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Flashcards in Fever Deck (11)
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1
Q

Infectious causes vary depending on 3 criteria

A

1 age of the child < 3/12 much more prone to SBI (low immune fn)
<4/52 12-15% are SBI
2 immunizations status of child ( fully immunized 1% SBI Not fully immunized 5% SBI)
3 geography eg malaria Ross river fever, dengue

2
Q

Difficulties assessing the young child

A

1 lack of localizing signs
2 signs difficult in an irritable Child
3 signs are non specific eg D/V can be Lower lobe pneumonia, meningitis, UTI, meningitis
4 URTI infection does NOT rule out a SBI underlying

3
Q

Signs of toxicity ABCD

A

A alert / arousal level
B breathing grunting increased WOB
C circulation color , capillary refill
D decline in fluids in ( taking <50% of normal fluids)
Fluids out UO <4 wet nappies per day skin turbot , mm
DEFG DONT forget Glucose

4
Q

Children <3/12 with a fever

A

1 don’t localise infection well
2 can appear well / not appear unwell
3 can deteriorate quickly
4 URTI does not rule out SBI

Full examination from top to toe fontaelle 
Face mouth HC rashes 
ENT
LN genitals chest CVS Abdoman
Neuro
Musculoskeletal 
Limping limb movements
5
Q

Investigations in a child <3/12 with a fever

A
FBC and diff
Blood cultures 
Urine MCS
LP proteins glucose cells
For ALL <1/12 
For most 1-2/12
For some 2-3/12 
CXR
6
Q

Febrile child <3/12

A

Admit to hospital
Septic work up
IV antibiotics
Amoxicillin and gentamicin

7
Q

Febrile child <12/12

A
7% have UTI 
Bag urine no use for culture
Nitrate + high Pr of UTI 
<12/12 in/out catherer or Suprapubic aspirate
>12/12 ? Clean catch/
8
Q

When would you consider a CXR in a Febrile child

A

<3/12 no localizing signs
Increased RR / low oxygen stats
Temp>39 no localisng sings
Young children can have penumonia with NO clinical signs TRAP

9
Q

Contraindications to LP

A
1 decreased LOC
2 focal Neuro signs
3 bleeding disorder
4 local infection at site of LP
5 unstable vital signs
10
Q

Indications for empiric use of antibiotics

A

1 febrile neonates and baby <3/12

2 any toxic/severely unwell child

11
Q

GCS in paed

A

Alert to
Voice
Pain
Unresponsive