Paediatric Emergencies

Question 1

where would you assess the capillary refill time on a child?

Answer 1

the sternum, this is more representative than digits which are more affected by temperature changes

Question 2

what are features of moderate respiratory distress in infants?

Answer 2

tachycardia, RR>50, nasal flaring, grunting, use of accessory muscles, inter/sub costal recessions, head bobbing, poor feeding

Question 3

what are features of severe respiratory distress?

Answer 3

cyanosis, exhaustion, reduced conscious level, saturation <92% despite O2 therapy, rising partial pressure of CO2

Question 4

what supportive therapy can be given in respiratory distress?

Answer 4

supplementary O2, non-invasive respiratory support (CPAP or BiPAP), invasive ventilation

Question 5

How can the causes of shock be categorised?

Answer 5

hypovolaemic, maldistribution of fluid, cardiogenic, neurogenic

Question 5

What are some clinical features of shock?

Answer 5

sunken fontanelle, tachycardia, tachypnoea, reduced skin turgor, reduced urine output, cold extremities, hypotension, pale/mottled skin, prolonged cap refill

Question 6

what are some late signs of shock (decompensated)?

Answer 6

acidotic breathing, bradycardia, confusion, blue peripheries, no urine output, hypotension

Question 7

what amount of fluid bolus would be given to a child in shock?

Answer 7

10ml/kg

Question 8

In children which of falling systolic blood pressure or tachycardia is an earlier indicator of shock?

Answer 8

tachycardia
blood pressure is a late sign of decompensated shock in children