By Strobel, Stephan
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Extra info for The Great Ormond Street colour handbook of paediatrics and child health
Example text
5 kPa) indicate severe disease with a high risk of cerebral oedema. In the rare cases that require artificial ventilation for exhaustion or shock, the initial target PaCO2 must be similar to the value that the patient was achieving. This will prevent worsening of acidosis and cerebral oedema. The heart rate, blood pressure and peripheral perfusion must be regularly assessed. 9%) saline and the circulation reassessed. The possibility of a serious infection precipitating DKA must be considered. 39 Fat hypertrophy in a 12-year-old with insulin-dependent diabetes, caused by injecting insulin repeatedly at the same site rather than rotating the sites.
7). MIDAZOLAM This agent is probably the most commonly used benzodiazepine in the last 15 years and is still the drug of choice in combination with morphine to provide sedation and analgesia on the PICU. It has a half-life of 2–4 hrs. Respiratory depression can occur if given in excess or too rapidly. Withdrawal symptoms can occur after modest duration of use. Its advantage is that it has a number of routes of administration which has given it an important role in the acute treatment of seizure disorders.
7 Soft callus formation after a femoral shaft fracture. Imaging The skeletal survey should be performed in normal working hours after explaining the reasons for it to the carers. Two health professionals should remain with the baby throughout the examination and they should initial each film. The skeletal survey should include: • Skull: AP and Lateral • Spine: Lateral • Chest: AP • Upper and lower limbs: AP • Pelvis: AP • Both hands: PA • Both feet: DP Additional views may be necessary such as oblique views of the chest to identify rib fractures: coned views of the metaphyseal regions when these are not clearly seen on the limb views, lateral long bone views when a fracture has been identified to evaluate displacement, and a Townes view when an occipital fracture is suspected.