Paediatric Emergencies (PALS) Flashcards

A child with meningococcal septicaemia is identified by:

Answer: Non-blanching petechial or purpuric rash with fever and signs of septic shock

Non-blanching petechiae or purpura in a febrile child with haemodynamic compromise is meningococcal disease until proven otherwise — requiring immediate pre-hospital antibiotic administration (benzylpenicillin) and urgent transport.

Pre-hospital benzylpenicillin G is indicated for:

Answer: Suspected meningococcal disease when transport time exceeds 30 minutes

Pre-hospital penicillin is given for suspected meningococcal disease (non-blanching rash with systemic illness) when transport time is significant, as any delay in antibiotic administration worsens outcomes.

Intussusception in an infant classically presents with:

Answer: Episodic colicky pain, drawing up of legs, vomiting, and 'redcurrant jelly' stool

Intussusception (bowel telescoping) causes intermittent colicky pain (infant draws up legs and cries, then is quiet between episodes), vomiting, and the classic 'redcurrant jelly' stool representing bloody mucus.

The 'Rule of Palms' estimates burn TBSA in children using:

Answer: The patient's own palm (including fingers) = approximately 1% TBSA

The patient's own palm (with fingers) represents approximately 1% of their TBSA in both adults and children — useful for estimating irregular, scattered burns where the Rule of Nines is less applicable.

Bronchospasm in a child with known asthma is initially treated with:

Answer: Inhaled short-acting beta-2 agonist (salbutamol) via MDI and spacer or nebuliser

Salbutamol (albuterol) MDI with spacer is as effective as nebulised delivery in mild-to-moderate asthma and faster to administer; severe cases warrant back-to-back nebulisers, IV/IM salbutamol, and ipratropium.

In PALS, adenosine dosing for SVT is:

Answer: 0.1mg/kg rapid IV push (maximum 6mg first dose) followed by a rapid saline flush

Paediatric adenosine: 0.1mg/kg (max 6mg) rapid IV push as close to the heart as possible, followed immediately by a rapid saline flush to deliver the drug before its short half-life allows breakdown.