Additional Information
Book Details
Abstract
Children in Intensive Care fulfils a unique role in supporting clinical staff during the day-to-day management of the sick child. Presented in quick reference format, and in plain English, the book offers a unique guide to the wide variety of situations that a practitioner is likely to encounter during daily practice. Rich with reference tables, algorithms, artworks and ‘Alert’ boxes, the book offers a wealth of information which ranges from physiology to drug dosage calculation, drug compatibility lists, reference ranges, and X-ray interpretation. New chapters include oncologic emergencies, pain management and sedation, together with the latest information on the management of sepsis, the collapsed child, and care of the child following spinal surgery.
- Information presented in quick reference format, with accompanying reference tables, to facilitate on-the-spot usage
- Advanced Life Support Group algorithms provide safe and easy-to-follow protocols to the management of emergency situations
- Contains input from a broad range of paediatric specialists – intensivists, anaesthetists, haematologists, oncologists, air ambulance physicians and retrieval nurses, pharmacists, specialist dieticians, and respiratory physiotherapists – to ensure full coverage and accuracy of information
- Contains helpful ‘Quick Guide’ and ‘Warning’ boxes to provide key information at a glance, while helpful mnemonics assist with learning
- Contains chapters on normal child development, safe-guarding children and young people, and patient transport
- Perfect for use on the wards, theatres, high-dependency units and intensive care units as well as during retrieval and A&E
- Ideal for newcomers and experienced staff alike, whether they be junior doctors or nursing staff
- Additional authorship brings the expertise of Marilyn McDougall, a Senior Paediatric Intensive Care Consultant
- Contains brand new chapters - oncology emergencies and pain & sedation - as well as the latest information on topics including sepsis and the collapsed neonate, and care of children after spinal surgery
- Comprehensively expanded cardiac chapter presents new surgical approaches as well as practical tips on pacing, care of chest drains and basic echocardiograph terminology
- Drug chapter now includes reversal agents, new drug profiles and an updated compatibilities chart
- Expanded artwork program explains clinical concepts and practical procedures
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES2 | ||
| CHILDREN IN INTENSIVE CARE | i | ||
| Dedication\r | ii | ||
| CHILDREN IN INTENSIVE CARE: A Survival Guide | iii | ||
| Copyright | iv | ||
| CONTENTS | v | ||
| FOREWORD | ix | ||
| PREFACE | xi | ||
| ACKNOWLEDGEMENTS | xiii | ||
| 1 - ALL ABOUT RESUSCITATION | 1 | ||
| CARDIOPULMONARY ASSESSMENT | 1 | ||
| Airway | 1 | ||
| Breathing | 1 | ||
| Circulation | 1 | ||
| THE INITIAL APPROACH TO BASIC LIFE SUPPORT AND LIFE SUPPORT ALGORITHMS (ALSG 2016) | 2 | ||
| Nonshockable rhythm – asystole/pulseless electrical activity (See Fig. 1.3 for management) (ALSG 2016) | 2 | ||
| Shockable rhythm (ventricular fibrillation/pulseless ventricular tachycardia) | 6 | ||
| EARLY TREATMENT OF VENTRICULAR TACHYCARDIA (WITH PULSE) ALGORITHM (ALSG 2016) | 8 | ||
| Resuscitation drug doses – cardiac arrest | 8 | ||
