A: Optimal airway position for infants
Note how a rolled towel is placed under the baby’s shoulders to allow space for the occiput and avoid flexion of the neck and airway.
Video links to examples of children with signs of respiratory distress:
Example video showing a bulging fontanelle (excuse the slightly cheesy style!)
Non accidental injury
Sadly, NAI in under 2’s causes more than 10% of serious injuries to children.
Stigmata of possible NAI include:
- Bruising on the cheeks, neck, genitals, buttocks and back
- Pattern bruising from an implement including fingertip bruising
- Burns to hands, legs, feet and buttocks
- Subconjunctival haemorrhage
- Epistaxis in infants
Example of subconjunctival haemorrhage:
Click for UK Sepsis Trust guidance for different clinical settings. Scroll down for the Screening and Action tool for under 5s for prehospital care and ambulance services.
References regarding IM benzylpenicillin that Tim mentions:
- Harnden A. Parenteral penicillin for children with meningococcal disease before hospital admission: case-control study. BMJ. 2006 Jun 3;332(7553):1295–8.
- Hahné SJM, Charlett A, Purcell B, Samuelsson S, Camaroni I, Ehrhard I, et al. Effectiveness of antibiotics given before admission in reducing mortality from meningococcal disease: systematic review. BMJ. 2006 Jun 3;332(7553):1299–303.
- Sörensen HT, Nielsen GL, Schönheyder HC, Steffensen FH, Hansen I, Sabroe S, Dahlerup JF, Hamburger H, Olsen J: Outcome of pre-hospital antibiotic treatment of meningococcal disease. J Clin Epidemiol 1998, 51:717–721.
Example of a paediatric drug calculator from WATCh.