Paediatric medications in the Emergency Department.
Which is the correct antibiotic choice for acute meningicoccal disease?
Give IV Ceftriaxone ASAP---if you cannot get an IV then use the IM or IO route.
Cefotaxime dose is 50mg/kg IV. If these are not available then Benzyl Penicillin 60mg/kg IV should be used (Max 2.4 gms).
A 15kg child is having his first tonic clonic seizure. Which of the following is CORRECT?
It is important to check the BSL but Dextrose is not routinely given as a bolus. Diazepam should not be given IM. Phenytoin is still considered a choice for a second line drug along with Levetiracetam (Keppra).
Which of the following Adrenaline doses is the INCORRECT one?
Adrenaline infusion starts at 01 to 1 mic/kg/min.
What is "Alprostanil" (Prostaglandin E1) used for?
Start at 5 to 10 nanograns/kg/min. Can increase up to 50 nanograms/kg/min but usually that is not required. Anticipate possible apnoea and hypotension. Obviously with these doses double and triple check your infusion.
Which of the following was NOT used in paediatric care in the 1980s in Australia?
Racemic adrenaline is a 50:50 mixture of both the L and D isomer of adrenaline. The adrenaline we use now is just a diluted L isomer.
Mrs Winslow's soothing syrup was developed in the USA in 1849 and was widely used to settle babies in Australia from 1860 to 1920. It contained morphine.
For a mildly unwell child with acute otitis media and no "red flags" which antibiotic is correct to be given?
From the RCH guidelines.
When you are starting IV insulin on a child with DKA which of the following is the most appropriate regime?
Start Actrapid at 0.5 to 0.1unit/kg/hour. No bolus. Remember your IV fluids are vital and will bring down the BSL in these dehydrated children.
Lantus is long acting insulin---not appropriate for an infusion.
Which combination of medications is the best for a young child with severe croup?
Again RCH guidelines. Budesonide 2mg nebs can be considered in mild to moderate croup where they will not take Redipred orally.
I want to use Ketamine in the sedation of a child with a lip laceration. Which of the following would be the safest choice?
On balance the slow IV has less side effects like apnoea. For IM Ketamine 8mg/kg is high----use 4mg/kg and add 2mg/kg in 10min time if required.
Generally adding together sedatives increases complication rates.
Which of these 4 famous Australian Olympians did NOT have asthma as a child?
You would think that asthma would hold you back from elite sport but a surprising number of Olympians suffered from asthma as a child and into adulthood.