| Emergency antiarrhythmic drugs | 10 | ||
| INTRAOSSEOUS ACCESS | 11 | ||
| Advantages of intraosseous access | 11 | ||
| Contraindications | 11 | ||
| Guidelines on the insertion of an intraosseous needle in the proximal tibia | 11 | ||
| Sinus tachycardia or supraventricular tachycardia (ALSG 2016) | 12 | ||
| Vagal manoeuvres | 12 | ||
| USE OF THE DEFIBRILLATOR | 12 | ||
| Defibrillation | 13 | ||
| Synchronised cardioversion | 14 | ||
| Choice of pads or paddle | 14 | ||
| Defibrillation pads | 14 | ||
| SHOCK | 14 | ||
| Compensated shock | 16 | ||
| Decompensated shock | 18 | ||
| Management of shock | 18 | ||
| USEFUL MNEMONICS | 18 | ||
| NEWBORN RESUSCITATION | 18 | ||
| MANAGEMENT OF A BLOCKED TRACHEOSTOMY | 20 | ||
| NEEDLE THORACOCENTESIS | 20 | ||
| MANAGEMENT OF ANAPHYLAXIS | 20 | ||
| Dose of intramuscular adrenaline for acute anaphylaxis | 22 | ||
| Management of hyperkalaemia | 25 | ||
| REFERENCES | 26 | ||
| 2 - AIRWAY AND BREATHING | 29 | ||
| UPPER RESPIRATORY TRACT | 31 | ||
| Precautions and action in upper airway obstruction | 31 | ||
| Causes of airway obstruction (stridor) | 31 | ||
| Croup (laryngotracheobronchitis) | 32 | ||
| Epiglottitis | 33 | ||
| Foreign-body aspiration | 33 | ||
| Bacterial tracheitis | 33 | ||
| LOWER RESPIRATORY TRACT | 33 | ||
| Bronchiolitis | 34 | ||
| CLINICAL PRESENTATION | 34 | ||
| PNEUMONIA | 35 | ||
| PAEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME | 36 | ||
| Management of severe asthma | 39 | ||
| MANAGEMENT OF ASTHMA | 39 | ||
| CRITERIA FOR INTUBATION (PHIPPS & GARRARD 2003; ALSG 2016) | 41 | ||
| STRATEGIES FOR VENTILATION | 41 | ||
| PEAK PAUSE PRESSURES | 42 | ||
| CRISIS MANAGEMENT | 42 | ||
| Pertussis | 42 | ||
| Oxygenation | 43 | ||
| Oxyhaemoglobin dissociation curve | 43 | ||
| How do we assess oxygenation? | 44 | ||
| Pao2/Fio2 ratio | 44 | ||
| Oxygenation index | 44 | ||
| Pulse oximetry | 45 | ||
| Mixed venous oxygen saturations (SvO2) | 45 | ||
| Blood gas analysis | 46 | ||
| PARTIAL PRESSURES PAO2 AND PACO2 | 46 | ||
| CO-OXIMETRY | 46 | ||
| METHAEMOGLOBINAEMIA | 46 | ||
| Carboxyhaemoglobin | 46 | ||
| ACID–BASE BALANCE AND INTERPRETATION OF BLOOD GASES | 47 | ||
| Buffers | 47 | ||
| Respiration | 48 | ||
| Renal secretion | 48 | ||
| Interpretation of blood gas analyses | 48 | ||
| Anion gap | 49 | ||
| Stewart model (STRS 2016) | 50 | ||
| SYSTEMATIC REVIEW OF CHEST X-RAY | 51 | ||
| Bones and soft tissue | 51 | ||
| Mediastinum including thymus | 51 | ||
| Heart and great vessels | 52 | ||
| SIGNS OF HEART FAILURE ON CHEST X-RAY | 53 | ||
| Lungs | 53 | ||
| Abdomen | 54 | ||
| Striking abnormalities on chest x-ray – what to look out for | 54 | ||
| LUNG PERFUSION | 56 | ||
| MEANS AND METHODS OF OXYGEN DELIVERY | 56 | ||
| Low flow | 56 | ||
| High flow | 57 | ||
| SETTING UP OPTIFLOW | 57 | ||
| INTUBATION | 59 | ||
| Emergency checklist for intubation – step by step | 60 | ||
| Capnography | 61 | ||
| Interpreting ventilatory function using capnography – examples/troubleshooting | 62 | ||
| VENTILATION AND DEFINITION OF TERMS | 66 | ||
| INDICATIONS FOR ASSISTED VENTILATION | 66 | ||
| MODES OF VENTILATION | 66 | ||
| Noninvasive ventilation | 66 | ||
| CONTINUOUS POSITIVE AIRWAY PRESSURE | 66 | ||
| BIPHASIC/BILEVEL POSITIVE AIRWAY PRESSURE | 66 | ||
