The Unwell Child

Question 1

What are the three approaches to an unwell child?

Answer 1

Primary ABCDE assessment and resuscitation
Secondary assessment and emergency treatment
Stabilisation and transfer

Question 2

What to assess in an ABCD assessment of a child

Answer 2

A+B - effort of breathing, resp rate, stridor, wheeze, skin colour

C - heart rate, pulse volume, capillary refill, skin temps

D - concious level, posture, pupils

E - fever, rash, bruising

Question 3

Is resp rate higher or lower in children

Answer 3

Higher

Question 4

Airway Presentation of common differentials

Answer 4

Infection - bubbling airways
Croup - barking cough, stridor when agitated
Epiglottitis - drooling, sniffing position
Inhaled foreign body - sudden onset stridor
Acute asthma - wheeze

Question 5

Differentials (common paediatric problems) 8

Answer 5

Croup
Acute asthma
Epiglottitis
Inhaled foreign body
Supraventricular tachycardia (most common arrythmia in kids)
Congenital heart disease
Seizures
Sepsis

Question 6

Prx of Congenital heart disease

Answer 6

• most identified in birth scan
• poor feeding
• sleepy
• fast breathing

Question 7

Prx of SVT in children

Answer 7

• palpitations
• chest pain
• dizziness

Question 8

Prx of Childhood Sepsis

Answer 8

FEVER NOT ALWAYS PRESENT IN BABIES
- low BP
- generally unwell
- decreased wet nappies

Question 9

Management of the Differentials

Answer 9

Croup - nebulized adrenaline and oral dexamethosone (Corticosteroid)
Acute asthma - bronchodilators
Epiglottitis - intubation and antibiotics
Inhaled foreign body - surgical removal
Supraventricular tachycardia (most common arrythmia in kids) - vagal manouveres, IV adenosine