ILA2 - ill children

Question 1

Ethical dilemmas of vaccinations

Answer 1

Prevent patient/child/parent’s autonomy. Low rate of diseases in the UK (not relevant). Expensive intervention. Infections aid evolution. Religious beliefs and origins of vaccines.

Question 2

Process for notifiable diseases

Answer 2

Phone public health England in 24hrs followed by written report within 3 days. Notify ‘Proper Officer’ in local authority.

Question 3

Examples of some notifiable diseases

Answer 3

Acute meningitis, cholera, malaria, Hep A&B, rabies, rubella, TB, whooping cough, acute encephalitis, meningococcal septicaemia.

Question 4

Management of a child patient identified as RED in traffic light system

Answer 4

transfer to secondary/specialist care

Question 5

Management of a child patient identified as Amber in traffic light system

Answer 5

manage by parents at home after full assessment by Dr and parents given SAFETY NET advice.

Question 6

Management of a child patient identified as GREEN in traffic light system

Answer 6

managed by parents at home with full care advise.

Question 7

Safety net

Answer 7

warning of symptoms which could indicate deterioration of child. Info on how to access further healthcare. Discuss case with other healthcare professionals (incl out-of-hours). Arrange follow-up appt.

Question 8

Features of RED child

Answer 8

mottled skin, non responsive to social cues, not roused easily, weak high-pitched cry, grunting, tachypnoea, reduced skin turgor, bulging fontanelle, focal seizures, non-blanching rash, fever/temperature.

Question 9

features of AMBER child

Answer 9

pallor, no smile, deceased activity, wakes after prolonged stimulation, nasal flaring, low Ox Sats, crackles in chart, tachycardia and tachypnoea (less severe than red), poor feeding, dry mucous membranes, rigorously,,fever, reduced urine output

Question 10

Features in a green child

Answer 10

normal colour, responds normally to cues, awake, strong cry, moist mucous membranes, normal eyes and skin, no fever, tachypnoea, tachycardia.

Question 11

Vaccines at 8 weeks old

Answer 11

6-in-1, pneumococcal, meningococcal group B (PCV), rotavirus

Question 12

Vaccine at 12 weeks old

Answer 12

6-in-1, rotavirus

Question 13

Vaccines at 16weeks old

Answer 13

6-in-1, pneumococcal, meningococcal group B.

Question 14

Vaccines at 1 year of age

Answer 14

Haemophilus influenza (Hib) & meningitis group C, pneumococcal, MMR, meningococcal group B

Question 15

Vaccines at 3years 4months/preschool

Answer 15

4-in-1, MMR

Question 16

Vaccines for girls 12-13years

Answer 16

cervical cancer HPV

Question 17

Vaccines at 14yrs

Answer 17

3-in-1 teenage booster, Meningococcal A,C,W and Y (MenACWY)

Question 18

Contents of 6-in-1 vaccine

Answer 18

Diptheria, tetanus, pertussis (whooping cough), polio, H. influenza type B, Hep B

Question 19

Contents of MMR

Answer 19

measles, mumps and rubella

Question 20

Contents of 4 in 1 preschool vaccine

Answer 20

diphtheria, Hep B, pertussis/whooping cough, tetanus

Question 21

Contents of 3-in-1 vaccine for teenage booster/14years

Answer 21

tetanus, diphtheria, polio