| CONTINUOUS POSITIVE AIRWAY PRESSURE/EXPIRATORY POSITIVE AIRWAY PRESSURE | 67 | ||
| INSPIRATORY POSITIVE AIRWAY PRESSURE | 67 | ||
| INDICATIONS | 67 | ||
| SETTING UP BILEVEL POSITIVE AIRWAY PRESSURE | 67 | ||
| Invasive ventilatory modes via tracheal intubation or tracheotomy | 69 | ||
| POSITIVE END-EXPIRATORY PRESSURE | 70 | ||
| OTHER MODES OF VENTILATION | 70 | ||
| Neurally adjusted ventilator assist | 70 | ||
| SETTING UP NEURALLY ADJUSTED VENTILATOR ASSIST | 71 | ||
| COMMENCING NEURALLY ADJUSTED VENTILATOR ASSIST | 73 | ||
| WEANING NEURALLY ADJUSTED VENTILATOR ASSIST | 75 | ||
| HIGH–FREQUENCY VENTILATION | 76 | ||
| Ventilator recording for high-frequency oscillation ventilation | 77 | ||
| Diffuse lung disease | 77 | ||
| Unilateral or patchy lung involvement | 79 | ||
| PATHOLOGY WITH AIR-TRAPPING | 79 | ||
| PATHOLOGY WITH DIFFUSE HAZE (ACUTE RESPIRATORY DISTRESS SYNDROME) | 79 | ||
| Lung hypoplasia | 79 | ||
| UNIFORM PULMONARY HYPOPLASIA | 79 | ||
| NONUNIFORM PULMONARY HYPOPLASIA (CONGENITAL DIAPHRAGMATIC HERNIA) | 80 | ||
| Air leak syndromes | 80 | ||
| RECURRENT PNEUMOTHORACES | 80 | ||
| SEVERE AIR LEAK – WITH OR WITHOUT CYSTS IN LUNGS | 80 | ||
| USE OF INHALED NITRIC OXIDE | 81 | ||
| Prone positioning | 81 | ||
| BRONCHOALVEOLAR LAVAGE (BAL) (NONBRONCHOSCOPIC) IN A VENTILATED CHILD | 82 | ||
| REFERENCES | 83 | ||
| 3 - CARDIAC CARE | 87 | ||
| NORMAL HEART | 87 | ||
| Heart murmurs and shunt murmurs | 88 | ||
| Understanding basic echocardiogram terminology | 89 | ||
| NORMAL ELECTROCARDIOGRAM | 90 | ||
| CARDIAC OUTPUT | 94 | ||
| INVASIVE INTRAVASCULAR PRESSURE MONITORING | 95 | ||
| Intra-arterial pressure | 95 | ||
| Atrial pressure | 95 | ||
| Checking the position of a central venous catheter | 97 | ||
| TOP TIPS FOR POSTOPERATIVE CARDIAC MANAGEMENT | 97 | ||
| CARDIOPULMONARY BYPASS | 99 | ||
| Pulmonary hypertensive crisis | 100 | ||
| REMOVAL OF LEFT ATRIAL LINE | 100 | ||
| Care of chest drains | 101 | ||
| CLASSIFICATION OF CONGENITAL HEART DISEASE | 102 | ||
| Defects with increased pulmonary blood flow | 103 | ||
| PATENT DUCTUS ARTERIOSUS | 103 | ||
| ATRIAL SEPTAL DEFECT | 104 | ||
| VENTRICULAR SEPTAL DEFECT | 104 | ||
| ATRIOVENTRICULAR SEPTAL DEFECT | 105 | ||
| Defects with decreased pulmonary blood flow | 106 | ||
| PULMONARY STENOSIS | 106 | ||
| PULMONARY ATRESIA | 106 | ||
| MODIFIED BLALOCK-TAUSSIG SHUNT | 107 | ||
| BLOCKED BLALOCK-TAUSSIG SHUNT | 108 | ||
| FALLOT’S TETRALOGY (FIG. 3.8) | 108 | ||
| TRICUSPID ATRESIA | 110 | ||
| Defects with decreased systemic blood flow | 111 | ||
| COARCTATION OF AORTA | 111 | ||
| AORTIC STENOSIS | 111 | ||
| INTERRUPTED AORTIC ARCH | 112 | ||
| HYPOPLASTIC LEFT HEART SYNDROME (FIG. 3.11) | 115 | ||
| Altered circulation | 121 | ||
| D-TRANSPOSITION OF THE GREAT ARTERIES | 121 | ||
| TRUNCUS ARTERIOSUS (COMMON ARTERIAL TRUNK) | 127 | ||
| TOTAL ANOMALOUS PULMONARY VENOUS DRAINAGE | 129 | ||
| DOUBLE-OUTLET RIGHT VENTRICLE | 131 | ||
| Other complex congenital heart defects | 133 | ||
| ANOMALOUS LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY | 133 | ||
| VASCULAR RING | 135 | ||
| COR TRIATRIATUM | 136 | ||
| CARDIOMYOPATHY | 136 | ||
| DILATED CARDIOMYOPATHY | 136 | ||
| HYPERTROPHIC CARDIOMYOPATHY | 137 | ||
| MYOCARDITIS | 138 | ||
| ARRHYTHMIAS | 139 | ||
| Examples of bradyarrhythmias | 140 | ||
