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Pediatrics: Managing Acute Infections at Central Hospital

Guidelines for managing acute infections in pediatric patients at Central Hospital, including fever, seizures, meningitis, respiratory infections, and more. Learn about treatment options and monitoring methods.

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Pediatrics: Managing Acute Infections at Central Hospital

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  1. ACUTE PEDIATRIC INFECTION PATIENTS AT CENTRAL HOSPITAL Helena Ruotsalainen

  2. FEVER AND SEIZURES • anticonvulsants:per rectum diatzepam 0.5mg/kg ad 10mg;to buccal mucus midatzolamin 0.25mg/kg ad 10mg;iv loratzepam 0.1mg/kg ad 2mg • Parasetamol 15mg/kgx1-4/d po, p.rect.,iv • Lab:WBC,CRP,blood culture (glu, Ca)urine specimen, spinal tap, x-ray • Iv-connection : fluids, drugs

  3. F E V E R • Consciousness, reacts to speech, open eyes, movements? • Hypotension, saturation, pulse • Neck stiffness / floppy • Dislike of being handled • Respiration: tachypnea • Skin: purpura/ petecchia

  4. MENINGITIS Meningococcus ad 1/10 dies, pneumococcus Purpura, restlessness, head extension Spinal tap:white cell count, protein high, glu low, bacteria Th: iv-cephalosporin; iv penicillin+ gentamycin Dexametason 0,15mg/kg:4, furesis (?) Herpes encephalitis: iv-aciclovir

  5. FLUIDS (braininfection, septichemia) • Reduced fluids (75-80%) for avoiding brain odema but take also care of extra losses:fever, vomiting, diarrhea. • Follow up blood pressure, urine excretion (least 1ml/kg/h – 2-3ml/kg/h), weight • Viral meningitis: symptomatic care (fluids, pain killers for headache)

  6. RESPIRATORY INFECTIONS • Laryngitis: inspiratorystridor, barkingcough.Th:metylprednisolonpo/im, adrenalinim/inhalation • Bronchiolitis,bronchitis:wheezing,retractions.Th:symphatomimetic-inhalations, mucussuction • Whoopingcough(pertussis):apnoe, paroxysmalcough.4-6weeks.Th:eythromycin • Tonsillitis: penicillin, iv-fluids(difficulties to eat)

  7. P N E U M O N I A • Fever, cough, pain when breathing • Tachypnea 40-60 /min, low saturation • Auscultation:rales, silent • Lab: WBC, CRP, blood culture • Thx-x-ray: lobar, pleuritis, emphyema, tbx( upper lobes, hilar nodes) • Th:iv-penicillin, po ampicillin,azithromycin, cephalosporin,+gentamycin, iv-fluids

  8. G A S T R O E N T E R I T I S • Bacterial: salmonella, shigella (tourism), yersinia,campylobacter(soil,meat); enterohaemorrhagice.coli=EHEC (cattle, milk,water).Blood in stools, oligouria. Kidneyproblem. Intensiveward, dialysis. Butsometimesneeds no therapy.-Fluids (iv-ORS) • Viral:rota, adeno, entero, noro. Th: ORS 50-60 ml/kg 4-6t, then5ml/kg/everystool

  9. URINARY TRACT INFECTIONS Pyelonephritis ac: fever, nausea, vomitis, pain in kidneys, abdominal pain urine culture, microscopia, WBC, crp, krea th: cephalosporin, TMP-SMZ, iv-fluids? Lower urinary tract infections: dysuria, low fever th: po at primary ward

  10. SKIN, SOFT TISSUE, BONEINFECTIONS • Pemphigus (infants), impetigo,erysipelas • Lympadenitis, abscesses, cellulitis • Osteomyelitis, arthritis • cause: fromskininjuries / dryatopicskin;fromrespiratorytractbacteries • Th:cephalosporin,kloxacillin,klindamycin,penic localtherapy;insomecasessurgery

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