BIOMED
Pathophysiology
Everything be alphabetical here (except for Homeostasis at the bottom) 😘
(& Mental Health, Lmao)
There are a lot of neonatal conditions covered, seen in high level NICU/NCCU Units.
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Table of Contents:
1 | Ageing
2 | Canc...
☞ Use AVPU to assess child level of consciousness ☞ Manage initial pharmacological management of a seizing patient ☞ Identify appropriate airway management techniques
Seizures Uncontrolled electrical activity in brain causing temporary abnormalities in muscle tone, behaviours, sensations, or states of awareness.
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Neurological Assessment
Blood Glucose ☞ children with seizures and/or ↓ level of consciousness need BGL checked to rule out hypoglycaemia as a cause of deterioration.
Posturing ☞ abnormal flex ion (decorticate) or extension (decerebrate) in response to central stimulation indicates serious neurological dysfunction and requires immediate attention and intervention.
Pupil Response ☞ fixed, dilated or unequal pupils indicate severe neurological state and emergency intervention is required. May be indicative of ↑ intracranial pressure (ICP).
Fontanelle ☞ gentle palpating of fontanelle, looking for bulging, full or tense fontanelle exhibits that may indicate raised ICP and thus requires immediate attention.
Seizure Management First 5 minutes: supportive care in lateral position. Most will stop without further mediations.
Supportive care: Patient airway, protecting patient and self from harm/injury.
Pharmacological management if >5mins.
May need to support with oxygen and suction.
Documentation and planning.
Should the patient stop breathing with other observations in tact:
☞ apply supplemental oxygen +/- bag and mask support if the respiratory effect is not adequate,
☞ use a nasopharyngeal airway if struggling to maintain airway patently, and
☞ perform a jaw-thrust to open the airway.
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The nasopharyngeal airway is the preferred airway in patients with seizures as there is a high chance they will have trismus (spasm of jaw muscles causing it to stay tightly closed).
Nasopharyngeal airway (NPA):
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Oropharyngeal airway:
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ABCD Assessment of breathing and airway is required after administration of benzodiazepines.
☞ inspect for visible obstruction ☞ clear airway with suction if required ☞ open airway with head-tilt/chin lift/jaw thrust as appropriate ☞ use airway adjuncts to support airway if none of the above work