| SINUS BRADYCARDIA (FIG. 3.27) | 140 | ||
| JUNCTIONAL (NODAL) RHYTHM (FIG. 3.28) | 140 | ||
| Heart (AV) block | 141 | ||
| FIRST-DEGREE HEART BLOCK (FIG. 3.29) | 141 | ||
| SECOND-DEGREE HEART BLOCK (FIG. 3.30) | 141 | ||
| MOBITZ TYPE I (WENCKEBACH PHENOMENON) | 141 | ||
| MOBITZ TYPE II | 142 | ||
| TWO-TO-ONE (OR HIGHER) AV BLOCK | 142 | ||
| THIRD-DEGREE OR COMPLETE HEART BLOCK (FIG. 3.31) | 142 | ||
| Examples of tachyarrhythmias | 143 | ||
| SINUS TACHYCARDIA (FIG. 3.32) | 143 | ||
| SUPRAVENTRICULAR TACHYCARDIA (FIG. 3.33) | 143 | ||
| Bigemini | 146 | ||
| ATRIAL FIBRILLATION (FIG. 3.36) | 147 | ||
| VENTRICULAR FIBRILLATION | 147 | ||
| VENTRICULAR TACHYCARDIA (FIG. 3.38) | 147 | ||
| EARLY TREATMENT OF VENTRICULAR TACHYCARDIA (WITH PULSE) (ADVANCED LIFE SUPPORT GROUP 2016) | 148 | ||
| ASYSTOLE (FIG. 3.39) | 148 | ||
| PULSELESS ELECTRICAL ACTIVITY (FIG. 3.40) | 149 | ||
| WOLFF–PARKINSON–WHITE SYNDROME (FIG. 3.41) | 149 | ||
| LONG QT SYNDROME | 150 | ||
| ANAESTHESIA OF PATIENTS WITH LONG QT FOR EMERGENCY INTUBATION AND VENTILATION | 151 | ||
| Understanding Cardiac Pacing | 152 | ||
| EXTRACORPOREAL MEMBRANE OXYGENATION | 154 | ||
| What does an extracorporeal membrane oxygenation circuit look like? See Fig. 3.43 | 158 | ||
| Where do the cannulae go in the different types of extracorporeal membrane oxygenation? | 159 | ||
| What are the differences between venovenous and venoarterial extracorporeal membrane oxygenation? | 159 | ||
| Managing the patient on extracorporeal membrane oxygenation | 160 | ||
| Complications on extracorporeal membrane oxygenation | 162 | ||
| VENTRICULAR ASSIST DEVICES | 163 | ||
| REFERENCES | 163 | ||
| 4 - THE KIDNEYS AND RENAL REPLACEMENT | 171 | ||
| KEY CONCEPTS | 171 | ||
| NEW BIOMARKER | 173 | ||
| ACUTE KIDNEY INJURY | 173 | ||
| PERITONEAL DIALYSIS | 175 | ||
| Problems | 177 | ||
| Causes | 177 | ||
| Action | 177 | ||
| CONTINUOUS VENO-VENOUS HAEMOFILTRATION | 178 | ||
| CONTINUOUS VENO-VENOUS HAEMODIAFILTRATION | 178 | ||
| HAEMODIALYSIS | 179 | ||
| FLUIDS FOR CONTINUOUS VENO-VENOUS HAEMOFILTRATION /CONTINUOUS VENO-VENOUS HAEMODIAFILTRATION | 179 | ||
| ANTICOAGULATION | 180 | ||
| Heparin | 180 | ||
| Epoprostenol/prostacyclin | 180 | ||
| Citrate | 180 | ||
| Monitoring | 181 | ||
| Priming the circuit | 182 | ||
| Checklist for continuous veno-venous haemofiltration/HD | 182 | ||
| TROUBLESHOOTING CONTINUOUS VENO-VENOUS HAEMOFILTRATION/CONTINUOUS VENO-VENOUS HAEMODIAFILTRATION: GENERAL REASONS | 182 | ||
| FOR ALARMS | 182 | ||
| PLASMA EXCHANGE | 183 | ||
| RENAL DISEASE | 184 | ||
| Nephrotic syndrome | 184 | ||
| Haemolytic–uraemic syndrome | 185 | ||
| HYPERTENSIVE CRISIS | 186 | ||
| RENAL TRANSPLANT | 187 | ||
| REFERENCES | 189 | ||
| 5 - LIVER FUNCTION AND FAILURE | 191 | ||
| UNDERSTANDING LIVER FUNCTION | 191 | ||
| Phototherapy | 194 | ||
| Unconjugated bilirubin | 194 | ||
| Conjugated bilirubin | 194 | ||
| BILIARY ATRESIA | 195 | ||
| ACUTE LIVER FAILURE | 195 | ||
| Aetiology | 195 | ||
| Prognosis | 197 | ||
| Goals of management | 198 | ||
| Encephalopathy | 198 | ||
| PORTAL HYPERTENSION | 199 | ||
| Ascites | 199 | ||
| Variceal haemorrhage | 200 | ||
| SENGSTAKEN-BLAKEMORE TUBE | 201 | ||
| LIVER TRANSPLANT | 201 | ||
| Postoperative care | 202 | ||
| Complications posttransplant | 202 | ||
