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?