FINALS SAQ83: MENINGOCOCCAL SEPTICAEMIA & PEDIATRIC SEPSIS
00:00 A 4-year-old child is admitted to the emergency department with suspected meningococcal septicaemia. You are asked to help resuscitate the patient prior to transfer to a tertiary centre.
a) List the clinical features of meningococcal septicaemia. (35%)
b) Outline the initial management of this patient? (45%)
c) Which investigations will guide care? (20%)
5:36 You are called to the emergency department to see a 2-year-old child who presents with a four-hour history of high temperature and drowsiness. On examination, there is prolonged capillary refill time and a non-blanching rash. A presumptive diagnosis of meningococcal septicaemia is made.
a) What are the normal weight, pulse rate, mean arterial blood pressure and capillary refill time for a child of this age? (4 marks)
b) Define appropriate resuscitation goals for this child (2 marks) and outline the management in the first 15 minutes after presentation. (7 marks)
c) After 15 minutes, the child remains shocked and is unresponsive to fluid. What is the most likely pathophysiological derangement in this child’s circulation (2 marks) and what are the important further treatment options? (5 marks)
7:42 You are called to the emergency department to review a 2-year-old baby who is unwell with suspected meningococcal septicaemia.
a) State the normal weight, heart rate, mean arterial pressure and capillary refill time in a child of this age. (4 marks)
b) The mean arterial pressure is 50 mmHg. State how you would restore the circulation. (3 marks)
c) Name the antibiotic and its dose (per kilogram body weight) that should be given Immediately. (1 mark)
d) List four indications for intubation, apart from those relating to airway or respiratory concerns. (4 marks)
e) State three abnormalities that you might see on the patient’s blood tests. (3 marks)
f) The child continues to be hypotensive despite resuscitation with intravenous fluids. State a further five steps in your ongoing management. (5 marks)
10:26 Pediatric sepsis definitions
12:50 Pediatric sepsis recognition
13:55 Pediatric sepsis resuscitation
19:47 Anaesthesia sepsis algorithm
26:22 Influence of Organ System Pathology on Pharmacodynamics and Pharmacokinetics
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