Workup of febrile siezure
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The document discusses the work up and treatment of febrile seizures in infants and children. It recommends performing tests like a CSF analysis if meningitis is suspected and an EEG for atypical febrile seizures. For treatment, it advises providing immediate first aid by staying calm, positioning the child on their side, and removing any objects from their mouth. Measures to lower the fever like cold compresses and antipyretics are also suggested along with treating the underlying cause of fever. Anticonvulsants like intravenous or rectal diazepam may be given.
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The document discusses the assessment and management of febrile children in primary care. It outlines appropriate methods for measuring temperature in children of different ages. Common causes of fever are infections, but also include conditions, convulsions, and external factors. Children are assessed using a "traffic light" system to determine the level of risk (green, amber, red) based on symptoms and history. Management involves antipyretics, hydration, and follow-up care or referral depending on risk level. Specific infections that may cause fever are also mentioned.
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Ffion Davies gives her take on how to spot the sick child in the Emergency Department.
Paediatric medicine is no doubt hard and can at times be scary. There is nothing worse, in Ffion’s opinion, than sending a child home who later represents to the hospital in a worse condition, or even worse, later dies.
So, how does one spot the sick child amongst the droves of children who will present with fever and vomiting.
In this talk, Ffion gives a lesson on how to spot the sick children in the ‘grey’ zone – those that are not clearly sick and not clearly well.
Ffion breaks her thinking into two main areas: physiology and psychology.
Physiology matters. Scrutinising a full set of observations/vitals (in the context of the child’s age) will help avoid the feared crime of discharging a sick child.
Ffion discusses tachypnoea as a prime example of a simple physiological compensation to raise one’s suspicion of serious disease.
Similarly, psychology matters. Ffion talks in depth as to why she considers this to be true.
Talks on Paediatric Emergency Medicine are always popular because Emergency Medicine physicians are insecure about mismanaging a child. Are children precious? Are adults just big children? Therein lies the problem.
Less knowledge, less experience and perhaps less confidence. Compounding this is the complexities of having to deal with the stressed parents when you yourself are stressed because of the situation.
Ffion continues to talk about systems of thinking and decision making. She compares Type 1 thinking which is automatic and instinctive with Type 2 thinking, which is more considered. She explains the risks and benefits of relying more upon Type 2 thinking when considering the sick child in the Emergency Department.
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2) It describes the structured primary survey using ABCDE (airway, breathing, circulation, disability, exposure) to evaluate respiratory, cardiac, and neurological function.
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2. It is important to consider common conditions first, get additional opinions if the patient is not improving, and refer to specialists in a timely manner when needed.
3. Pediatricians must thoroughly assess patients' medical histories and symptoms, as underestimating any complaint can be a pitfall.
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Ffion Davies gives her take on how to spot the sick child in the Emergency Department.
Paediatric medicine is no doubt hard and can at times be scary. There is nothing worse, in Ffion’s opinion, than sending a child home who later represents to the hospital in a worse condition, or even worse, later dies.
So, how does one spot the sick child amongst the droves of children who will present with fever and vomiting.
In this talk, Ffion gives a lesson on how to spot the sick children in the ‘grey’ zone – those that are not clearly sick and not clearly well.
Ffion breaks her thinking into two main areas: physiology and psychology.
Physiology matters. Scrutinising a full set of observations/vitals (in the context of the child’s age) will help avoid the feared crime of discharging a sick child.
Ffion discusses tachypnoea as a prime example of a simple physiological compensation to raise one’s suspicion of serious disease.
Similarly, psychology matters. Ffion talks in depth as to why she considers this to be true.
Talks on Paediatric Emergency Medicine are always popular because Emergency Medicine physicians are insecure about mismanaging a child. Are children precious? Are adults just big children? Therein lies the problem.
Less knowledge, less experience and perhaps less confidence. Compounding this is the complexities of having to deal with the stressed parents when you yourself are stressed because of the situation.
Ffion continues to talk about systems of thinking and decision making. She compares Type 1 thinking which is automatic and instinctive with Type 2 thinking, which is more considered. She explains the risks and benefits of relying more upon Type 2 thinking when considering the sick child in the Emergency Department.
Finally, Ffion concludes by talking about strategies to improve your own management of the paediatric population in the Emergency Department. She discusses improving your knowledge base, using resuscitation aids and checklists and training by using stress inoculation simulations.
For more like this, head to our podcast page. #CodaPodcast
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This document provides information on assessing a sick child, including:
1) It outlines the pediatric assessment triangle (PAT) approach which uses appearance, work of breathing, and circulation to the skin to rapidly identify respiratory or circulatory compromise.
2) It describes the structured primary survey using ABCDE (airway, breathing, circulation, disability, exposure) to evaluate respiratory, cardiac, and neurological function.
3) It presents a case scenario of a 3-month old infant admitted with bronchiolitis who is deteriorating, with increased work of breathing, tachypnea, and low oxygen saturation, requiring immediate intervention.
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Management of late preterm babies
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This document outlines guidelines for neonatal transport, including indications for transfer to a neonatal care unit such as very low birth weight or need for mechanical ventilation. It discusses components of transport such as assessing the need for referral, stabilizing the infant, writing notes, and arranging for a provider to accompany. It emphasizes the importance of communication and family support during transport, ensuring warmth for the infant, and providing care such as checking breathing and feeding during transportation. The overall goal is to safely transfer infants in need of higher level neonatal care to the appropriate facility.