| HEPATORENAL SYNDROME (HRS) | 203 | ||
| HEPATOPULMONARY SYNDROME | 203 | ||
| REFERENCES | 203 | ||
| 6 - NEUROLOGY – ASSESSMENT AND MANAGEMENT | 207 | ||
| GUIDELINES FOR NEUROLOGIC ASSESSMENT | 207 | ||
| COMPONENTS OF THE GLASGOW COMA SCALE | 207 | ||
| Verbal response | 209 | ||
| Motor response | 209 | ||
| THE CRANIAL NERVES | 210 | ||
| What causes coma in childhood? | 213 | ||
| How does one assess coma in childhood? | 213 | ||
| IDENTIFICATION AND MANAGEMENT OF RAISED INTRACRANIAL PRESSURE | 213 | ||
| The relationship between intracranial pressure and cerebral perfusion pressure | 214 | ||
| Causes of raised intracranial pressure | 215 | ||
| Compensatory mechanisms | 215 | ||
| Clinical signs and symptoms | 215 | ||
| Management | 216 | ||
| CARE | 218 | ||
| MONITORING | 218 | ||
| INTRACRANIAL PRESSURE MONITORING | 219 | ||
| Cerebrospinal fluid | 219 | ||
| INDICATIONS FOR CEREBROSPINAL FLUID DRAINAGE | 220 | ||
| HYDROCEPHALUS | 220 | ||
| TREATMENT | 220 | ||
| EXTRAVENTRICULAR DRAINS | 221 | ||
| COMMON DIAGNOSTIC TESTS | 221 | ||
| Electroencephalography | 221 | ||
| Computed tomography scan | 221 | ||
| Magnetic resonance imaging scan | 222 | ||
| The cerebral function analysing monitor | 222 | ||
| DIABETES INSIPIDUS | 222 | ||
| Signs and symptoms | 223 | ||
| Management | 223 | ||
| SEIZURES | 223 | ||
| Causes of seizures | 224 | ||
| Status epilepticus | 224 | ||
| DYSTONIA | 225 | ||
| Aetiology of dystonia in childhood | 227 | ||
| Treatment | 227 | ||
| ORAL MEDICATIONS | 227 | ||
| Status dystonicus or dystonic storm | 228 | ||
| DEMYELINATING CONDITIONS | 228 | ||
| GUILLAIN-BARRÉ SYNDROME | 228 | ||
| Typical signs and symptoms | 228 | ||
| Treatment | 232 | ||
| ACUTE DISSEMINATED ENCEPHALITIS | 232 | ||
| Diagnosis | 233 | ||
| Treatment | 233 | ||
| Prognosis | 233 | ||
| TRANSVERSE MYELITIS | 233 | ||
| Presentation | 234 | ||
| Treatment | 234 | ||
| Prognosis | 235 | ||
| MYASTHENIA GRAVIS | 235 | ||
| Management | 236 | ||
| MENINGITIS | 236 | ||
| Signs and symptoms | 236 | ||
| Management | 237 | ||
| POSTERIOR REVERSIBLE LEUKOENCEPHALOPATHY SYNDROME | 238 | ||
| SPINAL MUSCULAR ATROPHY | 238 | ||
| Diagnosis | 240 | ||
| Treatment | 240 | ||
| REFERENCES | 240 | ||
| 7 - ONCOLOGY EMERGENCY | 245 | ||
| CARING FOR AN ONCOLOGY PATIENT IN PAEDIATRIC INTENSIVE CARE UNIT – GENERAL PRINCIPLES | 245 | ||
| CENTRAL VENOUS ACCESS | 245 | ||
| GENERAL PRINCIPLES OF CARE OF LONG–TERM CENTRAL VENOUS CATHETERS | 246 | ||
| CHEMOTHERAPY – COMMON SIDE EFFECTS | 246 | ||
| Specific side effects | 249 | ||
| Tumour lysis syndrome | 253 | ||
| Superior vena cava obstruction/syndrome | 255 | ||
| Malignant airway obstruction | 255 | ||
| Spinal cord compression | 256 | ||
| Graft-versus-host disease | 257 | ||
| Venoocclusive disease (sinusoidal obstruction syndrome) | 258 | ||
| Oncology terminology | 259 | ||
| Specialist oncology drugs | 259 | ||
| Care of peripherally inserted central catheter line | 260 | ||
| Accessing a PORT-A-CATH (Smiths Medical) | 260 | ||
| Accessing the portal | 262 | ||
| REFERENCES | 263 | ||
| 8 - FLUIDS AND NUTRITION | 267 | ||
| GUIDELINES TO CALCULATE ESTIMATED WEIGHT | 267 | ||
| ENTERAL FEEDING | 269 | ||
| Nasogastric tube placement and use | 272 | ||
| CORRECT METHODS | 272 | ||
| Gastrostomy use and care | 272 | ||
