To learn 22/05
FLACC
Faces
Legs
Activity
Consolability
Crying
Assesses pain in infants
Merkel et al 1997
Hello my name is
Grainger, 2013
A-E assessment
Thomas 2017
NEWS2
NICE 2021
AVPU
American College of Surgeons 1989
GCS
Jennete and Teasdale 1974
Consent and confidentiality
NMC code 2018
SBAR
Permanente, 2002
Sepsis most common cause of AKI
Zarbock et al, 2015
Sepsis 6
Uk sepsis trust 2022
Oxygen target for COPD
88-92%
BTS 2017
Justifying ctheterisation
600ml
Darrah et al 2009
MUST tool
Malnutrition advisory group, 2004
screening tool identifies adults at risk of malnutrition/ obesity
Fever is a natural response to infection and it is not recommended to treat
Sepsis Turst Guidelines 2002
Person Centred Care
Rogers, 1940
Clinical signs of sepsis
RR above 22
SBP below 100
HR above 90
Temp below 36 or above 38
National Kidney Trust, 2024
Higher risk for AKI
NHS England 2016
'Think Kidney' Guidelines
Diuretics
ACE Inhibitors
Metformin
NSAIDs
Frequency of neuro obs and what for
Head injury, sudden deterioration in consciousness, patients unconscious upon arrival at hospital, post first seizure
1/2 hourly for 2 hours
1 hourly for 4 hours
2 hourly for 6 houors
4 hourly for 12 hours
review
Assessing for hypovolaemia
Systolic under 100
HR over 90
CRT over 2 secs
RR over 20
NEWS over 5
NICE 2017
Use pain rating scale and allow child choice
RCN 2009
3 Ps of pain management
Pharmacological
Psychological
Physical
BC Children's hospital 2024
Paediatric sepsis 6
Sepsis trust paediatric group 2016
Clear post op instructions for parents
parentsBaily et al 2019
Artifically raising O2 sats using liberal O2 increases mortality risk
Chu et al 2018
MI risk factors
Diabetes
Hypertension
Physical inactivity
Smoking
NICE 2020
Upright position allows for lung expansion and improves lung volume
Peate and Dutton 2021
Analogue pain scale 1-10
Hayes and Patterson 1921
WHO analgesia ladder
1986
manual bp more accurate
MHRA 2021
Uncontrolled pain can have detrimental effects on the cardiovascularly compromised child
RCN, 2017
Uncontrolled pain as a red flag for deterioration
MacPherson et al 2020
12 lead ECG as an important diagnostic tool
NICE Guidelines 2014
Contraindication for NIV
Cognitive impairment that warrants enhanced observation
BTS 2016
Mortality in sepsis improved by 50%
NHS scotland 2016
PEWS
NHS England 2018
Healthy levels of glucose
glucosePreprandial- 4-7 mmol/l
11.1 mmol/L or higher after 2 since eating= possibly diabetic
The monroe kellie doctrine
Relationship between contens of cranium and intracranial pressure
Tisse, blood and CSF= total volume
Normal IC pressure= 7-15mmHg
increase in one= decrease in another
2 signs of cushings triad
rising BP
slowing HR
slowing RR
Adult IVs
Intravenous fluid therapy in adults 2013,
Crystalloids for IV resus and maintenance
IV bolus for 15 mins
30ml/kg/day max
Child IVs
IV fluid therapy in children and young people 2020,
IV bolus for 10 minutes
Crystalloids for IV and maintenance
100ml/kg/hr for first 10kg
50ml/kg/hr for second 10kg
20ml/kg/hr after that