Related Subjects:Sick Neonate
|APGAR Scoring
|Approach to Assessing Sick Child
|Sick Child with Acute Gastroenteritis
|Sick Child with Respiratory Distress
|Sick child Diabetes Mellitus Type 1 and DKA
Paediatric emergencies
Important Values: Also see Paediatric emergency drug chart |
- High flow oxygen for all
- Adrenaline 1 in 10,000: 10 mcg/kg IV/IO
- Fluid bolus: 0.9% Saline 20 ml/Kg IV/IO consider warmed
- Glucose 10% 2ml/kg IV/IO for hypoglycaemia
- Sodium Bicarbonate 8.4% 1 mmol/kg
- Defibrillation 4 joules/kg
- Compression rate 100-120/min
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About
- Start with ABCDE moving through it quickly
- Give high flow oxygen and consider ventilation if remains hypoxic
- Get pulse oximetry and heart monitoring started and access
Airways and Breathing
- Look listen and feel and smell
- Rash: Meningococcal disease, measles, chickenpox
- Cyanosis, anaemia, trauma, rash - see if it blanches
- Ketones on breath? (Check CBG) DKA or Alcoholic drinks
- Airways obstruction or respiratory distress
- Jaw and neck positioning: Head tilt, chin lift, jaw thrust but immobilize neck if cervical injury suspected
- Oxygen and suctioning and remove any foreign body
- Chest compressions may be needed
- Work of breathing and effort
- Respiratory rate
- Wheeze or stridor
- Auscultate for air entry is it bilateral and equal
- Central cyanosis
Circulation
- Heart rate and pulse volume
- Capillary refill time: prolonged if more than 2 seconds
- Blood pressure
Disability
- Level of consciousness
- Posture: low tone, decorticate, decerebrate
- Pupil size and reactivity. Unilateral Dilated pupil is an ominous sign
Shock
- Hypovolaemia: Often due to dehydration from GI losses, DKA, Blood loss
- Cardiogenic: Arrhythmias, heart failure
- Stridor: Croup/epiglottitis, foreign body, congenital malformations, trauma
- Lung disorders: Asthma, Bronchiolitis, Pneumonia, Pneumothorax
Shock
- Hypovolaemia: Dehydration from GI losses, DKA, Blood loss
- Cardiogenic: Arrhythmias, heart failure
Breathing issues
- Stridor: Croup/epiglottitis, foreign body, congenital malformations, trauma
- Lung disorders: Asthma, Bronchiolitis, Pneumonia, Pneumothorax
Drowsy
- DKA (high CBG) or Hypoglycaemia (Low CBG)
- Post ictal
- Head injury
- Meningitis/Encephalitis
- Inborn errors of metabolism
- Drug or Poison ingestions? naloxone
- Intracranial haemorrhage
Acute Abdomen
- Appendicitis
- Intestinal obstruction
- Perforation and Peritonitis
- Intussusception
- Malrotation, Bowel atresia/stenosis
2015 Resuscitation council
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References
Guidelines Paediatric basic life support 2015