11 The child with decreased conscious level
In children, coma is caused by a diffuse metabolic insult (including cerebral hypoxia and ischaemia) in 95% of cases, and by structural lesions in the remaining 5%. Metabolic disturbances can…
In children, coma is caused by a diffuse metabolic insult (including cerebral hypoxia and ischaemia) in 95% of cases, and by structural lesions in the remaining 5%. Metabolic disturbances can…
Four cardiac arrest rhythms will be discussed in this chapter: 1 Asystole. 2 Pulseless electrical activity (including electromechanical dissociation). 3 Ventricular fibrillation. 4 Pulseless ventricular tachycardia. The four are divided into two groups: two…
Exceptions Increased effort of breathing does not occur in three circumstances: 1 Exhaustion. 2 Central respiratory depression. 3 Neuromuscular disease. Efficacy of breathing: chest expansion/abdominal excursion, breath sounds – reduced or absent, and…
Post-resuscitation investigations Chest radiograph Arterial or central venous blood gasses Haemoglobin, haematocrit and platelets Group and save serum for cross-match Sodium, potassium, calcium, urea and creatinine Clotting screen Blood glucose…
Indications of inhalational injury History of exposure to smoke in a confined space Burns around the mouth and nose Carbonaceous sputum Cough Hoarseness Weak voice Stridor The rapid oedema that…
Normal cerebral blood flow is 50 mL of blood per 100 g of brain tissue per minute. A fall in cerebral perfusion pressure decreases cerebral blood flow. A flow below 20 mL/100 g brain…
Exceptions Increased effort of breathing does not occur in three circumstances: 1 Exhaustion (with imminent respiratory arrest). 2 Central respiratory depression. 3 Neuromuscular disease. Efficacy of breathing: chest expansion/abdominal excursion, breath sounds –…
The child must be stabilised before transfer. Massive, Open, Long Bone Fractures The blood loss from any long bone fractures may be significant; open fractures bleed more than closed ones…