Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
9 Cards in this Set
- Front
- Back
|
Definition... |
More common in boys, ARM is present when either the anus is not present or the bowel opens in the wrong position in the perineum via a fistula. |
|
|
Signs and Symptoms... |
Abnormal looking perimeum, delayed or no passage of meconium, abdominal distension, bilious vomit, drooling of saliva if coexisting with oesophangeal atresia. |
|
|
Examination... |
Full examination looking for dysmorphic features, cardiac abnormalities, limb abnormalities, abdominal distension, absence of anus, abnormal positioning of bowel opening. |
|
|
Caution... |
Presence of meconium in the nappy does not exclude ARM as passage can be via a fistula. Clean perineum to establish if there is a normally sited anus. |
|
|
Management Step 1... |
Call for help. |
|
|
Step 2... |
Keep nil by mouth and insert NGT, aspirating 4hourly leaving on free drainage connected to a bile bag. |
|
|
Step 3... |
IV Cannulation, Bloods for FBC, U&E, glucose and blood cultures. IV fluids, IV broad spectrum abx, Vit K and pre-transfusion blood spot. |
|
|
Step 4... |
Chest X Ray - NGT siting, vertebral and cardiac abnormalities. Abdo X Ray - Dilated bowel and vertebral abnormalities. |
|
|
Step 5... |
Take photographs, document, datex, debrief, refer and transfer to surgical unit. |
