Core conditions. Flashcards
RF for asthma.
Atopic history.
Smoking at home.
Prematurity.
Dust.
Asthma investigations.
PEFR.
CXR.
Spirometry.
Inhaler technique.
<5 yo asthma chronic Mx.
SABA.
Inhaled corticosteroid.
Leukotrine receptor antagonist (montelukast).
Refer to paediatric specialist.
> 5 yo asthma chronic Mx.
SABA. Inhaled corticosteroid. LABA. Increase steroid. Daily steroid tablet. Refer.
Acute asthma Mx.
O2. Nebulised bronchodilators. Steroids –IV hydrocortisone or PO prednisolone. IV Aminophylline. IV Magnesium Sulphate. IV salbutamol.
Pathogen most commonly causing bronchiolitis.
RSV.
Ix in bronchiolitis.
Blood gas.
NPA.
CXR.
Fluid assessment.
RF for bronchiolitis.
Prematurity. SCBU. Hx of admissions. Heart disease. Immunodeficiency. Developmental delay.
Mx bronchiolitis.
Supportive – O2, NG feed/IV, suctioning.
Signs of bronchiolitis on Ex.
Increased respiratory effort. Accessory muscles + recessions. Grunting. Hyperinflation. Nasal flaring.
When do you admit a child with bronchiolitis?
RR >60 50-75% normal fluid intake. Dehydration. Respiratory distress. Apnoea. O2% <92. Carer anxiety.
Criteria for discharging child with bronchiolitis.
Adequate intake.
Sats >92% off oxygen including 4 hours of sleep.
Clinically stable.
Safety netting.
What is VIW?
Recurrent episodes of wheezing in an <3 yo thought to be linked to a viral trigger. May develop into asthma.
Red flags for VIW.
Present from birth.
Persistent productive cough.
Weight faltering.
Focal neuro signs.
Mx VIW.
Oxygen.
Bronchodilators.
Smoking cessation advice.
Safety netting.
Criteria for admission with VIW.
Tachypnoeic. Can't feed. Floppy/unresponsive. Accessory muscle use. Cyanosis.
What is croup?
(acute laryngotracheobronchitis)
URTI caused by viral infection.
Pathogens causing croup.
Parainfluenzae 1, 2, 3.
RSV.
Signs of croup.
Barking cough.
Stridor.
Drooling.
Hoarseness.
DDx croup.
Epiglottitis.
Bronchiolitis.
Bacterial tracheitis.
Distinguishing features separating pneumonia from bronchiolitis.
Pneumonia causes a higher fever and lower sats.
Pneumonia Mx.
IV/PO amoxicillin (oral as effective if tolerated).
Fluids.
Oxygen.
What should you not do if you suspect epiglottitis?
Look in child’s mouth or lie them flat.
Pathogen causing epiglottitis.
Haemophilus Influenzae B.
