pRRAPID

Question 1

How would you recognise and respond to AIRWAY issues in young children?

Answer 1

RECOGNITION
-Talking?
-Abnormal noises?
-LOOK for chest movement
-LISTEN for breath sounds
-FEEL for expired air
RESPONSE
-Call for help
-Basic manoeuvres
–Older child = head tilt chin lift
–Infant = neutral position
–C-spine injury = jaw thrust
-Airway adjuncts
-Suction secretions
-o2 therapy

Question 2

What 2 things are important to remember when managing children’s airways compared with adults?

Answer 2

-Children have smaller airways so are more easily obstructed
-Children get frightened easily which can cause airway obstruction to worsen

Question 3

How would you recognise and respond to BREATHING issues in young children?

Answer 3

RECOGNITION
-Effort (recession, tracheal tug, grunting, nasal flare, head bobbing)
-Efficacy (chest expansion, auscultation, spo2, RR)
-Effefcts (HR, skin colour, mental state)
RESPONSE
-BVM ventilation if not breathing
-15L/min o2 via NRBM
-ABG (venous / capillary if young)
-CXR

Question 4

How would you recognise and respond to CIRCULATION issues in young children?

Answer 4

RECOGNITION
-Vital signs (HR, BP, CRT)
-Skin + mucus membrane perfusion (colour, skin turgor)
-Organ perfusion (urine output, mental state)
RESPONSE
-IV/IO access (proximal tibia)
-Blood gas, glucose, FBC, U+Es
-Cardiac monitoring (3-lead or 12-lead)
-Fluid bolus 10ml/kg (assess response +repeat)

Question 5

What is important to remember about hypotension in young children?

Answer 5

-It is a pre-terminal late sign
-Remains stable for a long time

Question 6

How would you recognise and respond to DISABILITY issues in young children?

Answer 6

RECOGNITION
-AVPU
-Pupils
-Posture
-BG
-Seizures?
RESPONSE
-Protect airway
-Recovery position
-Give glucose
-Treat seizures
NB for DKA, delay giving insulin for 1h after fluids to avoid cerebral oedema

Question 7

How would you recognise and respond to EXPOSURE issues in young children?

Answer 7

RECOGNITION
-Expose (ALL of patient, try to do one part at a time especially in neonates) - injuries, bleeding, rash
-Temperature + review vital signs
-Review drugs + fluids chart
-Full H+E if possible
-Review results
RESPONSE
-Senior help
-Documentation
-Management plan
-Communication
-ICU/HDU transfer

Question 8

How do vital signs parameters vary with children of different ages (generally)?

Answer 8

HR - decreases with age
RR - decreases with age
BP - increases with age
Temp - increases with age (slightly)