Emergency Flashcards
(34 cards)
Why are five rescue breaths and a ratio of 15:2 used in paediatric BLS?
Because children are much more likely to be suffering from a respiratory arrest than cardiac
How do you give chest compressions to a small child?
Use the heel of one hand in the middle of a line joining the nipples. Compress the lower half of the sternum to a third of the chest’s depth.
What is the preferred site for an IO?
Anteromedial surface of the proximal tibia, 1-2cms medial to and 1-2cms distal to the tibial tuberosity
What are the contraindications for an IO?
- Osteoporosis
- Osteogenesis imperfecta
- Infection at target site
- Vascular injury proximal to insertion site
- Fracture in target bone
- Previous insertion at site within last 48 hours
What is the ideal position for a child suffering anaphylaxis when they are not comatose?
On their back with their legs raised
What position do you put a comatose child suffering anaphylaxis in? Why?
Left-lateral position to prevent caval compression
What are the three drugs used to treat anaphylaxis?
1) Adrenaline 1:1000
2) Chlorphenamine
3) Hydrocortisone
What are the IM doses of the drugs used to treat anaphylaxis for a baby aged <6 months?
- Adrenaline = 0.15ml
- Chlorphenamine = 25mcg/kg
- Hydrocortisone = 25mg
What are the IM doses of the drugs used to treat anaphylaxis for a child aged 6 months to 6 years?
- Adrenaline = 0.15ml
- Chlorphenamine = 2.5mg
- Hydrocortisone = 50mg
What are the IM doses of the drugs used to treat anaphylaxis for a child aged 6-12 years?
- Adrenaline = 0.3ml
- Chlorphenamine = 5mg
- Hydrocortisone = 100mg
What are the IM doses of the drugs used to treat anaphylaxis for an adolescent?
- Adrenaline = 0.5ml
- Chlorphenamine = `10mg
- Hydrocortisone = 200mg
How do you calculate IV fluid bolus in a child?
20ml/kg
What does an infant <3 months old with a fever of unknown cause require?
Full septic screen including lumbar puncture
What medication do you give in a febrile child with suspected herpes simplex encephalitis?
IV aciclovir
If a febrile child is >3 months old and bacterial meningitis is confirmed, give __ _____________.
IV corticosteroids
Children with a fever lasting 5 days or more should be assessed by a paediatrician for _________ _______.
Kawasaki disease
What fractures are indicative of NAI?
- Rib # in very young children, particularly posterior, multiple or same location on adjacent ribs
- Humeral # in non-mobile children
- Spiral fracture on humerus of any age
- Femoral # in non-mobile children
- Spinal # of any age
What investigations should children have if physical abuse is suspected?
- Skeletal survey and ophthalmology review (<2 years)
- Head CT (<1 year)
- Coag, FBC and film in patients with bruising
- Bone profile, vit D and PTH in patients with #
- Urine toxicology for poisoning
- Medical photography
What are the differential diagnoses for NAI/child abuse?
- Osteogenesis imperfecta
- Immune thrombocytopenic purpura (ITP)
- Leukaemia
- HSP
- Coagulation disorders
- Scurvy
- Blue spots (congenital dermal melanocytosis)
- Osteoporosis
What mental health disorder is associated with child sexual assault and abuse?
Conversion disorder
What is encephalitis?
Inflammation and swelling of the active tissues of the brain caused by an infection or an autoimmune response
What are the signs of encephalitis in children?
- Altered behaviour, cognition or consciousness
- Fever or recent febrile illness
- Seizures
- Focal neurological signs
- Vomiting
- Meningism
What is meningism?
The clinical syndrome of headache, neck stiffness and photophobia, often with nausea and vomiting. It is most often caused by inflammation of the meninges, but other causes include raised intracranial pressure.
What are the infective causes of encephalitis?
- HSV
- Mumps
- Varicella zoster (chickenpox)
- Rabies
- Parvovirus (slapped cheek syndrome)
- Influenza
- Toxoplasmosis
- TB
- Mycoplasma
- Malaria
- Dengue
- Rickettsia
- Lyme disease
