Paeds Flashcards
Bronchiolitis admission criteria
Sats <92% OA
<2/3 feeds or dehydrated
Apnea’s
Increased WOB
Age febrile convulsions
6 month to 6 years
GORD in babies
Progression over time
Starts between birth and 3 months
Resolves by 6-12months
Occurs 3/4 of 4m olds
5% have it 6x/day
Red flags for atraumatic limp
Fever Severe pain, NWB Poor response analgesia Erythema, swelling Pain worse at night Multiple attendances Back pain or neurology Abnormal bloods
Feeding volume babies
100-150ml/kg/day
Bronchiolitis worst on day
Days 3-4 (peak illness)
West syndrome
Infantile spasms
Flex at waist, legs extend, arms over head Often cry before or after Often come in cluster Often before or after sleep Admit! Tx to prevent developmental delay
Acute limp ddx
Amber traffic lights signs (sepsis)
Pallor
Not responding to cues
No smile
Wakes on prolonged stimulus
Decreased activity
Nasal flaring
Tachypnea
Sats under 95
Crackles on chest
Tachycardia
CRT prolonged
Dry mucus membranes
Poor feeding reduced urine OP
3-6months and T over 39
Fever over 5 days
Rigors
Seeing of limb or joint
Non weight bearing on extremity
Red flags sepsis
Pale, mottled, ashen, blue
No response to social cues
Appears ill
Does not wake or stay awake
Weak, high pitched cry
Continuous cry
Reduced skin turgor
Under 3 months and T 38
Non blanching rash
Bulging fontanelle
Focal seizures
Focal neuro seizures
Kawasaki Dx
Crash and Burn
Fever for more than 5 days and at least 4 of the following:
- conjunctivitis (bilat)
- rash (polymorphous)
- adenopathy (cervical)
- strawberry tongue
- hands and feet (oedema, erythema, desquamation)
Pulled elbow explanation
Slipped out of ligament in elbow
Partial dislocation
Very simple to replace
No complications
Can happen again
Will grow out of it by the time they are 6
Common with a simple fix
Home within 20 mins
T1 diabetes explanation
Diabetes is when your body is unable to control your blood sugar levels
In this case it is because you do not produce enough insulin (hormone to use sugar in body)
Autoimmune response where your body has attacked your insulin producing cells.
We will need to replace your insulin levels daily for the rest of your life.
Manageable but risky and burdensome condition.
DKA explanation
You have a severe lack of insulin for a prolonged period of time
Your body is unable to use the sugar that is available and instead burns fat
This releases ketones as waste products
This makes your blood more acidic and can be fatal if you are not treated in hospital
Need fluids and insulin
BRUE definition
Under 1 year old
Under 1 minute duration
Return to baseline state
Not explained by medical condition
Can Include:
- cyanosis or pallor
- absent, decreased or irregular breathing
- change in tone
- altered consciousness
Low risk BRUE
Over 60 days old
Born over 32 weeks and corrected age over 45 weeks
No CPR
Under 1 min duration
First event
Management low risk BRUE
No association with SIDS
- sudden infant death syndrome
Unlikely to recur
Can be discharged home after period of monitoring in ED
Advice; eliminate exposure to tobacco, never shake baby to resistor them, GP follow up in 48h, back to sleep (lullaby trust)
SIDS define
Sudden infant death syndrome
Unexplained death under 1 year old
RF for SIDS
Babies sleeping on stomach
Overheating in sleep
Too soft sleeping surface, blankets, toys
Exposure to smokers
Mothers under 20
Premature or low birth weight
Sibling who died of SIDS
Febrile seizure explanation
Something we see in children up to 6 yo
Can have a fit or seizure when they have a temperature
Unlikely to result in any harm or long term consequences
May have another febrile seizure in the future
Will grow out of it
Not epilepsy
Very small increased risk of epilepsy
Age for transient synovitis
3-10yo
If younger than 3 think of something else? Septic
