Peadatrics

Question 1

What percentage of pead deaths occur in low-middle income regions/countries?

Answer 1

95%

Question 2

What amount of the 9000000 paediatric deaths are trauma.

Answer 2

100000 caused mostly by RTCs.

Question 3

What % of casualties at R2E Camp Bastion in 2008 were under 17 years old?

Answer 3

8%

Question 4

What are we obligated to?

Answer 4

NATO Principle of Universal Care. Treat any person with life, limb or sight injury.

Question 5

What is the right of a child under the UN Charte of Rights?

Answer 5

Must be treated by competent, trained professionals.

Question 6

What is especially pertinent when treating peads?

Answer 6

Cultural influences and beliefs.

Question 7

Qhat can you find out from in-theatre briefs?

Answer 7

Who is eligible for treatment.

Question 8

How is the CABCDE approach different for peads?

Answer 8

It is CABCDEFG
F is for fluids.
G is for glucose

Question 9

DEFG means?

Answer 9

Don’t ever forget glucose.

Question 10

How is the BATLS paradigm carried out on a pead?

Answer 10

C- CAT but adjust adjunts.

A- Neutral position for under 1
Care taken when head tilt chinlift to avoid soft pallet.
Anticipate large tounge.
Insert OPA the right way round with use of a tongue depressor.
Surgical Airways avoided under 12. Use needle cric.
Consider manual c-spine.

B-Oxygen wafting may reduce mask distress
Children have smaller lung capacity so only ventilate to rise chest.
Consider nasal suction

C-IV can be challenging especially is shut down profusion.
Early use of IO access.
Hypotension is a sudden and late sign
No evidence for hypotensive resuscitation.
Fluids always given to maintain strong radial or brachial (infants) pulse
Small boals of 10ml/kg crystalloid and repeat till strong pulse or condition improves.
Check CRT sternal. Less than 2.

D- GCS can be applicable or modified but AVPU is usually best.

E-Keep warm cover head in really young.
More susceptible to hypoglycemia
Treat with 2ml/Kg of 10% glucose.

Question 11

Waht is WETFLAG

Answer 11

W- Weight in Kg-
Age 1-12 months 0.5 x age in months + 4
Age 1-5 2x Age +8
6-12 3x Age +7
E- Energy for defib 4J/kg
T- Tube (internal diameter) age/4 +4
F- Fluid 10ml/kg
L- Lorazepam- 0.1mg/kg
G- Glucose 10% dextrose 2ml/kg

Question 12

What is different about cardic arrest in children?

Answer 12

Relatively uncommon
Usually hypoxia and hypovolimia caused
Majority of cases proceed respiratory arrest followed by secondary cardic arrest.
Primary cardic arrests occur in children with prexisting conditions.

Question 13

How should you handel parents, gardians and escorts.

Answer 13

May contribute/hamper care
Communication is obligatory
Involve them
Make yourself aware of local laws and customs

Question 14

How can you assess pain on a child?

Answer 14

Facial signs

Wong-Baker Scale

Question 15

How can analgesia be given to children?

Answer 15

IV/IO morphine 0.1mg/Kg
Avoid IM.

Ketamine 0.25-0.5mg /Kg starting dose

Simple analgesia
Paracetamol 15mg/kg
Ibuprofen 5mg/kg