Recognising the sick child

Question 1

At which point is clinical shock detected?

Answer 1

20mls/kg = 25% of circulating volume

Question 2

Management of circulation

Answer 2

20mls/kg of 0.9% saline
Reassess
Repeat if still shocked
Reassess
May need blood if haemorrhage/trauma
>20mls/kg may need INOTROPES, may just need more fluid
>60mls/kg PICU should already be aware
20mls/kg = 25% of circulating volume = point at which clinical shock detected

Question 3

One of the main causes of dehydration in children

Answer 3

Gastroenteritis

Question 4

Signs of dehydration

Answer 4

Dry mucous membranes e.g eyes and sunken eyes
Decreased skin turgor
Decreased urine output
(shock)
(conscious level altered >10%)

Question 5

Assessment of conscious level

Answer 5

AVPU
GCS
Pupils
Posture – decorticate/decerebrate

Don’t ever forget Glucose

Question 6

How to calculate systolic BP?

Answer 6

85 + (age in years x 2)

Question 7

HR for <1 year?

Answer 7

110-160

Question 8

RR for <1 year?

Answer 8

30-40

Question 9

Decorticate?

Answer 9

Cervical spinal tract/cerebral hemisphere

Question 10

Decerebrate?

Answer 10

Problems with midbrain or pons

Question 11

Nutrient deficiencies from late weaning?

Answer 11

Zinc and iron

Question 12

Eating vulnerabilities in school age children?

Answer 12

• chronic disease
• disordered eating patterns (e.g. faddism)
• supply/demand imbalance (obesity)

Question 13

Eating vulnerabilities in adolescence?

Answer 13

• eating disorder
• obesity
• early pregnancy

Question 14

3 amazing breastfeeding benefits

Answer 14

• greater likelihood of higher IQ
• lower obesity risk for baby in later life
• lower risk of maternal breast cancer

Question 15

Breastfeeding and diarrhoea?

Answer 15

Breastfeeding reduces diarrhoea

Question 16

Breastfeeding and respiratory infection rates?

Answer 16

Breastfeeding reduces rates of respiratory infection

Question 17

Dental health and children?

Answer 17

From 6 months, children should be introduced to drinking from cups and tooth brushing should begin as soon as teeth appear

Question 18

What increases the risk of dental caries massively?

Answer 18

Amount of free sugars and frequency

Question 19

What is child obesity associated with>

Answer 19

Maternal obesity
Early weaning
Rapid weight gain in first two years

Question 20

Early introduction of solids associated with

Answer 20

• Living in a deprived area
• Opinions of the infant’s maternal grandmother
• Personal disagreement with advice to wait until baby was 4 months
• Lack of encouragement from friends to wait until baby was 4 months
• Being in receipt of free samples of manufactured food

Question 21

Public health interventions

Answer 21

Healthy start