SBI 301 Paeds Flashcards
Infant Diameter of airways vs Adult
4mm for infants Vs 16 for adults
An infant age is waht?
1 month to 1 year
Small child age is?
1-5 years
Child age is?
6-12 years
Adolescent age is?
13-18
1mm of swelling to an infant airway increases airway resistnace by?
16 times
Whats the narrowest part of the upper airway
Cricoid ring
Larync is higher in Children, this means what for forgien body
SCIWORA is what
Spinal cord injury withou radiographic abnormality
Explain SCIWORA
What indicates resp failure
Infants become bradycardic when hypoxic therfore manage with O2 not atropine
when do you commence resus for kids
HR > 60bpm and unresponsive and not breathing
Paeds weight Calculation is?
(Age+4) * 2 = weight in KG
Joules in cardiac arrest calculations
4jouls/kg
Steps of a Paed resus
Danger
Response
Send
Airway
Breathing - No - 2 Breaths
CPR - 15-2
Defib 4J/KG
Rhythm analysis/drugs for a paed in shockble rhythm
Shock @ 4j/kg
Adrenaline 10mcg/kg after 2nd shock than every 2nd
Amiodarone 5mg/kg after 3 shocks
Rhythm analysis/drugs for a paed in Non-shockble rhythm
Dont Shock
Adrenaline 10mcg/kg immediatley then every 2nd shock
What are the steps for the paediatric assessment
- Scene safety
- PAT
- Primary Survey DRABCDE
Any critical interventions - Secondary Survey
History and Vital signs - Management and treatments
- Differential and provisional diagnosis
- Transport decision
What are the three sides to the PAT
- Appearance
- Work of breathing
- Circulation
Describe TICLS
- Tone- floppy lethargic or moving spontaneous.
- Interactions- do they interact normally interested in objects and sounds or uninterested.
- Consolabilty- can they be consoled or are they agitated
- Look- make eye contact or vacant glazed stare.
- Speech- sound strong and spontaneous or weak and muffled.
Four things to look for in Work of Breathing
- Listen for sounds, strider, wheeze grunt.
- Patients position
- Accessory muscle use.
- Nasal flaring
Three things to look for in circulation
- Pale
- Mottling
- Cyanosis
5 signs of respiratory distress
- Intercostal retraction
- Nasal flaring
- Sternal retraction
- Pallor
- Tracheal tug
Why do kids grunt to breath
Trying to generate PEEP to splint the alveolar.
Typically seen in pneumonia
What is the ratio for CPR and what age does it change?
15:2
Changes to 30-2 at 9 years
Drug protocols for cardiac arrest in shockable rhythms
- Adrenaline after second shock. Then every second shock
- 10mcg/kg 1:10,000 - Amiodarone after three shocks
- 5mg/kg
How do you calculate the Joules for peads
Joules = weight x 4
Paediatric treatment of anaphylaxis is?
Position pt
Adrenaline (1:100) 10mcg/kg every 5 minutes whilst indicated
Oxygen target 94%
Salbutamol Neb over 5= 5mg under 5= 2.5mg whilst indicated
Fluids IV 20ml/kg
Hydrocortisone IV 4mg/kg once
Clinical manifestations of epiglottis
Fever 4-8 hours prior
Acute onset of upper airway obstruction
Lethargy
Drooling
Dysphagia
What is the asthma treatment?
Both life threatening and non life threatening
O2- 94-98%
Salbutamol- under 5= 2.5 mg over 5= 5mg whilst indicated
Ipatropium Bromide- 2-6years 250mcg, max dose = 500mcg
Life threatening start with
Adrenaline- 10mcg/kg every five minutes
Then as above
Croup Manifestations
1 history of common cold
- Low grade fever
- Seel bark
- Strider on inspiration
What is treatment for severe croup
- O2 94-98
- Adrenaline
- Neb
- 500mcg/kg
- every 30 minutes
Seizure treatment whilst actively fitting
- Protect Pt by removing objects
- Consider backup
- Consider cause. Eclampsia etc.
- Midazolam
- IM 0.15mg/kg
- every 5 minutes
- 0.45mg/kg max dose
No contra indications.
What things to find out with History taking of a seizure patient
1- Time of onset
2- Mechanism of injury
3- fever, aloc
4- past Med Hx
5-meds
6- Allergies
Treatment of Hypoglycaemia
1- glucose get if able to swallow
-entire tube 15grams
If unable to swallow
2- glucose 10%
-IV
0.2g/kg (2ml/kg)
Repeat onec at 10 minutes. COnsult if not at 4mmol after 2nd bolus
Glucagon
Treatment for hyperglycaemia
1-administer compound sodium lactate
- 10ml/kg
- max dose 10ml/kg
