Sick child 1, Common acute illness - part 1 Flashcards
Appreciate the target HR, RR and BP in kids
What are some of the differences between adult and child anatomy ?
- Infants have relatively large head and prominent occiput
- Relatively large surface area compared to volume
- High anterior larynx/floppy epiglottis
- More flexible ribs – hence you should not be worrying about fracturing ribs
- Blood volume 80mls/kg – baby tends to have 2-300mls of blood.
- HbF at birth
What do you need to be wary of when giving fluids to a baby?
Due to them having roughly 300mls of blood you can fluid overload them and essentially drown them putting them into HF if you are not careful
What are some of the common infections/conditions that children present with ?
- Bronchiolitis/URTI/Croup 28%
- Gastroenteritis 8.8%
- Seizures/epilepsy 6.6%
- Pneumonia/LRTI 6.2%
- Asthma 5.7%
- “Viral illness” 5.2%
- Head injury 2.3%
- Abdominal pain 3.5%
- UTI 2.2%
What are some of the signs/symptoms of sepsis in kids < 5 that you need to look out for ?
- Looks mottled, bluish or pale
- Is very lethargic or difficult to wake
- Feels abnormally cold to touch
- Is breathing very fast
- Has a rash that does not fade when you press it
- Has a fit or convulsion
What is the treatment of sepsis ?
Supportive/antimicrobial
What is bronchiolitis ?
A common LRTI causing inflammation of the bronchioles that affects babies and young children under 2 years old.
What are some of the signs and symptoms of bronchiolitis ?
Usually initially similar to common cold - fever, cough, blocked or runny nose. Then my develop symptoms of:
- A rasping and persistent dry cough
- Rapid or noisy breathing (wheezing)
- Brief pauses in their breathing
- Feeding less and having fewer wet nappies
- Vomiting after feeding
- Being irritable
What is the cause and treatment of bronchiolitis ?
- Respiratory syncytial virus (RSV)
- Treatment is supportive
What is croup and what usually causes it ?
A childhood condition caused by inflammation of the upper respiratory tract (predominantly the larynx and trachea but it may affect the bronchi) as a result of viral infection.
Usually caused by the parainfluenza virus
What are the signs and symptoms of croup ?
Usually starts with nonspecific symptoms of viral URTI, such as runny nose, sore throat, fever and cough then develop:
- Bark-like cough
- Hoarse or croaky voice
- Difficulty breathing
- Stridor (Harsh grating sound when breathing in)
What is the treatment of croup?
Oral steroid either dexamethasone or prednisolone to help reduce swelling (inflammation) in your child’s throat.
What is the characteristic sign seen on X-ray in patients with severe croup ?
Steeple sign (narrowing produces the shape of a church steeple within the trachea itself.)
In rare cases epiglottitis can cause similar symptoms to croup, how would you distinguish between the two ?
In these cases, however, your child will usually feel very unwell generally, rather than just having the specific symptoms of croup.
What is epiglottitis and what is it caused by ?
- Inflammation and swelling of the epiglottis
- Most common cause is Haemophilus influenzae type b (Hib) bacteria
What are the common sign/symptoms of epiglottits?
- Severe sore throat
- Difficulty and pain when swallowing
- Difficulty breathing, which may improve when leaning forwards
- Breathing that sounds abnormal and high-pitched (stridor)
- High temp (fever) of 38C (100.4F) or above
- Irritability and restlessness
- Muffled or hoarse voice
- Drooling
What is meningitis ?
An infection of the protective membranes that surround the brain and spinal cord (meninges).
What are the signs/symptoms of meningitis ?
- Fever
- Being sick
- Headache
- Blotchy rash that doesn’t fade when a glass is rolled over it (this won’t always develop)
- Stiff neck
- Dislike of bright lights
- Drowsiness or unresponsiveness
- Seizures (fits)
What test is shown here and what condition is it mainly associated with ?
Tumbler test - to test for a non blanching rash
Positive test is suggestive of meningitis although can sometimes be sepsis
What is the first-line investigation to do for CNS infections i.e. meningitis and encephalitis ?
Lumbar puncture
What are some of the signs/symptoms of encephalitis and what mainly causes it ?
Mainly caused by viral infections
Usually starts of with flu-like symptoms e.g. headaches and fever then can develop more serious ones:
- Confusion or disorientation
- Seizures (fits)
- Changes in personality and behaviour
- Difficulty speaking
- Weakness or loss of movement in some parts of the body
- Loss of consciousness
