Unwell Child Flashcards by Nirman Noorpuri

What are the anatomical and physiological differences between pediatric and adults?

Large prominent occiput
And big tongue

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What are the three things in the paediatric triangle

Appearance
Work of breathing
Circulation

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What could it mean if a paediatric appearance is low

CNS,metabolic - provide oxygen

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What could it mean if a paediatric is having work of breathing issues

Respiratory distress

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What could it mean if a paediatric is having work of breathing issues and is low on appearance

Respiratory failure

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What could it mean if a paediatric appearance is low and is having circulation problem

Shock

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What could it mean if a paediatric appearance is low and is having work of breathing and circulation issues

Cardiovascular failure

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What are the signs of deterioration

Increased work of breathing
Cyanosis
Bradycardia

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What is asthma

It’s an acute inflammation of the airway leads to a wheeze.can be caused by a trigger e.g pollen,dust

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What is moderate exacerbation asthma

able to talk in full sentences

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Moderate exacerbation heart rate and resp rate

less than 140 min age 2-5 HR
Less than 125 ages 5 over HR
Less than 40 min age 2-5 RR
Less than 30 min over 5 RR

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What is acute severe

The inability to complete sentence in one breath

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Acute severe heart rate and resp rate

more than 140 age 2-5 HR
more than 125 over 5 HR
more then 40 min 2-5 RR
morw then 30 min 5 over RR

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What is life threatening

Silent chest and cyanosis

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Life threatening heart rate and resp rate

Hypotension,poor respiratory effect and exhaustion

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What is Bronchiolitis

Is the inflammation of the bronchioles,acute and self limiting infection

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What are the symptoms of bronchiolitis

reduced SPO2,increased RR,Recession
Irregular breathing

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When will you need to transport a pediatric to hospital with Bronchiolitis

High-risk baby,less than 2 months Tachypnoeic and tachycardia

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What is Upper Respiratory Tract Infections

are common in pediatric includes Tonsillitis/sore throat
Otitis media
Common cold

What are the signs and symptoms of URTI

Sore throat
Cough
Fever
Headache

What is the physical exam of URTI

Breath odour
Inflamed tonsils
Respiratory distress or stridor
‘Muffled’ voice – quinsy

What is lower respiratory tract infection

This includes infections such as pneumonia

What are the signs and symptoms of LRTI

Fever
Cough
Tachypnoea
Nasal Flaring
Chest recession

why would you transfer to hospital for URTI/LRTI

less than 2 years, Unable to take medicine orally
Dehydrated
Severe DIB
Concerns of meningococcal disease
Diminished fluid intake

What is Croup

Inflammation around the larynx

what are the symptoms of croup

sounds like a bark when coughing Use of accessory muscles Can present with respiratory distress, respiratory failure and respiratory arrest Hoarse voice

What is the management of croup

Modified TAUSSIG croup score for severity- Consider Dexamethasone oxygen,calm approach

What is the Modified TAUSSIG Croup Score

stridor - Only on Crying, exertion (1) - At rest (2) - Severe (3) Recession - - Only on Crying, exertion (1) - At rest (2) - Severe (3)

What is Epiglottis

This is an acute inflammation of the epiglottis which left untreated can be potentially fatal

What are the causes of Epiglottis

Bacterial infection or injury Very rare now due to HIB vaccine

What are the symptoms of epiglottis

Fever Unwell/ distressed Stridor Difficult and painful to swallow

How do manage epiglottis

oxygen priority call to hospital

What is Febrile illness

Most common medical problem in childhood.Suggests an underlying infection.Temperature >38oC is likely to be significant

What is the NICE traffic tool

the presence or absence of symptoms and signs Green - low risk Amber - intermediate risk Red - High risk

What are the dehydration red flags

Appears unwell or deteriorating Altered responsiveness Sunken eyes Tachycardia Tachypnoea Reduced skin turgor

What are causes of convulsions

Febrile - occurs from a sudden rise in temperature Brain insults Epilepsy Convulsive Status Epilepticus

How to deal with a Convulsion

OP and NP tubes 100% oxygen as per JRCALC in an active seizure Oxygen titrated to 94-98% for post-ictal phase And being prepared with the bag valve mask

What is childhood gastroenteritis

Sudden onset of diarrhoea.At risk of dehydration

What is Encephalitis

Swelling (inflammation) of the brain, most often due to infections.

What is Hydrocephalus

A buildup of fluid inside the skull.

What is Meningitis

Infection of the membranes covering the brain meninges

How to deal with overdoes/ poisoniong management

Oxygen,NEVER induce vomiting Consider 12 lead ECG Convey to hospital with sample and containers

What is septicaemia

bacteria invade the bloodstream

Treatment of Meningococcal Meningitis and Septicaemia

High flow O2 Full set of observations + BM on the way to hospital Paramedics can give benzylpenicillin