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35 Cards in this Set
- Front
- Back
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Upper Airway Obstruction/Stridor Differentials |
Croup Epiglottitis tracheitis Inhailed foreign body anaphylaxis airway abscess congenital |
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Assessment for airway |
effort: accessory muscles, nasal flaring, tracheal tug, grunting efficacy: chest wall movement, tidal volume, CO2 effect: hypoventilation (obtundation, bradycardia) |
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Croup Score |
0-2 breath sounds stridor cough nasal flare/chest recesssion cyanosis >4 Hdu >7 intubation |
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Autism features |
social deficit restrictive and repetitive behaviours early childhood limitation of function not intellectual or global delay (language, temper, imagination, social anxiety) |
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autism management issues |
assessment (notification, planning, parents, limit exam) admission process (community based, minimise fasting, keep rituals, comfort items, lighting, premed, avoid restraint) communication (child and parent, staff awareness) |
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fasting in children |
food >6 hrs formula > 4 breast > 3 clear fluids > 2 |
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definition of neonatal apnoea |
cessation of breathing for >20s
OR <20s withHR drop by >30bpm Desaturation <85% for 5s |
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risk factors for apnoea of prematurity |
PGA <56 wks (1% apnoea risk) Previous apnoeas Anaemia protective (small for gestation) |
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diseases of prematurity |
apnoeas respiratory distress and BPD PDA intraventricular haemorrhage retinopathy of prematurity decreased global renal function anaemia necrotising enterocolotis |
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signs of severe dehydration |
>7% skin: delayed CRT >3s, mottled, tissue turgor circulation: hypotension respiratory: bradypnoea neurological: altered GCS |
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estimated ongoing losses |
insensible 2-5ml/kg/hr small open wound 5-10ml/kg/hr large cavity open 10-15ml/kg/hr |
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Gross Motor Function Classification (Cerebral Palsy) |
1 - unassisted mobilisation, able to run/jump 2 - stabilisation for stairs, minimal run/jump 3 - unassisted sitting, wheelchair for long distance 4 - supported sitting, wheelchair dependent 5 - minimal trunk and motor control |
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Cerebral Palsy Features |
Neurological - spasticity, dyskinesia, ataxia, seizures, intellect Respiratory - chronic lung disease, aspiration, scoliosis Muscoskeletal - contraction, spasm, osteopenia, wasting, poor ex tol, hypothermia, Iv access Gut - drooling, dental, reflux, constipation GU - incontinence, latex allergy pain anxiety |
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innocent murmurs of childhood |
still's murmur - musical supine venous hum - disappears on supine and jugular compression pulmonary ejection - left high pitched |
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criteria for investigating murmur |
<1 yr old symptomatic examination (praecordial, loud, non-early systolic, no postural change, abnormal heart sounds) ECG (left axis or LVH) |
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antibiotic prophylaxis for cardiac disease |
oral, respiratory - breach of skin gut and GU - active infection not fully corrected cyanotic disease fully corrected cyanotic disease <6mths bioprosthetic material (valve) transplant with regurgitant valve previous IE |
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down syndrome features |
general - weight and drug dose, venous access, positioning airway - midface hypoplasia, OSA, subglottic stenosis, atlantoaxial instability respiratory - recurrent chest infection cardiac - 40-50% anatomical disease (AVSD) neurological - delay and retardation skeletal - laxity endocrine - obesity and hypothyroid gut - reflux immune - decreased immunity |
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risk for emergence delirium |
patient - age 2-5. anxiety procedure - short, painful, head and neck, eye anaesthesia - volatile, rapid emergence |
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foetal shunts and saturations |
SVC (30) right ventricle PFO (60) descending aorta and PDA (55) |
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neonatal resuscitation |
1. suction if meconium and non-vigorous 2. ventilation if HR <100 and no effort (air), CPAP if distress 3. CPR if HR <60 (3:1, 90bpm, 100%O2) 4. additional fluids, adrenaline |
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neonatal sats |
3 mins > 70 5 mins > 80 |
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preterm resus |
do not dry (glad wrap) 30% O2 small equipment (mask, ETT, laryngoscope) PIP 20cmH2O |
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paediatric ETT |
age/4 + 4 (uncuffed) age/4 + 3 (cuffed) oral depth size x3 nasal depth size x4 or age/2+12 (after 4 years) |
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neonatal ETT |
size gestational age (wks) /10 depth weight (kg) + 6 |
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cuffed vs uncuffed |
+ ventilation low flow FGF decreased aspiration monitoring - smaller expensive cuff pressure, cuff monitoring no murphy eye less historical safety |
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pyloric stenosis electrolytes |
hypovolaemia - gastric loss
hyponatraemia - gastric loss, renal loss from excessive HCO3 delivery distal tubule hypochloraemia - gastric loss hypokalaemia - gastric loss, renal loss to conserve sodium (aldosterone) alkalosis - gastric H+ loss, aciduria from Na conservation urinary chloride >20 best indicator of normovolaemia (as sodium is lost with HCO3 even in hypovolaemia) last to correct if alkalosis is present |
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associations of omphalacele/exomphalos |
trisomy 21 beckwith wiedemann gut malformations cardiac malformation |
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parkland formula |
4ml/kg/hr x % area FT burn = 24hrs half in 8 hrs, half in next 16 add maintenance aim UO >0.5ml/kg/hr |
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burns issues |
airway compromise fasting and nutrition fluids and blood loss adrenaline temperature IV access analgesia Suxamethonium |
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differences in PALS |
airway anatomy respiratory rate and physiology BP target depends on age CPR 15:2 adrenaline 10mcg/kg Rarely needed shock 4J/kg amiodarone 5mg/kg |
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APGAR |
appearance - central cyanosis, peripheral cyanosis, pink pulse - none, <100, >100 grimace - none, stimulation, cough or cry activity - none, poor, resistant respiration - non, gasping, vigorous |
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CRIES scale |
neonates crying requiring oxygen increased vitals expression sleepiness |
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FLACC scale |
infants to toddlers face legs arms crying consolability |
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risk factors for perioperative respiratory complications |
patient young age passive smoking recent URTI <6wks asthma or atopy reflux ex prem surgical ENT general surgery anaesthesia light anaesthesia vocal cord irritation junior staff medications ketamine, thiopentone, desflurane |
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VACTRL |
vertebral anorectal cardiac tracheo-oeophageal renal limbs |
