12.08.29 Ward round notes

Assessing breathing in a child

    • Effort

      • Head bobbing indicates accessory muscles

      • Grunting

      • Nasal flaring

      • Recession

    • Efficacy

      • Colour

      • Sats

    • Effect

      • CVS (tachcardia)

      • Neuro (decreased consciousness)



    • Collapse or closure of alveoli resulting in reduced or absent gas exchange

    • May affect part or all of one lung

    • It is a condition where the alveoli are deflated, as distinct from pulmonary consolidation

Febrile neutropenia in an infant

    • Extremely serious

      • Neutrophils >2 => Probably OK, but give antibiotics

      • Neutrophils <1 => Definitely admit and treat aggressively

    • Treat with tazocin (piperacillin + tazobactam) and gentamycin

    • Beware introducing infections through Portacath

Erythema toxicum neonatorum

    • Common rash in neonates

      • Appears in up to half of newborns carried to term, usually between day 2-5 after birth

    • Characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules

      • Lesions may be few or numerous

    • The eruption typically resolves within a few days

Random notes

    • A crying dehydrated child might make no tears

    • Measure CRT centrally (sternum) as well as peripherally