the critically ill child

12
/01/ -ftt£ Cfl,r{cALCl.1 /([ Cflle-D, £1 ffobl1 ---_. /IoIaptahw - le. rnalUj chanr crJ;- bJtt< (frafl6tf)()f"J(d Ctrcv/C; hoA ) /Y? tIe/{)JOIA, CtlR1 0 CC'C/f . - ()(owtlA anot -- J'Q11e [J 0h'J (ol?fnh:.Jlco Jo LIHIT£O K!5S£f2V£. - HalvrahoJl1 - lob 0/ Olj6J e mf cue Irnmclllle (mOle, OD jT) pt/YJt4/L1e!} haA , immune jl;nChOiA · fet?OvI !8ncho;/l t(J ,,()!i4'adant tii/tmna:; ---i:? IIY If ll).lE HEHBfl' ;tN;2 , @ (fl vCtJrDn f1 1 franJ/lJQ£ ---l7 JA{)NOIc£. c1t/lCAPI7Ctf

Upload: james-moon

Post on 25-Dec-2015

241 views

Category:

Documents


5 download

TRANSCRIPT

Page 1: The Critically Ill Child

/01/ -ftt£ Cfl,r{cALCl.1 /([ Cflle-D,

£1 ffobl1 ~ _~~~t!!th. ---_. ~ /IoIaptahw - le. rnalUj chanr crJ;- bJtt<

~Clat4 {'orrdt~pL/l1Iui1.

(frafl6tf)()f"J(d Ctrcv/C; hoA ) ~ /Y? tIe/{)JOIA, CtlR1 0 CC'C/f .

- ()(owtlA anot ~meY1t -- J'Q11e ~ [J tJOA)-~fAJ£AR'

0h'J (ol?fnh:.Jlco Jo LIHIT£O K!5S£f2V£.

- HalvrahoJl1 - lob 0/ Olj6Jemf cue Irnmclllle (mOle, OD jT) pt/YJt4/L1e!}

~ 7he~m0ltf!?la haA , immune jl;nChOiA

· fet?OvI !8ncho;/l

t(J ,,()!i4'adant tii/tmna:; ---i:? IIY If ll).lE HEHBfl' ;tN;2

, O~£AS6

@ (flvCtJrDnf11 franJ/lJQ£ ---l7 JA{)NOIc£. c1t/lCAPI7Ctf

Page 2: The Critically Ill Child

At' /:UClA / C1o~ umbJ..tcal vt'Eoeh. "" 1'SVR

/Urt3 elXpct10O'01A "" -tPVR (pArYCI1OIvf vo,ower . 1 ~,,(JzJ. ~ I e rodual .J-. I () pxn . (){

t PUJmomy ffioocl 0c>w ()1vscJe . ~ :::------t--!

l' © A hlovt Prt:.:s:&<J ~ J

[i;ncf.1CV\cU oJowve CIf fbrafYle,v\ ovalL.

[DucJv0 o.J1ctIosus COI'lSh1cb -';::> thr'Oml::o~ J 1k J In pu . cui. muscle 18 pre-ren1tel If {VI. blooi f;oveJ

/ s h'8r. / /. e. CfJn[ff){.:fcvt heaJt; U/OIorW. - VSD

- Palcnf-dvctw o.f/c;lo~.

- Ir()n~ ofk,r1oM .

Commonlvj fJdr /f'!evemldZe pUIY1G/lCrl{ {/C«JcU C/ dweaAe-.

PMn/lflen t /tIaL CLfCula hM

(. e. p%{ofent (limrJ10rtt h'1~O/t. pkW chanf1fblo l'eIYl0U4/\ (~evcvLt '0 oI_cv11/lf/)(A).

~ VICi(:V~ c'1Ue of fI Y f1./XI'lEH I A

ACiDOSiS

1PV1( - $;> In~ rfh.vnlur:J ! .1CJ

Page 3: The Critically Ill Child

ChJfJntc p/ClClPJ/Wt InJut/lcwnCvt.

fbtncda.i hI.( (XIXtC1 or aClc/O&ls /kK-1 an" caVJe,

~ HYp7VJJC()(),J1j rSlfndrome.

