Paediatrics - general Flashcards
When are vaccinations given up to and including the first year of life (4)?
- 8 weeks
- 12 weeks
- 16 weeks
- 1 year
What vaccinations are given at 8 weeks (3)?
- 6-in-1
- Rotavirus (oral)
- Men B
What vaccinations are given at 12 weeks (3)?
- 6-in-1 (2nd dose)
- Rotavirus (oral, 2nd dose)
- Pneumococcal vaccine (PCV)
What vaccinations are given at 16 weeks (2)?
- 6-in-1 (3rd dose)
- Men B (2nd dose)
What vaccinations are given at 1 year (4)?
- Hib/MenC
- MMR
- PCV (2nd dose)
- Men B (3rd dose)
After age 2 when are vaccines given to children (4)?
- One vaccine is given yearly until age 15
- Age 3/4
- Age 12/13
- Age 14
What vaccine is given yearly from age 2 until age 15?
Influenza vaccine
What vaccines are given at 3/4 years (2)?
- 4-in-1
- MMR
What vaccine is given at age 12/13?
HPV
What vaccines are given at age 14 (2)?
- 3-in-1
- Men ACWY
What vaccines are included in the 6-in-1 vaccine?
- Diphtheria
- Polio (IPV - inactivated polio vaccine)
- Pertussis (whooping cough)
- Hib (haemophilus influenza B)
- Hep B
- Tetanus
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What vaccines are included in the 4-in-1?
- DTaP (diphtheria, tetanus, pertussis)
- Polio (IPV)
What vaccines are included in the 3-in-1?
- Tetanus
- Diphtheria
- Polio
(Td/IPV)
POLIO - not pertussis
Which vaccinations in the paediatric schedule are live (3)?
- MMR
- Rotavirus
- Influenza
Which vaccines in the paediatric schedule are inactivated?
Most of 6-in-1
Which vaccines in the paediatric schedule are non infectious recombinant (3)?
- MenB
- PCV
- HPV
When is the newborn blood spot test done?
Day 5 after birth
What is tested for in the newborn blood spot test (4)?
- CF
- Sickle cell
- Congenital hypothyroidism
- Inherited metabolic disorders
Severe combined immunodeficiency (SCID) is also being trialed to be added
What inherited metabolic disorders are tested for on the newborn blood spot test (6)?
- Homocystinuria
- Maple syrup urine disease
- MCADD
- Isovaleric acidaemia
- Glutaric aciduria T1
-
Phenylketonuria = MC
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How should a child be treated who is choking (3)?
- Encourage coughing
- Back blows
- Abdominal or chest thrusts
When should abdominal vs chest thrusts be done in a child?
- Chest thrusts = under 1 year old
- Abdominal thrusts = over 1 year old
How should a baby that has just been delivered be resuscitated?
- Warm + dry the baby
- Place airway in neutral position
- Assess breathing + HR (with stethoscope)
If not breathing/ HR < 100 then… - 5 rescue breaths
If HR < 60… - Start compressions 3:1 ratio (compression:breath) -
How should a child be resuscitated?
- Responsive, breathing?
- Head tilt + chin lift
- 5 rescue breaths
Check femoral/ brachial pulse - Start CPR 15:2 (or 30:2 if alone)
How should chest compressions be done in children?
- < 1 year = 2 thumb encircling technique; 2 fingers, press down 4cm
- > 1 year = 1 or 2 hands depending on size, press down 5 cm
What is the makeup of most fluids given to paediatric patients?
- 0.9% saline
- 5% dextrose
with/ or without added KCl
How much KCl can be added per litre of fluid?
20-40 mol/l
What is the makeup of most fluids given to neonates?
10% dextrose (with or without additives)
What are the 3 main types of fluid given to children?
- Maintenance
- Shock/ resuscitation (haemodynamically compromised)
- Dehydration (clinical dehydration signs)
How is maintenance fluids calculated for children?
- 100 ml/kg first 10
- 50 ml/kg next 10
- 20 ml/kg rest
How is shock/ resuscitation fluids calculated in children?
10 ml/kg boluses initially
–> can give up to 40 ml/kg
0.9 NaCl - dextrose not needed
How is dehydration fluids calculated in children?
Well weight x % dehydration x 10 (essentially the weight of water needed to return the patient to their normal weight)
given over 24 hours
How is % dehydration calculated?
(well weight - current weight) / (well weight) X 100
essentially the loss of weight due to water as a % of body weight
What are the developmental motor milestones (5)?
- 6 weeks = head prone
- 6 months = sit (>9 months = limit)
- 9 months = crawl
- 12 months = walk (>18 months = limit)
- 15 months = steady walk
What are the developmental vision and fine motor milestones (4)?
- 6 weeks = fix + follow with eyes (> 12 weeks = limit)
- 4 months = reaches out for toys (> 6 months = limit)
- 7 months = transfer between hands (>9 months = limit)
- 10 months = mature pincer grip (>12 months = limit)
What are the developmental hearing, speech and language milestones (7)?
- From birth = startles to sound noise
- 3-4 months = “coos”
- 7 months = indiscriminate sounds
- 10 months = discriminate mama dada
- 12 months = 2-3 words other than mama dada
- 18 months = understands “where is your nose”
- 2 years = simple phrases
What are the developmental social, emotional and developmental milestones (4)?
- 6 weeks = smiles (>8 weeks = limit)
- 6-8 months = food in mouth
- 12 months = waves, play peek-a-boo
- 2 years = toilet trained, plays with toys (symbolic play)
When does a hand preference usually develop?
<12 months
What could make a baby late to reach milestones + late to develop a hand preference?
Cerebral palsy
When are premature babies expected to reach the milestones?
Corrected to gestational age - so later than term babies
When are children/ babies typically examined through their life (5)?
- NIPE < 72 hours
- 6-8 weeks check
- Health visitor reviews
- Vaccinations
- School nurse checks
What are the typical resp rate values at <1w, 3m, 2y, 10y, >10y?
- < 1w = 40-60
- 1w - 3m = 30-50
- 3m - 2y = 30-40
- 2 - 10y = 14-24
- > 10y = 12-20
What are the typical heart rate values at <1y, 1-2y, 2-5y, >5y?
- < 1y = 110-160
- 1-2y = 95-140
- 2-5y = 80-120
- > 5y = 60-100
