Burn injuries
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This document provides information about burn injuries, including prevention, first aid, and emergency care. It discusses common causes of burns like cooking and smoking, and recommends precautions like never leaving cooking unattended. For first aid of burns, it advises stopping the burning by smothering flames, removing clothing, and applying cold compresses. Significant burns require emergency care and fluid resuscitation based on the Parkland formula to replace lost fluids. The document also covers burn classifications and charts for determining percentage of total body surface area burned.
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Urea cycle defects
Urea cycle disorders result from defects in the metabolic pathway that converts nitrogen into urea for excretion. Symptoms range from hyperammonemia in newborns to neurological issues in older patients. Diagnosis involves measuring elevated ammonia levels and testing for specific enzyme deficiencies. Treatment focuses on reducing ammonia through dialysis, nitrogen scavengers, and dietary protein restriction, as well as replacing deficient cycle intermediates. Long term management centers on minimizing nitrogen intake and promoting alternative excretion routes to prevent hyperammonemic crises.
Transfusion of blood products
This document provides guidelines for transfusing various blood products including red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. It outlines the hemoglobin and platelet count thresholds for when transfusion is indicated for different patient populations and clinical situations. It also provides dosage calculation formulas and administration rate guidelines for transfusing these products safely. Special transfusion indications are discussed, such as using irradiated or CMV-negative products for immunocompromised patients.
Rsv bronchiolitis ppt
RSV bronchiolitis is a common lower respiratory tract infection in infants under 2 years old, characterized by wheezing. It is most often caused by the RSV virus. RSV spreads easily among children and causes seasonal epidemics in the winter. Symptoms range from mild to severe and include rhinorrhea, cough, wheezing and respiratory distress. Treatment focuses on supportive care and oxygen supplementation for severe or hypoxic cases. While most cases resolve without long term effects, some children may develop recurrent wheezing or asthma.
Pneumonia
This document discusses various types and causes of pneumonia in children. It describes the differences between lobar pneumonia, bronchopneumonia, and interstitial pneumonitis. Common infectious causes include respiratory viruses in young children and Streptococcus pneumoniae and Mycoplasma pneumoniae in older children. Clinical features, investigations, treatment, and prognosis are outlined. Pneumonia is a major cause of illness and death in developing countries. Immunizations have reduced cases of pneumonia from certain pathogens.
Croup
Croup is an inflammation of the larynx and trachea most commonly caused by parainfluenza virus. It presents with inspiratory stridor, barking cough, and hoarseness in children ages 6 months to 3 years. The Westley Croup Score is used to evaluate severity, and treatment depends on score but may include dexamethasone, nebulized epinephrine, and hospitalization for severe cases. Differential diagnoses include epiglottitis, bacterial tracheitis, retropharyngeal abscess, and foreign body aspiration.
Nutrition
This document discusses nutrition for infants and children. It covers basic caloric needs determined by weight, the introduction of solids beginning around 6 months, and vitamins and minerals important for growth and development. Breastmilk is outlined as the best source of nutrition for infants, providing antibodies, fats and proper nutrients for development. The risks and symptoms of deficiencies for various vitamins like A, B12, folate, C, and D are also summarized.
Approach to cxr
The document provides guidance on approaching and interpreting chest x-rays (CXR). It outlines steps to check the name, date and quality of the film, systematically scan the CXR looking for abnormalities, and determine if the lungs appear too white or black. Specific signs are described to help localize abnormalities, including the cardiac silhouette sign and pleural effusion signs. Examples are given of respiratory distress syndrome, tetralogy of fallot, transposition of great arteries, and total anomalous pulmonary venous return. The take home message is to summarize positive findings, compare to prior CXRs if available, and confirm findings with a radiologist.
Acute gastroenteritis
Acute Gastroenteritis is a major cause of morbidity and hospitalization in children. It is commonly caused by viruses like rotavirus in infants and norovirus in older children. Rotavirus causes severe dehydrating diarrhea primarily in children 6 months to 2 years of age during winter months. Diagnosis involves detection of virus or antigens in stool samples. Treatment focuses on rehydration and preventing complications through oral rehydration solutions and zinc supplementation in young children. Antibiotics are generally not needed unless a specific bacterial cause is identified. Vaccines have proven effective in preventing rotavirus infections.
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- 5. Burn Care ◂ Prevention ◂ First Aid ◂ Emergency care
- 6. Prevention
- 7. Prevention ◂ Cooking is a major cause of fire… so: ◂ Never leave it unattended ◂ If deep frying use equipment with a thermostat ◂ Make sure all appliances are turned off after use
- 8. Prevention ◂ Smoking: ◂ Never smoke in bed you could fall asleep ◂ Use a proper ashtray ◂ Never empty the ashtray into the rubbish bin before going to bed
- 9. Prevention ◂ Candles: ◂ Never leave them unattended ◂ Do not place them too close to curtains ◂ Ensure they are fully put before leaving the house or going to bed
- 10. Prevention ◂ Electric: ◂ Do not overload sockets ◂ Avoid buying uncertified/cheap electric goods ◂ Turn off appliances at night ◂ Call on electrician if fuses continually trip or electric wires look damaged
- 11. Prevention ◂ Arson: ◂ You are four times more likely to die in a fire if you do not have smoke alarm that works ◂ Close doors at night to prevent smoke traveling through your home.
- 12. First Aid Measures ◂ Extinguish flames by rolling the child on the ground; cover the child with a blanket, coat, or carpet. ◂ After determining that the airway is patent, remove smoldering clothing or clothing saturated with hot liquid. Jewelry, particularly rings and bracelets, should be removed or cut away to prevent constriction and vascular compromise during the edema phase in the 1st 24-72 hr after burn injury.
- 13. First Aid Measures ◂ In cases of chemical injury, brush off any remaining chemical, if powdered or solid; then use copious irrigation or wash the affected area with water. Call the local poison control center for the neutralizing agent to treat a chemical ingestion.
- 14. First Aid Measures ◂ Cover the burned area with clean, dry sheeting and apply cold (not iced) wet compresses to small injuries. Significant large-burn injury (>15% of BSA) decreases body temperature control and contraindicates the use of cold compresses. ◂ If the burn is caused by hot tar, use mineral oil to remove the tar. ◂ Administer analgesic medications.
- 15. Emergency Care
- 20. Rule of Nines
- 21. Fluid Resuscitation ◂ Parkland Formula ◂ 4 ml x %BSA x weight (kg) ◂ ½ over 8 hours – lag time ◂ ½ over 16 hours
Editor's Notes
- The National Fire Protection Association (NFPA) recommends replacing smoke detector batteries annually and the smoke detector alarm every 10 yr (or earlier, if indicated on the device)
- https://www.stjohn.org.nz/First-Aid/First-Aid-Library/Burns/
- Parkland formula is an appropriate starting guideline for fluid resuscitation (4 mL lactated Ringer solution/kg/% BSA burned). Half of the fluid is given over the 1st 8 hr, calculated from the time of onset of injury; the remaining fluid is given at an even rate over the next 16 hr
- The first 8 hours are calculated from the time of injury, meaning if a patient presents 2 hours (lag time) after the injury the fluids will be given over 6 hours