Paediatric Emergencies
Core concepts
Understand the paediatric assessment triangle (appearance, work of breathing, circulation) and the structured ABCDE approach with age-appropriate vital signs. Master paediatric resuscitation: weight-based drug dosing, the role of the intraosseous route, and the difference between respiratory and shock presentations. Cover bronchiolitis, croup, epiglottitis, and asthma; the febrile infant and sepsis; and the recognition of non-accidental injury. Understand dehydration assessment and fluid management, and the danger of rapid correction in DKA. Learn the approach to the child with a seizure, including febrile convulsion versus meningitis.
Traps
Examiners test that bradycardia in a child is usually hypoxia - oxygenate and ventilate before giving atropine. Beware the febrile infant under 3 months where full sepsis workup and empiric antibiotics are mandatory. In croup, do not examine the throat if epiglottitis is suspected. In paediatric DKA, rapid fluid boluses risk cerebral oedema.
Rule of thumb
In a sick child, respiratory effort and mental status change before blood pressure falls. Treat hypoxia and hypovolaemia aggressively; use the intraosseous route early when access is difficult.
Worked example
A 6-month-old with fever 39°C, grunting, and poor feeding: this is a febrile infant requiring full sepsis screen, empiric antibiotics, and admission - do not send home on antipyretics.