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PHASE 3A > PAEDS - important stuff > Flashcards

PAEDS - important stuff Flashcards

1
Q

IV fluid bolus calculation in the paediatric population

A

administered over 10 minutes at 10mL/kg

e.g. if child is 18kg, 10x18 = 180ml bolus over 10 minutes

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2
Q

green flags - paediatric assessment
a) colour (skin/lips/tongue)
b) activity
c) resp
d) circulation and hydration
e) other

A

a) normal colour

b) responds normally to social cues, content/smiles, stays awake or awakens quickly, strong normal cry/not crying

c) n/a

d) normal skin and eyes, moist mucous membranes

e) none of the amber/red symptoms or signs

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3
Q

amber flags - paediatric assessment
a) colour (skin/lips/tongue)
b) activity
c) resp
d) circulation and hydration
e) other

A

a) pallor reported by parent/carer

b) not responding normally to social cues
no smile
wakes only with prolonged stimulation
decreased activity

c) nasal flaring
tachypnoea (RR >50 in 6-12 months, >40 in >12m)
O2 sats 95% in air
chest crackles

d) tachycardia (>160 <12 months, >150 12-24 months, >140 2-5 years)
CRT >3 seconds
dry mucous membranes
poor feeding
reduced urine output

e) age 3-6 months and temp >39
fever for >5 days
rigors
swelling of limb/joint
non-weight bearing limb/using an extremity

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4
Q

red flags - paediatric assessment
a) colour (skin/lips/tongue)
b) activity
c) resp
d) circulation and hydration
e) other

A

a) pale/mottled/ashen/blue

b) no response to social cues
appears ill to healthcare professional
doesnt wake/if roused doesnt stay awake
weak, high pitched, or continuous cry

c) grunting
tachypnoea: RR>60
moderate or severe chest indrawing

d) reduced skin turgor

e) age <3 months and temp >38
non-blanching rash
bulging fontanelle
neck stiffness
status epilepticus
focal neuro signs/seizures

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5
Q

tachypnoea amber sign - > how many breaths per minute if
a) 6-12 months old
b) >12 months old

A

a) >50 breaths a minute
b) > 40 breaths a minute

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6
Q

tachypnoea red sign - > how many breaths per minute

A

> 60 breaths per minute in any age

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7
Q

tachycardia amber sign - how many beats per minute in…
a) <12 months
b) 12-24 months
c) 2-5 years

A

a) >160 beats per min

b) >150 beats per min

c) >140 beats per min

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8
Q

child imms schedule - when is the 6-1 vaccine given and what is included?

A

at 2, 3 and 4 months

diptheria, tetatnus, whooping cough, polio, Hib and Hep B

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9
Q

child imms schedule - when is Men B given?

A

2 months, 4 months, 12-13 months

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10
Q

child imms schedule - what is given at 12-13 months? (4)

A
  • Hib/Men C
  • MMR
  • PCR
  • Men B
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11
Q

child imms schedule - what is given at 3-4 years?

A

4-in-1 pre-school booster - diptheria, tetanus, whooping cough, polio
MMR

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12
Q

child imms schedule - what is given at 12-13 years?

A

HPV vaccine

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13
Q

child imms schedule - what is given between 13-18 years?

A

3-1 teen booster - tetanus, dibtheria, polio
Men ACWY

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14
Q

child BLS - chest compressions:breaths ratio?

A

15 compressions: 2 rescue breaths

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15
Q

child BLS - how many cm should the chest be pressed down in infants and children?

A

infants - 4cm
children - 5cm

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16
Q

children under what age should not receive corticosteroids when tx bacterial meningitis?

A

<3m

17
Q

APGAR scoring - when should it be calculated when assessing a newborn baby?

A

at 1 and 5 minutes (at 10 if still <7)

18
Q

APGAR scoring - after assessing at 1 and 5 minutes, when should it be reassessed if the score is still low?

A

at 10 minutes

19
Q

APGAR scoring - what is the maximum score? what score indicates a…
a) v low score
b) moderate low
c) baby is in good state

A

maximum = 10

a) 0-3
b) 4-6
c) 7-10

20
Q

what are the categories assessed in an APGAR score? (5)

A
  1. pulse
  2. resp effort
  3. colour
  4. muscle tone
  5. reflex irritability
21
Q

indications of a score 2 (highest score)
a) pulse
b) resp
c) colour
d) muscle tone
e) reflex irritability

A

a) >100
b) strong, crying
c) pink
d) active movement
e) cries on stimulations/sneezes, coughs

22
Q

indications of a score 1 (medium score)
a) pulse
b) resp
c) colour
d) muscle tone
e) reflex irritability

A

a) <100
b) weak, irregular
c) body pink, extremities blue
d) limb flexion
e) grimace

23
Q

indications of a score 0 (highest score)
a) pulse
b) resp
c) colour
d) muscle tone
e) reflex irritability

A

a) absent
b) nil
c) blue all over
d) flaccid
e) nil

24
Q

asthma management pathway in children aged 5-12

A
  1. SABA (salbutamol)
  2. SABA + low-dose inhaled ICS (<200mcg budesonide)
  3. SABA + ICS + LTRA (montelukast)
  4. switch LTRA for a LABA (e.g. salmeterol)
  5. switch the LABA and ICS for a low-dose combo maintenance and reliever therapy (MART)
  6. SABA + moderate ICS dose MART
  7. seek advice from asthma specialist and CONSIDER EITHER…
    - increase ICS dose to high
    - trial new drug e.g. theophylline
25
Q

low, moderate and high doses of ICS in the treatment of asthma in children

A

BUDESONIDE
low = <=200mcg
mod = 200-400mcg
high = >400mcg

26
Q

asthma treatment pathway in children <5

A
  1. SABA
  2. trial mod dose ICS for 8 weeks, if works then put on low dose ICS
  3. add LTRA (montelukast)
  4. stop LTRA and refer to paediatric asthma specialist
27
Q

neonatal murmur- continuous machinery murmur

A

patent ductus arteriosus

28
Q

neonatal murmur- harsh systolic ejection murmur over pulmonic and left sternal area, often with systolic thrill

A

tetralogy of fallot

29
Q

neonatal murmur- pansystolic murmur in lower left sternum

A

ventricular septal defect

30
Q

neonatal murmur- split double (split, fixed 2nd heart sound) + ejection systolic murmur

A

atrial septal defect

31
Q

neonatal murmur- harsh ejection click radiating to carotid vessels

A

aortic valve stenosis

32
Q

technique for chest compression in infants (<1)

A

two-thumb encircling technique

33
Q

initial tx for DKA if child is N&V, clinically dehydrated

A

IV fluids (0.9% NaCl 10ml/kg)

+

subcut insulin (0.1units/kg/hr)

34
Q

at what point should a child be referred if they are not yet…
a) smiling
b) sitting unsupported
c) walking unsupported
d) able to say 2-6 words

A

a) 10 weeks
b) 12 months
c) 18 months
d) 18 months

35
Q

developmental red flags (6)

A
  1. not holding object by 5m
  2. not sitting unsupported by 12m
  3. not standing/walking independently by 18m
  4. not running by 2.5 years
  5. no words by 18 months
  6. no interest in others by 18 months
36
Q

loud single S2, prominent right ventricular impulse, weak femoral pulses

A

transposition of great vessels

PHASE 3A (18 decks)

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