Paediatric- Respiratory

Question 1

Upper Airway Obstruction
Partial obstruction- effective cough

Answer 1

Partial obstruction- effective cough
- Encourage cough, utilize gravity, maintain BLS

Question 2

Upper Airway Obstruction
Partial obstruction- ineffective cough

Answer 2

• Utilise gravity, 5 back slaps alternating with 5 chest thrusts
• If unconscious- chest compressions, suction, magil’s forceps, forced ventilation
• If loss of C.O- Mx as per cardiac arrest

Question 3

Upper Airway Obstruction
Suspected epiglottitis
Signs and management

Answer 3

Signs: increased WOB, drooling, absence of cough, low pitched stridor
Management: DO NOT INSPECT AIRWAY, BLS, Tx

Question 4

Behaviour, stridor, RR, accessory muslce use, sp02

Croup
Assessment- Mild

Answer 4

Behaviour: Normal
Stridor: None or only when active
Respiratory rate: Normal
Accessory muscle use: None
Sp02: >96%

Question 5

Behaviour, stridor, RR, accessory muslce use, sp02

Croup
Assessment- Moderate

Answer 5

Behaviour: Intermittent mild agitation
Stridor: Intermittent at rest
Respiratory rate: Increased
Accessory muscle use: Moderate chest wall retraction
Sp02: >96%

Question 6

Behaviour, stridor, RR, accessory muslce use, sp02

Croup
Assessment- Severe

Answer 6

Behaviour: Increasing agitation, drowsiness
Stridor: Persistent at rest or decreasing (late sign)
Respiratory rate: Marked increase or decrease (late sign)
Accessory muscle use: Marked chest wall retraction
Sp02: <96% (late sign)

Question 7

All severities: Minimise distress, keep child with carer where possible

Croup
Management- Mild

Answer 7

• Dexamethasone 150mcg/kg (max 12mg)
• Self care
• Provide factsheet
• Safety net

Question 8

All severities: Minimise distress, keep child with carer where possible

Croup
Management- Moderate

Answer 8

• Dexamethasone 150mcg/kg (max 12mg)
• VED ambulance referral

Question 9

All severities: Minimise distress, keep child with carer where possible

Croup
Management- Severe

Answer 9

• High dose Dexamethasone 600mcg/kg (max 12mg)
• Adrenaline 5mg nebulised at 5 minute intervals until improvement
• Transport

Question 10

Conscious state, WOB, Tachycardia, Speech

Asthma
Assessment- Mild/moderate

Answer 10

Conscious state: Normal
WOB: Some increased WOB
Tachycardia: Tachycardia
Speech: Speaking in phrases/sentences

Question 11

Conscious state, WOB, Tachycardia, Speech

Asthma
Assessment- Severe

Answer 11

Conscious state: Agitated/distressed
WOB: Markedly increased WOB
Tachycardia: Tachycardia
Speech: Speaking in words

Question 12

Conscious state, WOB, Tachycardia, Speech

Asthma
Assessment- Critical

Answer 12

Conscious state: Altered conscious state
WOB: Maximal WOB
Tachycardia: Marked tachycardia
Speech: Unable