| Insertion and care of a nasojejunal tube | 274 | ||
| Nasojejunal tubes: checking position | 276 | ||
| TYPES OF FEEDING AND PRODUCTS AVAILABLE | 277 | ||
| Infant milks and children’s feed | 277 | ||
| USE OF MILK PRODUCTS AND CHILDREN’S FEEDS | 277 | ||
| PREMATURE BABIES | 278 | ||
| Preterm babies with birthweight less than 2 kg | 278 | ||
| Preterm babies greater than 2 kg until 6 months corrected gestational age | 278 | ||
| Whey-based milks | 278 | ||
| Casein-based milks | 278 | ||
| Soya milk | 278 | ||
| FULL-TERM BABIES’ MILK SUITABLE FOR INFANTS FROM 1 YEAR OF AGE | 279 | ||
| Follow-on formulas | 279 | ||
| CHILDREN’S FEEDS | 279 | ||
| Standard whole protein feeds (1–6-year-olds/8–20 kg) | 279 | ||
| High energy whole protein feeds (1–6-year-olds/8–20 kg) | 279 | ||
| Peptide-based feeds | 280 | ||
| Other Specialist Formulas | 280 | ||
| Vegetarian Milk | 280 | ||
| Vegan Milk | 280 | ||
| Halal Milk Formula | 280 | ||
| Cow’s Milk Protein Allergy | 280 | ||
| Diagnosis, treatment, and prognosis of cow’s milk protein allergy | 281 | ||
| Infant low-lactose formula | 283 | ||
| Fructose-based and low-calcium infant formula | 284 | ||
| Other products | 284 | ||
| VITAMIN SUPPLEMENTS | 284 | ||
| SPECIAL DIETS FOR SPECIAL KIDS | 284 | ||
| Ketogenic diet | 284 | ||
| COELIAC DISEASE | 285 | ||
| CYSTIC FIBROSIS | 285 | ||
| DIABETES MELLITUS | 285 | ||
| Inborn errors of metabolism | 286 | ||
| ILLNESS MANAGEMENT OF INBORN ERRORS OF METABOLISM | 286 | ||
| DISORDERS OF PROTEIN METABOLISM | 286 | ||
| PHENYLKETONURIA | 287 | ||
| MAPLE SYRUP URINE DISEASE | 287 | ||
| ORGANIC ACIDAEMIAS | 287 | ||
| UREA CYCLE DEFECTS | 288 | ||
| DISORDERS OF FAT METABOLISM | 288 | ||
| GLUCOSE-6-PHOSPHATASE DEFICIENCY | 288 | ||
| GALACTOSAEMIA | 289 | ||
| TOTAL PARENTERAL NUTRITION | 289 | ||
| How to prepare 0.9% sodium chloride in 10% glucose | 289 | ||
| How to prepare 3% solutions of sodium chloride | 290 | ||
| Dextrose solutions | 290 | ||
| INSENSIBLE LOSS | 290 | ||
| BURNS | 290 | ||
| REFERENCES | 290 | ||
| 9 - BLOOD AND ELECTROLYTES | 293 | ||
| NORMAL VALUES: FULL BLOOD COUNT | 293 | ||
| Creatinine phosphokinase | 295 | ||
| Procalcitonin | 296 | ||
| Troponin | 296 | ||
| TRANSFUSION COMPONENTS | 297 | ||
| Blood products for neonates (up to 28 days) (JPAC 2014) | 298 | ||
| Red cell transfusion in neonates (JPAC 2014) | 298 | ||
| Large-volume transfusion in cardiac surgery (JPAC 2014) | 298 | ||
| Top-up transfusion in neonates (JPAC 2014) | 298 | ||
| Neonatal platelet transfusion (JPAC 2014) | 298 | ||
| Neonatal fresh frozen plasma and cryoprecipitate transfusion (JPAC 2014) | 299 | ||
| Transfusion practice in paediatrics | 299 | ||
| MAJOR HAEMORRHAGE | 299 | ||
| Crash blood/emergency release blood | 299 | ||
| TRANSFUSION COMPATIBILITY | 300 | ||
| RHD ANTIGENS | 300 | ||
| Cytomegalovirus-negative products | 302 | ||
| Hepatitis E virus-negative blood components | 302 | ||
| REFERENCES | 303 | ||
| 10 - DRUGS | 307 | ||
| DRUGS FOR INTUBATION | 308 | ||
| QUICK-REFERENCE GUIDE FOR CALCULATING INFUSIONS | 309 | ||
| INOTROPIC AND CHRONOTROPIC DRUGS | 311 | ||
| DRUGS COMMONLY USED AS INTRAVENOUS INFUSIONS | 311 | ||
| Adenosine | 311 | ||
| Adrenaline (epinephrine) | 313 | ||
| Aminophylline | 313 | ||
| Amiodarone | 314 | ||
| Argipressin (vasopressin) | 314 | ||
