bumps and babes
DESCRIPTION
By Christopher I’Anson SJA Advanced Student Doctor Leeds LINKS training Officer 2012-13. Bumps and Babes. Topics. Something that is not really covered much... Obstetrics: Bleeding Less movement Birth/delivery Unconscious or fitting Babies: CPR Children: Communication - PowerPoint PPT PresentationTRANSCRIPT
Bumps and BabesBy Christopher I’AnsonSJA Advanced Student DoctorLeeds LINKS training Officer 2012-13
Topics Something that is not really covered much...
Obstetrics:▪ Bleeding▪ Less movement▪ Birth/delivery▪ Unconscious or fitting
Babies:▪ CPR
Children:▪ Communication▪ Reference ranges▪ Medications▪ CPR
Obstetrics
Obstetrics= babies inside the womb (pregnancy) From conception-birth The womb (uterus) increases in size as
the baby grows
Obstetrics: Questions
If you can remember, ask: How many weeks pregnant they are When they are due Any problems in the past with this or
other pregnancies Everything okay with this pregnancy so
far Number of babies
Obsetrics
Movements: Babies first start to move inside the
womb between 16-25 weeks This is normal Mums usually know what is normal
amount for their baby Can become decreased normally (sleep)
or abnormally ▪ If in doubt send to hospital
Obstetrics
There are several things that can occur: Bleeding These should be dealt Trauma with as serious and Less movements needing hospital
referral
Vulnerable adult? Yes pregnant women are; they are more
likely to experience domestic violence
Obstetrics
Delivery: Not necessarily an emergency although
the mother should get to hospital sooner rather that later
Signs:▪ Contractions/ pain (1st in 90%)▪ Waters breaking▪ Bleeding (be cautious)
Obstetrics
What to do? Do NOT try to deliver the baby! (unless
you are trained at have the correct equipment)
Call for an 999 if delivery is imminent or you are concerned
Treat any other problems like shock Make them comfortable No medications! Can have small sips of water
Obstetrics: Eclampsia
This is a serious condition! It is where a pregnant patient fits
due to high blood pressure (after pre-eclampsia)
Actions: ABCDE Call 999 and extra help if needed Try and place patient in the recovery
position*
Obstetrics: Recover position Slightly different!
Try to put the patient on to their left side Does it matter?
Put support under their back
Questions?
Paediatrics
Babies:▪ Spotting the sick child▪ CPR▪ Choking
Children:▪ Communication▪ Reference ranges▪ Medications▪ CPR
Babies
Not going into much detail about them Do not see often Should be seen by an experienced HCP▪ Hospital and or duty HCP
Spotting the sick child or infant Signs:
Crying Grunt (in infants) Cyanosis (blue) Intercostal recession Subcostal recession Tracheal tug Increased respiratory
rate Nasal flaring
http://www.youtube.com/watch?v=U-RfbrnMJZE&feature=related
http://www.youtube.com/watch?v=sJLHiTaXrtc
Babies
CPR: Most likely needed due to respiratory
arrest 5 starter breaths Compressions▪ Two fingers (same place)▪ 1/3 of the chest
30/2 DEMO
Babies
Chocking
•Position the child as shown
Not worked
•5 back blows (lighter than adults)
•Chest compressions
GROSE!
Children
The main difficulty with children is communication Varies from age to age Varies from child to child Varies from situation Children can be inadvertently misleading Will respond to closed question (will go
with what you say)
Children: Presentations
Children can not localise or describe symptoms well Do not understand Not experienced enough to localise/
describe E.g. Tummy pain may mean head pain
Children: Top tips
Ask mum/ parent Get child to be engaged
Play Be silly (having a few magic tricks will
help) Talk to them▪ At their level (height and age)▪ Even if to young to reply
Children: reference rangesAge Resps Pulse BP (systolic)
<1 30-40 110-160 70-90
2-5 20-30 95-140 80-100
5-12 15-20 80-120 90-110
>12 12-20 60-100 100-120
Children: Doses of paracetamolAge Dose of
ParacetamolMinimum interval
Max in 24hrs
3months-1 year 125mg 4 hours 500mg
1-5 years 250mg 4 hours 1g
6-12 years 500mg 4 hours 2g
>12years 500-1000mg 4 hours 4g
Children: CPR
DRABC(s)
5 starter breaths
30:2(one
handed)
ANY QUESTIONS?