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Recognition of the seriously ill child

Recognition of the seriously ill child. Recognition of the seriously ill child Objectives. To understand the structured approach to recognition of the seriously ill child To learn a rapid clinical assessment sequence to identify serious illness in a child.

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Recognition of the seriously ill child

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  1. Recognition of the seriously ill child

  2. Recognition of the seriously ill childObjectives • To understand the structured approach to recognition of the seriously ill child • To learn a rapid clinical assessment sequence to identify serious illness in a child

  3. Commonest causes of death in childhood (England and Wales) 2002

  4. Cardiac Arrest in ChildrenAetiologies

  5. Recognition of serious illness • Potential respiratory failure • Potential circulatory failure • Potential central neurological failure

  6. Potential Respiratory Failure

  7. Effort of Breathing • Accessory muscle use • Grunting • Alar nasae flaring • Child’s position • feeding

  8. Effort of Breathing

  9. Effort of Breathing

  10. Effort of Breathing: associated sounds • Inspiratory stridor • upper airway pathology • Expiratory wheeze • lower airway pathology

  11. Effort of breathing EXHAUSTION IS A PRE-TERMINAL SIGN

  12. Potential respiratory failure

  13. Efficacy of Breathing • Chest expansion • Air entry • Pulse oximetry

  14. Efficacy of breathing A SILENT CHEST IS A PRE-TERMINAL SIGN

  15. Potential Respiratory Failure

  16. Effects of Respiratory Inadequacy • Heart rate • Skin colour • Mental status

  17. Effects of RespiratoryInadequacy CENTRAL CYANOSIS IS A PRE-TERMINAL SIGN

  18. Potential Circulatory FailureEarly recognition of shock

  19. Cardiovascular Signs • Heart rate • Capillary refill time • Blood Pressure

  20. Cardiovascular signsCapillary refill

  21. Cardiovascular signsCapillary refill

  22. Potential Circulatory FailureEarly recognition of shock

  23. Effects of circulatory inadequacy • Respiratory rate • Skin temperature / colour • Mental status

  24. Cardiovascular signs HYPOTENSION IS A PRE-TERMINAL SIGN BRADYCARDIA IS A PRE-TERMINAL SIGN

  25. Potential Central Neurological Failure

  26. Potential Central Neurological Failure

  27. Potential Central Neurological Failure

  28. Potential Central Neurological FailurePostures Decorticate posture

  29. Potential Central Neurological FailurePostures Decerebrate posture

  30. Potential Central Neurological Failure

  31. Exposure • Bleeding • Rashes • Swelling • Temperature

  32. Recognition of the seriously ill child Any questions ?

  33. Airway & breathing effort efficacy Effects Disability Conscious level Posture Pupils Circulation heart rate capillary refill blood pressure skin temperature Exposure SummaryRapid assessment

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