• /)I~.tef? hat Cipv?oJU> - /CJU.Cr limbO I?1cr'e CtpnD llt'o/

WhIM @ 10 @ tfhont at chcIal !tbd.

!do pe If fOiflcktttU ate. /5)tXJd fJ1{f/JI~ I 1irJCt 10 g;t Ktt/e It'.o/'. ctwJrr..,n tUf..et...t nof,C fXLi'WMCKf ciufa.;:e .

Page 4: The Critically Ill Child

1!ecdm!,1l (;

) J 'the coo£-

@ ~PVI< 17

~ 0 Hf9h 1;0z ~ b In f;o,! CaY( eaU£: fop-ftop jJflMOmutaA ).

/ (!) fLutJt5 VOWH£ t:f low) - CPAP 0 PEEP

, @ Correct A-Ci/X)SlS (lc:I>p 0 ~c). r\

@J ~k HYf'uvENnc.AT{ Ot-:J - ~ Pa(J)2

o HCl.t-ntawc &.j&em/CpICSJG.Ie - 10 VSh(}nkYl!j

(§) p\!ISCOStTY (tf hf1h-)

(}) InhUled /VO

! IV IDlazoltte I tJl~ \ /hO~CUlduA £

®? fCMO.

Page 5: The Critically Ill Child

\ \7

" meJ;aMc rate IS minimUM

fhBmon.eMial.2an.e L /flOI-tGR IN PK£HS

j Fatw cudtA age.

Heat prcduchQA - 671tVCUfij / nOf}-6h,Vl/l19 t~

1:'\ 0 NfLA7£ cat1fi /1,' ~ c1lUlJl rJf ~ ~~ Mfl tr! ~ mho /flaH. A1aIr-~ /UC¥1ale-

CV t&11te OUfxvtI::tnl!ooJ 1t8::>ve. 8Kdv10 FAT . /nterscapvlor

~, fefltenaJ.

o~

'4cI.

/iJlfJlrmJ trLdah.Uc rate al 365 oC ,I!!

fHORtAury

Page 6: The Critically Ill Child

( Inflaml11Clb1 /'eCJp:;n~ is tGS5, 'a,U IetpcmK/JCCUA te Impaueot.

/)( cett (YJECLla Ia:I -7 01 6£otV£ SYtJOflOHf :::- lack thLjmJc I unchaA -7 ImfY)()ntA(

abJen.t .

(1 CeLl /tnck:u tAJelj ()/£Vdq:cct W1 @ l1ewbJrIA )

-? U/aJl attr;rafh - tgechOtA LS 6lo~ (ctte 10 ~/nflammClfrMt I'elJfOn£ ).

$ ~-aLL ~ V) tfY)ma/vffJ (Ab p1DcWchaA ) ~

-? taJJI~ tfYJmu('uhj .- (JA In bllXV6l mt£k.

-

Page 7: The Critically Ill Child

- 1 hC/p(JXtQ (r I pH 6 APCiAf2 8COte. :=::

- Bes'/ -; /0 WOfGST ~ 0 .sCoRE

---~ r- e> , 2~ Ht< Ab$(J)J- ~/oc

f<esp. eFr~ >100 Abfcvlt fAJeDk Ctt( SIYc?9Cry

Nv<XJe fo ()(2. IJmp &YYtQ A eli<.1 o.A Ac~ MohaA )

RrlfCvx t rntQ.bw.kj 0

('l.Jn fXJ Y't le. GnMo(~ CYz V\IWl CL r CeAJt- et..

Colo(f . ~tue J Pale . fud~ p}(')k AnJ<_ exhern , hv:> Jol ue.. .

