Paediatrics: A-E Flashcards
what is the 3 minute toolkit?
top to toe examination and physiology assessment
what does ABCDENTTT, DEFG stand for?
- Airways
- Breathing
- Circulation
- Disability (neuro)
- Ears, nose + throat examination
- Temperature
- Tummy
DEFG (don’t ever forget glucose)
3 minute toolkit overview: what do you look for for A
airway
- secretions
- stridor
- foreign body
3 minute toolkit overview: What do you look for for B
breathing (effort, efficacy, effect)
- RR
- Recession/accessory muscle use
- Oxygen saturation
- Auscaltation
3 minute toolkit overview: what do you look for for C?
Circulation
- Colour (e.g. pale, mottled)
- HR
- Cap Refill
- Temperature of hand and feet
3 minute toolkit overview: What do you look for for D?
Disability (neuro)
- Pupils
- Limb tone + movement
- AVPU score/GCS
airway assessment: child has reduced consciousness levels, why test gag reflex? what do you do?
oropharyngeal airway: if tolerated => child not protecting airway => jaw thrust + call anaesthetist
do children look better or worse than adults when hypoxic?
better
- children can be close to decompoenstaion when looking well
what oxy sats should ac child have
> 96%
oxy sats significant hypoxia ? worrying hypoxia?
sig: <94%
worrying: < 90%
at what oxy sats might a child start showing signs of cyanosis?
<85%
very late!
what does mottling of the skin suggest?
poor perfusion
what pulse should you use to get pulse rate?
radial pulse
(brachial in baby)
(can use pulse oximeter)
what is normal cap refill time?
<2 sec
where do you test cap refill?
- Central (sternum)
- Peripheral (fingers, toes, hands, feet)
what could cool peripheries suggest?
peripheral vasoconstriction due to sepsis, dehydrations
When should you measure BP of a child?
only measure if concerned
(drowsy or sick child)
(do it at the end of examination)
When might you get sluggish pupil responses?
- post fit
- drug overdose
When might you get assymetrical pupil responses?
space occupying lesion (extra/subdural haemorrhage)
When might a child be drowsy?
- Post fit
- High temp
When should you do the ENT assessment
leave till the end
How do you position patient to do ears bit of ENT?
sit child sideways on parent lap and hold tight, hold baby arms and head still
How to you position patient to do throat bit of ENT?
sit baby facing you on parent lap, hold baby arms and head still
Where do you measure temperature ?
timpanic (usually better)
axillary strip (recommended in babies)