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Flashcards in Paediatric Deck (37)
1

Paediatric Advanced Life Support Kit

The paramedic may ask you for equipment. Be familiar with the appropriate sized pieces of equipment.

2

BLS ratio for patients aged infant to puberty

15:2 @ 100-120

3

children and infants responses to illness

Severely unwell children can appear well then suddenly collapse.
More respiratory cause than cardiac in arrests.

4

Paediatric assessment triangle

Appearance.
Work of breathing.
Circulation to skin.

5

TICLS

Tone.
Inter-activeness.
Consolability.
Look/Gaze.
Speech/Cry.

6

CLITS

Consolability.
Look/Gaze.
Interactiveness.
Tone.
Speech/Cry.

7

Work of Breathing - assessment - Effort

Respiratory rate.
Recession.
Accessory muscle.
Nasal flare.
Stridor & Wheeze.
Expiratory grunting.

8

Work of breathing - assessment - Efficiency & Effect

Chest expansion.
Air entry.
Pulse rate.
Colour.
Mental status.

9

Circulation to skin

Colour.
Capillary refill.
Warmth of skin.

10

Respiratory Emergencies

Common 30-40% of acute admissions in children.
Potentially life threatening.
Early recognition and treatment saves lives.

11

Respiratory Emergencies - Assessment

Effort of breathing.
Efficiency of breathing.
Effects of respiratory inadequacy.

12

Signs of deterioration

Increasing recession.
Increasing respiratory rate.
Fatigue.
Altered mental status.
Cyanosis.

13

Upper Airway Emergency causes

Croup.
Inhaled foreign body.
Anaphylaxis.
Epiglottitis.

14

Upper Airway Emergencies - Acute upper airway obstructions are:

Infections.
Foreign bodies.
Angiodema (swelling i.e lips).
Trauma.

15

Croup - signs and symptoms

Common.
Not usually life threatening.
Viral infection.
Age 6months - 9yrs.
Gradual onset.
Harsh stridor.
Barking cough.
No drooling.
Temperature <38.5.
Able to drink.

16

Epiglottitis - signs and symptoms

Rare.
Life threatening.
Bacterial infection.
Age 2-6yrs.
Rapid onset.
Soft stridor.
Looks very unwell.
Quiet, sitting up.
Drooling.
Temperature >38.5.
Unable to drink.

17

Upper Airway Emergency - management

Maintain the airway.
Minimise time on scene.
Do not agitate the child.

18

Anaphylaxis - signs and symptoms

Severe allergic reaction.
Respiratory difficulty.
Hypotension.

19

Anaphylaxis - treatment

ABCDE.
IV fluid.
IM adrenaline.
Chlorphenamine.
Hydrocortisone.

20

Acute Asthma - information

Still results in death.
Night/early morning presentation.
Precipitated by infection/pollen.
Acute inflammation of the airways - wheeze, mucus, plugging, hypoxia, dehydration.

21

Complication of Acute Asthma can be...

A Spontaneous Pneumothorax.

22

Acute Asthma - Indicators of severity

Wheeze = poor.
Accessory Muscle = better
SPO2 = poor
Respiratory rate = better
ETCO2 = better

23

Severe Asthma - signs and symptoms

Too breathless to feed or talk.
Recession/use of accessory muscles.
RR >50 (2-5yrs).
RR >30 (5-18yrs).
HR >120BPM.
Peak flow < 50% predicted.

24

Life Threatening Asthma - signs and symptoms

Agitated/altered level of consciousness.
Poor respiratory effort/exhaustion.
Reduced RR.
SPO2 <33%.

25

Asthma Management

Calm.
High flow oxygen.
Nebulisers: salbutamol 2.5mg & ipratropium bromide 0.125-0.25mg.

In hospital:
Steroids.
Magnesium sulphate.
IV salbutamol.
Antibiotics.

26

Bronchiolitis - information

50% of infants will suffer form it during first 2 years of life.
Seasonal.
Viral.
Wheeze/cough.
Respiratory distress.
Apnoea (suspension of external breathing).

27

Asthma & Bronchiolitis - treatment

Oxygen.
Salbutamol (para)
Ipratropium bromide (para)
Hydrocortisone (para)

28

Pneumonia - signs & symptoms

Fever.
Lethargy.
SOB.
Pleuritic chest pain.
Responsible for 150 deaths per annum.

29

Inhaled foreign body - signs & symptoms

Inspiratory stridor (creaking or grating noise)/apnoea.
Sudden onset.
History of coughing/gagging.
Unilateral wheezing.

30

Inhaled foreign body - treatment

Never perform blind finger sweep.
Back blows.
infants 1yr = 5 x abdominal thrusts.
Check mouth.
Repeat.
Open airway.
5 x ventilations.
BLS.
Laryngoscopy (para)

31

Convulsing child - Simple Febrile

<15 mins, do not recur within 24 hrs

32

Convulsing child - Complex Febrile

>15 mins, recurs within 1hr-24hrs

33

Convulsing child - Status Febrile

>30 mins

34

Convulsing child - causes

Febrile.
Epilepsy
Other causes.

35

Convulsing child - treatment

Protect patient.
ABC.
BM measurement.
Oxygen.
Dextrose 40% gel (para)
IM glucagon (para).
IV glucose (para)
Glucose (para).
Diazepam (para).

36

Poisoning - assessment

Intentional by child.
Accidental.
Deliberate by adult.
Admit all overdoses.
Psychiatric involvement.

37

Meningococcal septicaemia

Respiratory rate and effort increase.
Heart rate increase.
Capillary refill increase.
Skin cool, mottled.
SpO2 <95%.
Temperature increase.
1 in 10 cases fatal.