| Clonidine | 315 | ||
| Dinoprostone (prostaglandin E2) | 316 | ||
| Dobutamine | 316 | ||
| Dopamine | 316 | ||
| Furosemide | 317 | ||
| Glyceryl trinitrate | 317 | ||
| Levosimendan | 317 | ||
| Lorazepam | 318 | ||
| Midazolam | 318 | ||
| Milrinone | 319 | ||
| Morphine | 319 | ||
| Noradrenaline (norepinephrine) | 319 | ||
| Propofol | 320 | ||
| Prostaglandin E2 | 320 | ||
| Salbutamol | 320 | ||
| Sodium nitroprusside (nipride) | 320 | ||
| Vecuronium | 321 | ||
| THERAPEUTIC DRUG MONITORING | 321 | ||
| Reversal agents | 321 | ||
| REFERENCES | 324 | ||
| 11 - PAIN AND SEDATION | 327 | ||
| ASSESSING PAIN AND SEDATION | 327 | ||
| Pain ratings scales for children | 330 | ||
| Assessing pain in children with cognitive impairment | 330 | ||
| TREATING CHILDREN IN PAIN | 332 | ||
| Neuropathic pain | 334 | ||
| Pharmacologic management of pain in children | 334 | ||
| Sedation | 334 | ||
| Means of analgesic administration | 337 | ||
| Epidural analgesia | 337 | ||
| Assessing sensory blockade in epidural analgesia | 338 | ||
| Assessing motor nerve blockage in epidural analgesia | 339 | ||
| RED FLAGS | 341 | ||
| PAIN SUMMARY | 341 | ||
| REFERENCES | 342 | ||
| 12 - HANDY HINTS FOR VARIOUS CONDITIONS | 345 | ||
| SEPSIS | 345 | ||
| NECROTISING FASCIITIS | 347 | ||
| Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis | 349 | ||
| DIAGNOSIS | 349 | ||
| TREATMENT | 349 | ||
| NEONATAL COLLAPSE | 350 | ||
| Parechovirus | 351 | ||
| SICKLE CELL CRISIS | 354 | ||
| DIABETIC KETOACIDOSIS | 354 | ||
| General resuscitation notes – ABCDE assessment | 355 | ||
| Fluid management in diabetic ketoacidosis | 356 | ||
| Fluid calculation | 357 | ||
| INSULIN | 358 | ||
| Cerebral Oedema in Diabetic Ketoacidosis | 359 | ||
| SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION | 359 | ||
| Signs and symptoms | 359 | ||
| Management | 359 | ||
| BURNS | 360 | ||
| CARE OF CHILD POST SCOLIOSIS SURGERY | 360 | ||
| Postoperative considerations: ABCD assessment | 360 | ||
| A – AIRWAY | 360 | ||
| B – BREATHING | 362 | ||
| C – CARDIOVASCULAR | 362 | ||
| D – DISABILITY | 362 | ||
| REFERENCES | 363 | ||
| 13 - TRANSPORT OF CRITICALLY ILL INFANTS AND CHILDREN | 365 | ||
| TRANSPORT TEAM COMPOSITION | 365 | ||
| AWAITING THE PAEDIATRIC CRITICAL CARE TRANSPORT TEAM – WHAT CAN YOU DO TO HELP? | 366 | ||
| Airway | 366 | ||
| Breathing | 366 | ||
| Circulation | 367 | ||
| Disability/neurology | 367 | ||
| Everything else | 367 | ||
| ARRIVAL OF THE PAEDIATRIC CRITICAL CARE TRANSPORT TEAM | 368 | ||
| Assessment of the infant/child | 368 | ||
| Airway | 370 | ||
| Breathing | 370 | ||
| Circulation | 370 | ||
| Neurology/trauma | 371 | ||
| Temperature control | 371 | ||
| Drugs/fluids | 371 | ||
| Family and communication | 372 | ||
| DOCUMENTATION transfer details | 372 | ||
| A medical summary | 373 | ||
| A nursing summary | 373 | ||
| Audit data | 373 | ||
| IN TRANSIT | 373 | ||
| LOOKING AFTER YOURSELF | 374 | ||
| Time-critical transfers | 374 | ||
| Time-critical neurosurgical transfer | 374 | ||
| Time-critical transfer for acute abdomen in children | 377 | ||
| Initial management of the child with acute abdominal pain | 377 | ||
| PRIMARY SURVEY | 377 | ||
| ‘RED FLAG’ indicators requiring URGENT ACTION (see NHS 2016 for detail) | 379 | ||
| Management of acute abdominal pain (Kim 2013) | 379 | ||
