pRRAPID

Question 1

What investigations should not be done in a child with croup?

Answer 1

Do not examine the throat

Upsetting the child will exacerbate symptoms so only essential investigations should be done. Investigations that can be avoided are CXR, cannulation (for bloods), capillary glucose and BP

Question 2

Why should you attach a 3 lead ECG when giving repeated doses of salbutamol?

Answer 2

S.E. = tachycardia and hypokalemia (hypokalemia –> arrhythmias)

Question 3

What should you consider adding to back to back nebulised ipratopium bromide and salbutamol?

Answer 3

Nebulised magnesium sulphate

Question 4

What SpO2 reading would indicate respiratory failure?

Answer 4

On air <90%

On O2 <95%

Question 5

What is the next step in management of acute asthma if the patient hasn’t responded to nebulisers and steroids?

Answer 5

IV - salbutamol or aminophylline (then consider Mg sulphate)