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Child Health > Acutely ill children > Flashcards

Acutely ill children Flashcards

1
Q

what are the trends in BP, HR and RR as you get older

A

HR and RR start high get lower, BP starts low and gets higher

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2
Q

what is you’re blood pressure when your >1

A

70-90

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3
Q

describe the differences in head anatomy in children (simple)

A

large head, prominent occiput, high anterior larynx/ floppy epiglottis

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4
Q

why is the large surface area of babies important

A

if they get burned will be a large proportion of skin affected- will lose more fluid

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5
Q

why is the floppy epiglottis and high anterior larynx

A

when intubating have to lift up epiglottis

high larynx means when opening airway put head in neutral position up till age 1 to prevent obstructing airway

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6
Q

why do children get costal recession when breathing hard

A

as ribs are flexible- why is very usual for children to break their ribs

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7
Q

what is childrens blood volume

A

80mls/kg

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8
Q

what type of haemoglobin do children have

A

HbF

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9
Q

what are the most common causes of childrens abdominal pain

A

gastroenteritis and constipation

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10
Q

what is bronchiolitis

A

acute inflammatory injury of the bronchioles, viral cause- mainly RSV

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11
Q

what are the signs of bronchiolitis

A

widespread fine crackles throughout lung fields, cold that goes to chest, struggling with feed. might need oxygen, tends to be over 5 days

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12
Q

what is the treatment for bronchiolitis

A

supportive- may need oxygen, change to smaller meals more often if stuggeling to eat

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13
Q

what is the risk of children under a month who get bronchiolitis

A

can get apnoea- need CPAP

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14
Q

what is croup

A

larygnotracheobronchitis, viral - usually parainfluenza, causes narrowing of the upper air way (stridor)

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15
Q

what is the treatment for croup

A

steroids (very low morbidity and mortality)

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16
Q

what can cause upper airway obstruction

A

epiglotisitis, bacterial infection, croup, inhaled foreign body

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17
Q

what are the signs of asthma

A

prolonged expiratory phase, wheezy

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18
Q

what are the signs of pneumonia

A

crackles on one side, temp, cough, can affect any age- different pathogens for different ages

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19
Q

what causes encephalitis

A

commonly viral- coxsackie

20
Q

what do tou get in encephalitis

A

focal neurological deficit

21
Q

what can cause meningitis

A

bacterial- meningococcal, strep, e coli

viral

22
Q

what are the investigations into CNS infections

A

lumbar punctures, imaging

23
Q

describe the rash in meningitis

A

fulminant pupura, non blanching

24
Q

what are febrile seizures

A

reaction to temperature- will last less than 5 mins

25
Q

what is a reflex anoxic seizures

A

when you get a fright/ bangs head and stops breathing can make fitting movement - do no treat with anti epileptics

26
Q

what are breath holding attacks

A

when you cry and then hold it and then cry again

27
Q

what are absence episodes

A

seizures lasting 10-30 seconds where you dont know whats happened
can just not be listening

28
Q

what injuries are suspicious of NAI

A

broken ribs, retinal haemorrhages from shaking, bruising behind ear

29
Q

what are the common GI/UG problems

A

viral gastroenteritis, GI obstruction (congenital pyloric stenosis, volvulus, intussusception and malrotation), acute abdomen (appendicitis), UTI, testicular torsion

30
Q

should you give children IV drips

A

avoid, get better a lot quicker when have food in belly

31
Q

what are common CVS complications

A

congenital heart disease (cyanosis, HF), arrhythmias (SVT)

bacterial endocarditis is rare but severe

32
Q

what is the commonest reason for acute illness in children

A

sepsis

33
Q

what children are at increased risk of sepsis

A

infants <3/12
immunosuppressed/ immunocompromised/ chemotherapy/ long term steroids
recent surgery
indwelling devices/ lines
complex neurodisability/ long term conditions
high index of clinical suspicious (tachypnoea, rash, leg pain, biphasic illness, poor feeding)
significant parental concern

34
Q

what is the paediatric sepsis 6

A

six things to do within an hour (ideally within 15 mins)
-high flow oxygen
-take bloods (cultures, glucose (target low), lactate)
-give IV or IO (into bone marrow) antibiotics
if shocked
-consider fluid resuscitation
-consider inotropic support early
involve senior clinicians/ specialists early

35
Q

what can cause circulatory failure

A

fluid loss- blood loss, gastroenteritis, burns

fluid maldistribution- septic shock, cardiac disease, anaphylaxis

36
Q

what can cause respiratory failure

A

resp distress- foreign body, croup, asthma

resp depression- convulsions, raised ICP, poisoning

37
Q

how do you asses the effort of breathing

A

rate, recession, accessory muscle use, head bobbing, costal recession, grunting (can be due to being cold, low BG, or way of giving themselves CPAP), nasal flaring

38
Q

how do you asses the efficacy of breathing

A

expansion, additional noises (inspiratory stridor, expiratory wheeze), pulse oximetry, effects on end organs (conscious level, pallor, tachycardia)

39
Q

what can prolong cap refill time in kids

A

being cold or sepsis

40
Q

hoe can you assess circualtion

A

HR, rhythm, BP, cap refill, effects on other organs- conscious levels, skin perfusion (temp, colour), urine output

41
Q

what does hypotension suggest

A

very bad- pre terminal sign

42
Q

how do you manage poor circulation in kids

A

20mls/kg of 0.9% saline
repeat if still shocked (may also need inotropes)
if 60mls/kg used then involve PICU

43
Q

when might you need blood transfusions in children

A

trauma/ haemorrhage

44
Q

what are the signs of 5-10% dehydration

A

mucous membranes, fontanelles/eyes mildly dry
skin turgor slightly decreased
urine output midly reduced
conscious level normal

45
Q

what are the signs of >10% dehydration

A

mucous membranes, fontanelles/eyes dry ++, sunken
skin turgor decreased
urine output significantly reduced
conscious level altered

46
Q

how do you asses a childs conscious level

A

AVPU
GCS
pupils
posture- decorticate (hand and feet inwards) /decerebrate (hands and feet outwards)

47
Q

what are decorticate/decerebrate postures a sign of

A

problems with brain stem, show neurological bruising

decerebrate worse

Child Health (17 decks)

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