| Intrahospital transfer | 380 | ||
| ESSENTIAL EQUIPMENT AND MONITORING | 380 | ||
| Helicopter/fixed-wing air retrieval | 381 | ||
| CHOICE OF AIRCRAFT | 381 | ||
| PLANNING FOR FLIGHT TRANSFER | 381 | ||
| Airway | 382 | ||
| Breathing | 383 | ||
| Cardiovascular | 384 | ||
| Disability and everything else | 384 | ||
| EFFECTS OF GAS EXPANSION AT ALTITUDE | 385 | ||
| REFERENCES | 385 | ||
| 14 - SAFEGUARDING CHILDREN AND YOUNG PEOPLE | 389 | ||
| SAFEGUARDING CHILDREN POLICIES AND TRAINING | 390 | ||
| TYPES OF CHILD ABUSE | 390 | ||
| Physical abuse | 390 | ||
| Emotional abuse | 391 | ||
| Sexual abuse and exploitation | 391 | ||
| Neglect | 392 | ||
| LOOKED-AFTER CHILDREN | 392 | ||
| FEMALE GENITAL MUTILATION | 393 | ||
| HUMAN TRAFFICKING | 393 | ||
| CONCLUSION | 394 | ||
| REFERENCES | 394 | ||
| 15 - DEATH OF A CHILD | 397 | ||
| EXPECTED DEATH IN PAEDIATRIC INTENSIVE CARE UNIT | 397 | ||
| PALLIATIVE CARE | 398 | ||
| NURSE’S ROLE | 399 | ||
| DOCTOR’S ROLE | 400 | ||
| Postmortem | 400 | ||
| Ethical issues in paediatric organ donation | 401 | ||
| Donation after circulatory death (nonheartbeating donation) | 401 | ||
| Donation after brainstem death | 402 | ||
| BRAINSTEM DEATH DIAGNOSIS | 402 | ||
| Clinical tests for brainstem death | 403 | ||
| INVESTIGATIONS THAT MAY BE REQUIRED PRIOR TO ORGAN DONATION | 404 | ||
| CLINICAL MANAGEMENT GUIDELINES OF THE ORGAN DONOR | 406 | ||
| Physiologic optimisation of the potential donation after brainstem death donor (basic principles) | 406 | ||
| RELIGION | 407 | ||
| REFERENCES | 407 | ||
| 16 - CHILD DEVELOPMENT | 409 | ||
| NORMAL CHILD DEVELOPMENT | 409 | ||
| CHILDREN’S DEVELOPMENTAL CONCEPTS OF PAIN | 409 | ||
| Preoperational stage (2–7 years) | 412 | ||
| Concrete operational stage (7–10 years) | 412 | ||
| Formal operational stage (12+ years) | 412 | ||
| Rare but serious complications of these childhood illnesses | 412 | ||
| REFERENCES | 415 | ||
| 17 - QUICK REFERENCE TO SYNDROMES | 417 | ||
| ALAGILLE SYNDROME | 417 | ||
| CHARGE ASSOCIATION | 418 | ||
| CRI DU CHAT SYNDROME | 418 | ||
| DIGEORGE SYNDROME | 419 | ||
| DOWN SYNDROME (TRISOMY 21) | 419 | ||
| EDWARDS SYNDROME (TRISOMY 18) | 420 | ||
| HUNTER SYNDROME – MUCOPOLYSACCHARIDOSIS TYPE 2 | 420 | ||
| HURLER SYNDROME – MUCOPOLYSACCHARIDOSIS TYPE 1 | 421 | ||
| KLINEFELTER SYNDROME | 421 | ||
| MORQUIO SYNDROME – MUCOPOLYSACCHARIDOSIS TYPE 4 | 422 | ||
| NOONAN SYNDROME | 422 | ||
| PATAU SYNDROME (TRISOMY 13) | 422 | ||
| PIERRE ROBIN SYNDROME | 423 | ||
| POMPE SYNDROME OR GLYCOGEN STORAGE DISEASE TYPE 11 | 423 | ||
| PRADER–WILLI SYNDROME | 424 | ||
| RETT SYNDROME | 425 | ||
| SANFILIPPO SYNDROME – MUCOPOLYSACCHARIDOSIS TYPE 3 | 426 | ||
| STURGE–WEBER SYNDROME | 427 | ||
| TREACHER COLLINS SYNDROME (MANDIBULOFACIAL DYSOSTOSIS) | 427 | ||
| TURNER SYNDROME | 428 | ||
| VACTERL ASSOCIATION | 428 | ||
| REFERENCES | 428 | ||
| ABBREVIATIONS | 431 | ||
| INDEX | 437 | ||
| A | 437 | ||
| B | 439 | ||
| C | 440 | ||
| D | 443 | ||
| E | 445 | ||
| F | 445 | ||
| G | 446 | ||
| H | 447 | ||
| I | 448 | ||
| J | 449 | ||
| K | 449 | ||
| L | 450 | ||
| M | 450 | ||
| N | 452 | ||
| O | 453 | ||
| P | 453 | ||
| Q | 455 | ||
| R | 455 | ||
| S | 456 | ||
| T | 458 | ||
| U | 459 | ||
| V | 460 | ||
| W | 461 | ||
| Y | 461 | ||
| IBC | ES3 |