100 Cases in Paediatrics by Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph

By Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker

The hot version of this best-selling identify from the preferred a hundred situations sequence explores universal paediatric eventualities that may be encountered via the clinical scholar and junior health professional in the course of functional education at the ward, within the emergency division, in outpatient clinics and in the neighborhood, and that are prone to function in qualifying examinations. The ebook covers a finished diversity of shows from cough to constipation, geared up by way of sub-specialty region for ease of reference. accomplished solutions spotlight key take domestic issues from each one case and supply sensible suggestion on how one can take care of the demanding situations that ensue while working towards paediatric medication in any respect degrees.

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The Apgar scores were 7 at 1 min and 8 at 5 min. Examination The baby is not dysmorphic. 6ЊC and his central capillary refill time is 2 s. His lips, tongue and extremities are cyanosed. He is crying normally and has no signs of increased respiratory effort. Heart rate is 160 beats/min, femoral pulses are palpable, heart sounds are normal and no murmur is audible. Oxygen saturation is 70 per cent in air and does not rise with facial oxygen, which has been administered by the midwife. There is no hepatosplenomegaly.

This is common in all age groups but particularly in teenagers with their growing independence and risk-taking behaviour. Signs of impending respiratory failure • • • • • • • • • Exhaustion (this is a clinical impression) Unable to speak or complete sentences Colour – cyanosis Ϯ pallor Hypoxia despite high-flow humidified oxygen Restlessness and agitation are signs of hypoxia, especially in small children Silent chest – so little air entry that no wheeze is audible Tachycardia Drowsiness Peak expiratory flow rate (PEFR) persistently Ͻ30 per cent of predicted for height (tables are available) or personal best.

N. Examination Bradley is sitting up in bed with a nebulizer in progress containing 5 mg salbutamol. His oxygen saturation on 15 L of oxygen on arrival is documented as 89 per cent. He is quiet but able to answer questions with short sentences. His chest is hyperinflated (increased anteroposterior diameter) and he is using his accessory muscles of respiration. His respiratory rate is 60 breaths/min and he has marked tracheal tug with intercostal and subcostal recession. On auscultation there is equal but poor air entry with widespread expiratory wheeze.

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