Acutely Unwell Child Flashcards Preview

Hugh's MD3 Paediatrics > Acutely Unwell Child > Flashcards

Flashcards in Acutely Unwell Child Deck (20):
1

How do you assess circulation?

- HR - sats probe
- BP
- Central capillary refill
- Fontanelle

2

How do you assess disability?

- Conscious state
- Floppiness
- Tone
- Movement

3

How do you assess breathing?

- Chest rise and fall
- Listen for breathing noises
- Auscultate chest

4

How do you get IV assess?

IV
IO

5

What do you check on initial bloods?

FBE, UEC, CRP
Blood cultures
Lactate, pH - from blood gas

6

What other initial investigations can be performed?

Urine - SPA, catheter, clean catch

7

How much fluids do you give in acute resuscitation?

10-20ml/kg bolus then maintenance

8

What broad spectrum Abx are given in acute rescus

Cefotaxime 50mg/kg
Flucloxicillin 50mg/kg

Consider acyclovir

9

What do you give in a seizing patient?

Midazolam IM or IV - 0.15mg/kg

10

What do you support the airway in resuscitation? What is the trigger?

HR less than 60bpm
CPAP or intermittent breathing

11

What is the adrenaline dose in resuscitation?

0.1-0.3ml/kg in 1:10,000

12

How do you assess for meningitis on exam?

Eye tracking
Neck movements

13

What do you ask for in an LP?

MCS
Glucose
Protein
Virology

14

What are some causes of septic presentation in a neonate?

Meningitis
Group B strep
UTI
Other viral infections
Pneumonia

Cardiac failure
Pulmonary

15

What is the formula for high flow O2?

2L/kg to a maximum of 35L

16

What is the cut off for abnormal ketones?

0.6mmol/L on capillary blood

17

What are the biochemical criteria for DKA?

1. Venous pH less than 7.3 or bicarb less than 15
2. Presence of blood or urinary ketones

18

How are fluids given in DKA?

Bolus is considered though with a higher threshold
Maintenance fluids are given

19

How is the sugar corrected?

Insulin with fluids
Caution hypokalaemia

20

What is the risk with over hydrating children in DKA?

Cerebral oedema