Recognising the sick child Flashcards
At which point is clinical shock detected?
20mls/kg = 25% of circulating volume
Management of circulation
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
One of the main causes of dehydration in children
Gastroenteritis
Signs of dehydration
Dry mucous membranes e.g eyes and sunken eyes Decreased skin turgor Decreased urine output (shock) (conscious level altered >10%)
Assessment of conscious level
AVPU
GCS
Pupils
Posture – decorticate/decerebrate
Don’t ever forget Glucose
How to calculate systolic BP?
85 + (age in years x 2)
HR for <1 year?
110-160
RR for <1 year?
30-40
Decorticate?
Cervical spinal tract/cerebral hemisphere
Decerebrate?
Problems with midbrain or pons
Nutrient deficiencies from late weaning?
Zinc and iron
Eating vulnerabilities in school age children?
- chronic disease
- disordered eating patterns (e.g. faddism)
- supply/demand imbalance (obesity)
Eating vulnerabilities in adolescence?
- eating disorder
- obesity
- early pregnancy
3 amazing breastfeeding benefits
- greater likelihood of higher IQ
- lower obesity risk for baby in later life
- lower risk of maternal breast cancer
Breastfeeding and diarrhoea?
Breastfeeding reduces diarrhoea
Breastfeeding and respiratory infection rates?
Breastfeeding reduces rates of respiratory infection
Dental health and children?
From 6 months, children should be introduced to drinking from cups and tooth brushing should begin as soon as teeth appear
What increases the risk of dental caries massively?
Amount of free sugars and frequency
What is child obesity associated with>
Maternal obesity
Early weaning
Rapid weight gain in first two years
Early introduction of solids associated with
- 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
Public health interventions
Healthy start
