TM 5534:03 Study Guide - Final Guide: Hemoptysis, Perineum, Viral Load
Document Summary
Tropical paediatrics notes: assess a sick child and using an understanding of pathophysiology develop a management plan for shock. Assess a sick child intravascular volume in a child 80ml/kg (circulating blood volume) loss of 5% of intravascular volume start to experience symptoms/signs of dehydration: oliguria loss of 10% signs of shock confusion/mentally obtunded, unconscious. Dehydration signs and symptoms (5% or worse dehydration): conscious state (most useful) reduced cap refill time (most useful) reduced skin tugor tachypnoea, no urination for 6 or more hrs, sunken fontanelle, sunken eyes, dry mucous membranes. Risk factors: history of measles in past 6 months. If severely shocked, resuscitate (loss of >10% of intravascular volume with decreased cardiac output) Iv or intraosseous line replacement: give a bolus of n. saline 20ml/kg stat (if no peripheral pulse) or over 15 minutes (if there is a pulse but it is thready) If you have given 2 x 20ml/kg, that is 50% of their intravascular volume.
