Paediatrics - Queensland Health - Queensland Government

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Respiratory problems 3. Clinical assessment • Obtain complete patient history of particular importance is: - - a history of URTI symptoms in a child that is basically well - - history of chest conditions such as asthma, pneumonia - - if wheeze is present - - if child has stopped breathing (apnoea) for short periods of time -- how well is the child / infant feeding • • Perform standard clinical observations + O saturation 2 Perform physical examination: - - inspect for signs of respiratory distress (grunting, nasal flaring, sternal and / or intercostal / subcostal recession) - - inspect middle ear - - inspect for cyanosis (lips, tongue, extremities) present in severe cases - - auscultate chest for presence of wheezes / crackles 4. Management • Consult MO who will consider treating similar to: -- acute asthma, if wheeze is prominent, however in infants bronchodilators are unlikely to be effective -- pneumonia, if fever and rapid breathing is prominent -- O if SpO < 95% 2 2 • If child / infant is not feeding well, fluids may be required NG or IV 5. Follow up Patients who are not evacuated / hospitalised should be reviewed daily Consult MO if the patient is not improving 6. Referral / consultation Consult MO on all occasions bronchiolitis is suspected 568 Controlled copy V1.0 Pneumonia - child Recommend If baby < 3 months of age contact MO immediately Severe dehydration is unusual in pneumonia unless there are abnormal fluid losses from frequent diarrhoea or vomiting Background Children with co-existent illnesses are more at risk. Examples are bronchiolitis and chronic lung disease e.g. due to prematurity Related topics Upper respiratory tract infection - child Immunisation program Bronchiolitis 1. May present with • Cough dry or with sputum, fever, tachycardia • Rapid breathing, nasal flaring, grunting respirations and chest recession in infants, cyanosis, apnoea in infants Primary Clinical Care Manual 2011
Child < 3 months Contact MO immediately Resps ≥40 / min and / or recession grunting apnoea cyanosis Resps
Page 1 and 2: Section 6 Paediatrics
Page 3 and 4: Paediatric presentation History and
Page 5 and 6: Paediatric presentation Presentatio
Page 7 and 8: Paediatric presentation Standard cl
Page 9 and 10: Paediatric presentation Physical ex
Page 11 and 12: Child with fever Fever is usually a
Page 13 and 14: Child with stridor Stridor is a har
Page 15 and 16: Any history of significant trauma?
Page 17 and 18: Meningitis Meningitis Recommend Co
Page 19 and 20: 6. Referral / consultation Consult
Page 21 and 22: Respiratory problems • For the ch
Page 23 and 24: Respiratory problems 1. May present
Page 25: Respiratory problems 4. Management
Page 29 and 30: Immune complications Acute post st
Page 31 and 32: Immune complications Schedule 4 Ben
Page 33 and 34: Immune complications Acute rheumat
Page 35 and 36: Immune complications Australian gui
Page 37 and 38: presence of RHD Place person on Re
Page 39 and 40: Ear problems • Clean the ear usin
Page 41 and 42: Ear problems Acute otitis media (A
Page 43 and 44: Ear problems Schedule 4 Roxithromyc
Page 45 and 46: Ear problems 4. Management • Give
Page 47 and 48: See Simple analgesia back cover Ear
Page 49 and 50: Ear problems 6. Referral / consulta
Page 51 and 52: Ear problems 5. Follow up Children
Page 53 and 54: Ear problems Ear discharge in the p
Page 55 and 56: Ear problems 4. Management • Cons
Page 57 and 58: Ear problems Schedule 4 Flumethason
Page 59 and 60: Ear problems Foreign body / insect
Page 61 and 62: Gastrointestinal problems Acute gas
Page 63 and 64: Gastrointestinal problems 4. Manage
Page 65 and 66: Gastrointestinal problems • Bottl
Page 67 and 68: Gastrointestinal problems Nutrition
Page 69 and 70: 5. Follow up Review 1 - 2 days aft
Page 71 and 72: Gastrointestinal problems Intestin
Page 73 and 74: Gastrointestinal problems Schedule
Page 75 and 76: Gastrointestinal problems 4. Manage
Page 77 and 78:
Gastrointestinal problems Intussusc
Page 79 and 80:
Gastrointestinal problems • Perfo
Page 81 and 82:
Gastrointestinal problems Backgroun
Page 83 and 84:
Schedule 2 Folic Acid Gastrointesti
Page 85 and 86:
Urinary tract problems References 1
Page 87 and 88:
Urinary tract problems ○ where no
Page 89 and 90:
Bone and joint problems 3. Clinical
Page 91 and 92:
Abuse and neglect 2. Immediate mana
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Paediatrics - Queensland Health - Queensland Government

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