Recognition of a seriously ill child

Question 1

What are some abnormal CNS signs?

Answer 1

Not waking for feeding
Not sucking strongly on the breast
No rousable to activity
No tone in posture

Question 2

Which babies don’t have flexor tone?

Answer 2

Preterm babies

Sick babies

Question 3

What is apnoea?

Answer 3

Abnormal cessation of breathing for >10s, or with cyanosis, bradycardia

Question 4

What can cause apnoea in babies?

Answer 4

RSV infection 
Whooping cough 
Upper airway obstruction
- OSA
- Croup 
Sepsis
Acidosis
Oedema 
Patent ductus arteriosus

Question 5

What is the most common cause of bradycardia in children?

Answer 5

Hypoxia

Question 6

What conditions can cause a widened pulse pressure

Answer 6

Early stages of sepsis
Anaphylaxis
PDA
Anaemia
Aortic regurgitation

Question 7

What conditions can cause a narrowed pulse pressure

Answer 7

Blood loss/hypovolaemia 
Heart failure 
- Myocarditis 
Late stages of sepsis 
Aortic stenosis
Coarctation

Question 8

What are some causes of blanching rashes?

Answer 8

Measles and other viral exanthemas

Drug reaction

Question 9

What are some causes of non-blanching rashes?

Answer 9

Meningococcus

Gram negative sepsis

Question 10

How much fluid do you give in resuscitation?

Answer 10

20mL/kg bolus Hartmann’s/Plasmolite

Question 11

What is the major difference between Hartmann’s and n/saline

Answer 11

Hartman’s has lactate in it which gets converted into bicarb