vomiting/diarrhoea Flashcards
What is gastroenteritis and presentation?
Inflammation of digestive tract causing
- sudden onset watery diarrhoea settling in 7 days
- vomiting settling in 3 days
Most common cause of gastroenteritis in children?
Viral cause is most common, rotavirus
Indications for stool culture?
- suspect septicaemia
- there is blood and/or mucus in the stool
- the child is immunocompromised
- child recently abroad
What is the Mx for children with no evidence of dehydration?
For children with no evidence of dehydration
- continue breastfeeding and other milk feeds
- encourage fluid intake
- discourage fruit juices and carbonated drinks
- offer oral rehydration salt ORS
What is the Mx for children with evidence of dehydration?
- Give ORS solution (instead of offering)
- continue breastfeeding
- avoid fruit juice, carbonated drink
What is the presentation for clinical shock?
- Decreased level of consciousness
- pale mottled skin
- cold extremities
- weak pulses
- tachycardia
- prolonged capillary refill time
- hypotension
What is the Mx for clinical shock in children and adults?
Admit to emergency department
1)Children- start IV fluid resuscitation with bolus of 20ml/kg of 0.9% saline over less than 10 minutes
1)Adults – 1000ml/kg of 0.9% saline over less than 10 minutes
What are the red flags for children based on traffic light system?
- colour
- activity
- respiratory
- circulation
- temperature
- neurological
colour: pale/mottled/cyanosed
activity: no response to social cues
respiratory: RR >60. grunting
circulation: reduced skin turgor
temperature: if <3 months temperature of >38C
neurological: bulging fontanelle, neck stiffness, focal seizures can be indicative of meningitis, others include status epilepticus, focal seizures.
Immediate Mx if red, refer to paediatric specialist
What Investigations are needed for bronchiolitis?
No investigations needed, CXR not routinely done in children.
