidental injury?
- CT brain.
- Skeletal survey.
- Ophthalmology review to look for retinal haemorrhages.
- Full clotting screen.
Who can report concerns to child protection?
ANYONE. You do not have to be certain but you are expected to explain why you are concerned.
How does a healthcare professional refer suspected abuse to child protection?
Usually by phone to the duty social worker and then follow up in writing.
If there is concern the child is in immediate danger, the police should be contacted.
If you suspect a child is in immediate danger, what should you do as a healthcare professional?
Contact police.
As a medical student, if you suspect physical abuse while on placement, what should you do?
Speak to supervisor and block supervisor.
As a medical student, if you suspect physical abuse while NOT on placement, what should you do?
Contact the public child protection line.