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CASE HISTORY


Two hours later: admitted to paediatric ward.


Nursing assessment: Temp 38.4, HR 172, RR 45, BP 112/50.
Small pin prick rash on abdomen


Ward SHO reviewed child
Sleepy but rousable, no neck stiffness or photophobia, HR 171.
No rash but he has a few old chickenpox scars.
Chest clear.


Diagnosis:  viral URTI.  Child sent home.

Child 3 years old with short history of fever, shaking and generally unwell.


ED Triage assessment:
High temperature, he looks flushed, no rash, unwell child.


Ten minutes later– ED SHO:
Febrile child, listless, irritable and drowsy.
Temp 39.7, HR 170, RR 55.
Pyrexial and drowsy: ? cause, refer to paediatric team.


  help

QUESTIONS ON CASE 2


     Q 6 of 12: Persistently abnormal signs/symptoms?

YesNo <incorrect

INCORRECT : Still tachycardic, tachypnoeic, drowsy two hours after admission. Fever has diminished after antipyretics, but child still pyrexial; taken with other signs, cannot be dismissed as a viral illness.
Further Information
Normal values of vital signs
Age HR/min RR/min Systolic BP
<1 110-160 30-40 70-90
1-2 100-150 25-35 80-95
2-5 95-140 25-30 80-100
5-12 80-120 20-25 90-110
Over 12 60-100 15-20 100-120

From Advanced Paediatric Life Support—the Practical Approach. 30


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