L3 Unwell Infant Child V8 November 2022 PDF
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Uploaded by IntelligibleOmaha
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2022
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Summary
This document covers the management of unwell infants and children, including various childhood illnesses and emergencies, such as asthma, bronchiolitis, and pneumonia. It also provides information on signs, symptoms, and treatments for these conditions, as well as specific considerations for different age groups.
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Management of Newborns, Infants and Children – Component 10 Unwell Children & Infants ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Objectives Be able to recognise a seriously ill child & baby...
Management of Newborns, Infants and Children – Component 10 Unwell Children & Infants ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Objectives Be able to recognise a seriously ill child & baby Be able to assist the clinician in the management of seriously ill children and babies ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Anatomical and Physiological Differences Little children have very big heads, an infant head is already 2/3 the size it will be in adulthood. Large tongue Small nostrils and nasal breather up to 6 months which can cause serious respiratory distress if the nostrils fill with mucus Loose teeth can be a cause of a foreign body obstruction in the airway, especially as the infant/child airway is much smaller than that of an adult. ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Airway differences: – Large prominent (occiput) – Small face – Narrow nostrils opening of the nostrils 5 with recession, this is a sign during laboured inspiration. of serious respiratory compromise. ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 P.A.T. - Circulation to Skin Colour – Pallor (white or pale skin, indicates shunting of blood away from the skin) – Cyanosis (blue discolouration of skin caused by inadequate oxygenation) NOTE: Cyanosis in – Mottling (abnormal vessel tone in hands and feet may be capillary bed, causing patchy areas normal under 2 months of pallor & cyanosis) of age or when exposed to a cold environment. ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Paediatric Primary Survey Airway Breathing – Check Page for Age Circulation , Pulse, Cap refill, Skin warmth– Check Page for Age Disability – AVPU – Pupils – Blood sugar Expose Frequently reassess Should take < 2 minutes ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Signs of Deterioration Increasing work of breathing (recession, RR ) Cyanosis Bradycardia (pre-terminal sign in a sick child) Altered mental status / drowsiness Hypo / hypertonia Dehydration / signs of shock Hypoglycaemia ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 LAS policy on conveyance of paediatrics ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Respiratory Illness and Emergencies Childhood respiratory illnesses and emergencies are common and usually self limiting Tachypnoea is a feature in all They include: respiratory illness – Asthma – Bronchiolitis – URTIs – LRTIs / Pneumonia – Croup – Epiglottitis ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Asthma Acute inflammation of the airways – wheeze, mucus plugging, hypoxia, dehydration Asthma is very rare under 5 years Hypotension >110 in adults Respiratory Rate: Respiratory Rate: Exhaustion ≤40/min ages 2-5 years >40/min ages 2-5 years ≤30/min aged >5 years >30/min aged >5 years Abnormal PaC0₂ >25/min in adults (Normal range 4.6-6.0kPA) ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Bronchiolitis Inflammation of the bronchioles Acute, self limiting infection usually caused by respiratory syncytial virus (RSV) Predominantly in autumn and winter Coryzal baby (peak age 2-5 months) and first wheezy episode Worse in the first 72 hours before improving Other household members may also have similar features ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Signs and Symptoms Reduced SP02 Increased RR Recession Irregular breathing Inspiratory crackles Expiratory wheeze Low grade fever Possible apnoea ©Department of Clinical Education & Standards Unwell Infant and Child - Component 10 Bronchiolitis Management DR ABCDE (time critical correct A&B then transport) Aim of treatment is to provide respiratory support and feeding/hydration Give oxygen if saturations are persistently lower than
