Paediatrics: Respiratory and infections Flashcards
Paeds traffic light system
Colour
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Paediatric traffic light system
Activity
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Paediatric traffic light system
Respiratory including rate (Amber and Red)
Amber
6-12 months: >50
>12 months: > 40
Red
>60
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Paediatric traffic light system
Circulation + hydration
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Paediatric traffic light system
Other
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Barking cough without prominent stridor and raised temperature describes what condition?
Croup
Barking cough with biphasic stridor. Week of stability then rapid deterioration
Bacterial tracheitis
Snoring stridor, non-prominent cough, raised temp and drooling.
Epiglottis
How do you manage a child with croup-like symptoms?
All
- Oral dexamethasone (0.15mg/kg)/oral prednisilone is alternative
Severe:
- Admit
- Can give IM dexamethasone or neb budenoside as alternatives to oral drugs
- Nebulised adrenaline 5ml 1:5000
What circumstances would you admit someone with croup-like symptoms?
<6 months
Severe
Uncertainty about diagnosis
What causes bacterial tracheitis?
Staph aureus
How do you distinguish croup from whooping cough?
Croup: Barking cough
Whooping cough: Inspiratory whoop after cough.
–> Also vomiting and breathless spells
What gram negative coccobacillus is responsible for whooping cough?
B. pertussis
What is the treatment for whooping cough
If 21 days since the onset
Macrolide (<1yr: Clarithromycin, >1yr: erythromycin)
Co trimoxazole if macrolide not tolerated
Other than the patient, who else should receive antibiotics for whooping cough
Premature <32wks, non-immune/partially immune infants 32 wks
Pregnant women >=32 weeks
Those in a lot of contact with infants
What urgency should whooping cough be reported?
Urgent if acute phase
Routine if later diagnosis
How do you differentiate tonsillitis and quinsy?
Both have sore throat, fever, big red tonsils
Quinsy: + Can’t open mouth
How do tonsillitis and quinsy differ in their bacterial agents?
Tonsil: S. pneumoniae (G+ve streptococcus)
Quinsy: S. aureus (G+ve cocci, coag +ve), H.influenzae (G-ve coccobacilli)
When and how do you treat a bacterial tonsillitis
When: FEVERPain >4 or CENTOR >3
How:
1. Penicillin V
2. Clarithromycin
How do you treat quinsy?
Incision and drainage by ENT
What is the most common pathogen of pneumonia in children?
S. Pneumoniae (G+ve streptococcus)
How do you treat community acquired pneumonia?
Assess severity using CRB65/CURB65
Non severe: Amox PO 5 days (Clarithromyci alternative)
Severe: Co-amox IV then PO 7 days total
Dry cough, wheeze and crackles following on from coryzal symptoms in a 3-6 month old suggests what condition paeds resp infection?
Bronchiolitis (although pretty non-specific tbf)
What is the most common cause of bronchiolitis? How is it treated
RSV
Supportive: Humidified 02 (if <92%)
NG tube if can’t feed