The Acutely Ill Child Flashcards
What are the anatomical differences between a child and an adult?
infants have a relatively large head and prominent occiput; their sitting height proportionally more; relatively large SA compared to volume; high anterior larynx/floppy epiglottis; more flexible ribs; blood volume 80mls/kg
What is the difference between foetal Hb and adult Hb?
foetal Hb has a higher affinity for oxygen
What is the commonest reason for acute illness in childre?
sepsis
What is the treatment for sepsis?
antibiotics and supportive
What is the sepsis 6?
dminister high-flow oxygen to maintain target oxygen saturations greater than 94% Take blood cultures Give IV antibiotics Start IV fluid resus Check lactate level Monitor hourly urine output.
What is the most common respiratory problem in children?
bronchiolitis
What virus commonly causes bronchiolitis?
RSV
What is the treatmetn for bronchiolitis?
supportive
What is croup?
laryngotracheobronchitis
What is the differential with croup?
any other upper airway obstruction eg epiglottitis
Why has the incidence of epiglottitis reduced?
vaccination against haemophilus
What is the treatment for croup?
steroid
What are the two infections affecting the CNS in children?
meningitis and encephalitis
What are the investigations for CNS infection?
LP; imaging
Who gets febrile seizures?
children under 5/6 years
Why do children get febrile seizures?
rapid rise of temperature, unable to thermoregulate
What is seen in children alongside a febrile seizures?
minor infections eg otitis media or URTI
What is a reflex anoxic seizure?
brief period of asystole eg 10-15s; go white in responsse to noxious stimulus eg stress or injury
What is the difference between a breath holding attack and a reflex anoxic seizure?
pt turns blue rather than white
What happens before the breath holding attack?
child takes in a big breath; lets it out and then stops breathing
What is the most common arrhythmia seen in children?
SVT
What is accident and traume injury dependent on?
developmental age
What should always be considered iwith accidents and traume?
NAI
What are the causes of GI obstruction?
congential pyloric stenosis; volvulus; intussusception; malrotation