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SNS 2017 - Birth asphyxia and HIE management
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Pediatrics CME 2006
This document provides an overview of pediatric emergency medicine for EMT training. It covers general pediatric assessment techniques, common pediatric emergencies like respiratory issues, seizures, and more. Key points include differences in pediatric airways, treatments for conditions like foreign body airway obstruction, epiglottitis, croup, asthma and more. Normal vital sign ranges are provided by age.
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Birth asphyxia and respiratory distress are common conditions in newborns that can lead to neonatal death if not properly managed. Birth asphyxia is caused by a lack of oxygen during delivery and is diagnosed using the Apgar score and umbilical cord blood pH. Respiratory distress in newborns has pulmonary causes like respiratory distress syndrome or nonpulmonary causes like perinatal asphyxia. Management of both conditions involves providing oxygen, monitoring vital signs, treating infections, and supporting respiratory and cardiovascular functions. Timely identification and treatment can improve prognosis.
Hypothermia
Therapeutic hypothermia involves cooling infants to 33-35°C for 72 hours to reduce brain injury from perinatal asphyxia. Hypothermia aims to slow the secondary phase of cell death that begins 6-24 hours after injury. Several randomized controlled trials found hypothermia reduced death and disability rates compared to normothermia. A meta-analysis of these trials found hypothermia reduced the risk of death or severe disability by 19% and increased the chance of normal neurological outcomes by 53%. Hypothermia is now standard care for infants with moderate to severe hypoxic-ischemic encephalopathy.
Norma Newborn.pptx
The document provides information on assessing the physical characteristics and care needs of a normal newborn. It defines a normal newborn and lists their vital signs, measurements, and characteristics. The assessment examines the skin, head, eyes, chest, heart, abdomen, extremities and reflexes. Care needs include exclusive breastfeeding, immunization, hygiene, and nutrition. Ballard scoring is used to classify newborns by weight, gestation and neuromuscular maturity.
Neonatal seizures
Neonatal seizures can have various causes including perinatal asphyxia, intracranial hemorrhage, metabolic disturbances, infections and developmental defects. Evaluation involves a detailed history, examination, and testing for electrolyte and glucose levels, blood gases, imaging and metabolic screening. Management consists of treating the underlying cause, administering anti-seizure medications like phenobarbital, phenytoin or midazolam, and supportive care. Outcomes range from normal to neurological impairments and mortality, with prognosis depending on factors such as etiology, maturity, and control of seizures.
neonatalresuscitation1-210512085849.pdf
This document outlines the key steps in neonatal resuscitation for newborns requiring assistance to begin breathing or transition to life outside the womb. It discusses factors that may increase the need for resuscitation, important equipment, assessing the newborn using the APGAR score, and the steps of providing warmth, clearing the airway, breathing support, and circulation support like chest compressions and medications if needed. Effective resuscitation in the critical first minute after birth can prevent many newborn deaths from asphyxia globally each year.
Neonatal resuscitation 1
This document outlines the key steps in neonatal resuscitation for newborns requiring assistance to begin breathing or transition to life outside the womb. It discusses factors that may increase the need for resuscitation, important equipment, assessing the newborn using the APGAR score, and the steps of providing warmth, clearing the airway, breathing support, and circulation support like chest compressions or medications if needed. Effective resuscitation in the critical first minute after birth can prevent many newborn deaths from asphyxia globally each year.
REDtrain Parent First Aid- Paediatric First Aid for Parents
The document provides information on first aid for children, including:
1. The main causes of death in children are choking, drowning, poisoning, suffocation, and trauma.
2. When assessing a patient, one should check for danger, response, airway, breathing, and circulation in the primary survey.
3. The paediatric chain of survival includes prevention of arrest, early CPR within 2 minutes if unwitnessed, early activation of emergency services, early advanced life support, and early post-resuscitation care.
Redtrain Parent First Aid - Paediatric First Aid for Parents
Basic two hour Paediatric first aid course for parents of young infants and children to include practicals on CPR, Choking & other traumas &medical emergencies
Febrile convulsion
This document discusses febrile seizures in children. It defines febrile seizures as seizures occurring between 6 months and 5 years of age associated with a fever over 100.4°F. Febrile seizures are classified as simple or complex based on features such as duration, recurrence, and focal onset. They commonly occur in children aged 6 months to 2 years and are associated with infections. While the majority resolve spontaneously, recurrent seizures or those lasting over 30 minutes require medical treatment. Investigations are usually not needed for simple febrile seizures.
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Workup of febrile siezure
- 1. Work up of FEBRILE SEIZURES BY/MOHAMED SHARAF
- 2. Work up of febrile seizure ♦ Before diagnosing febrile seizures in infants and children, performance investigation to be sure that seizures are not caused by something other than simply the fever itself.
- 3. ►CSF analysis: If any doubt exists about the possibility of meningitis, a lumbar puncture with examination of the cerebrospinal fluid (CSF) is indicated, in children ( < 12 mo.&12-18 mo. of age ). ►EEG: is not warranted after a simple febrile seizure but may be useful for atypical febrile seizure (focal neurologic signs or pre-existing neurologic deficits) persist for >15 min. or recurrent >3 times. • Investigation
- 4. • Treatment ▬Immediate first aid measures: stay calm and carefully observe the child.(position) should not be held or restrained during a convulsion, To prevent choking, placed on his side or stomach.(suction) should gently remove all objects in the child's mouth.(mouth piece &O2). ▬Measures to lower the temperature: - cold fomentation -- antipyretic Treatment of the cause of fever: e.g. antibiotics acute tonsillitis▬ Diazepam 0,3 mg/kg/dose/IV:Anticonvulsant▬ or 0,5 mg/kg rectallY