(Ct:tK have A~"/\o ) U4I' rurrtL - co Looe ~fVI /1 f~·

It fU& aofh~ f~. CaocXb --- IfacmtaL /tulvre - 7 ioxa.et1MCrI ctlakJ</.), A-f'rf

- thv8 cIJ2,oteJY>lo.A

- 0l61emc eompacah(){/J -7~, ~/f3><I7O-F-oI CWCI

- /ttat ConctJzcw.:> -;/ prefV1. I m(j~ b,/CAA

- fo{/; naJ;ai ~fl,U) -:;> Mop. ct0Ju? (/nCVh./ cav}(/))

#!Y)an~ _. /Y)lllImtX- ';0 //112£6 /iuA (xyscpa.;Jul4A atJphc.;x/a.

• mUd ClIJjJu;XIQ (af{)« s -=r) - OVchClA /70;ejmot.i1A!phoq»x

• mode;ak 11 ( o/ffX 3 -4-) - Eqg 0 Ii1abk veaiz I~ c- 0 l.

~ A8G -;/ (lJve lJa/t('o.3 /b g:£ pH :/ 7- .~ ..... s=:

Page 8: The Critically Ill Child

(nett;: tapld / ~l)lve iJV(fJeIkfnle 1r7/OOlC;V.. )

\ £an #. Inlraual7K:U haRmort-hcx;f-

i~ (~Rmw~

Q/l a C«:i ~ I:x;u;>c ).

17 OXYlfAJ

CEfZ£81Vrl PEfZFuJ10N PJ28sSvfC~. C/OCtI£1'-f ISTey'

COAJTKO(., SEI 2o:e£S

I/fltXa!dtuu. IYlat.j ~ to -'Z? DOPAHIN£

cY" f)O/'sUTI'IHIAJe (S-I0-r3/k8/mm).

Page 9: The Critically Ill Child

NOJf - Hlo· 7KAcftEA dltCarxef:l ~

T2-2840 '" 7-CWl

33/40 '" CfCM

-- -..,. ... _-........

~( c1tt4tXe kr,. / tar

~--------------------------------1t LOIc/J.(1)McpUaIcnc.t atrrYf2 en chu~

(11"'; " ,. I -:/ IYJ()£ c/Juc/IrM laeft II7htt7nc IYlCfOCCfctlaL dt.,x~ .

("',

': -7 Carct£ae Cldl:dt to dve fo G f/YftJXI A

(3) AcIOOSIS.

-? molt CommCJA. ,hC(chU1 ::: ASYS70L£.

~ VF If (!) ('o~t4t:t£ Ife, ~~ @ 0Jctl(:m.(~'et)

@ N$'Oca.ra'lhA

@ f?o'JJnlFlB (~reM J. @) 1f~'lt:I vfay pnfJor1f):tho--t dj? &r II?Iwcd

( ~fJO - IAJcud dl.j11Ct1J1?tg J -'? ~hct ;- br::ID?; P(){7::- 10 ahJe-)')

AIRWAY (Ino~ ~ 10 ohJhvd),

• lAf2(;£ H13A-O I ~110flT NeCk

, lARGE 'TON 00£.

fka ~ bit c7.JTW THeUS7,

Page 10: The Critically Ill Child

~ p~c ;e/W) Ia& pl7B /

Efr IfJbffrlai clLaAM - ~ + 4 Ar - rS/kS 4- VF - 5'Y/ka .

Vd! e1\(XlMtO\ 1 OhJ J ~ 02-s"'X ~~oJ- .

J,-. L ·}(.W\.~ :;zs M I~ loo V'\.1UI\

0'ttQ, h()U\cA fl«; ~ J +hu MV~ .

~_o --+----- Ch ~ JIr1/hVl& (1Vi1clcU.t rJ(l Wvl\NlA}

/~ ~ ~"'ndoJ(;o lint'" .x9

1 • )

.

, Can rJ/!~ ~ chuo/ iactc ~ af?Iv 4S-- CO /YJlrJ CU'~

- M r!Jratvl ~ ~.

· $1) ~(J a«o6t oflwr ~fXYd 10 C p(e czjate

'Ader1~ O.Olrnu/ka 112~ It:> o-/rna lka If °leA>fXJl'U£. ,

. Gve ;{h1(Co:!, emp'l7c0L4 - dRfJ· OY) durahDA cf ~ .' / tf nD A-8G-av~.

8 '41,2rnf/k{j(6lcd) /rnl/ka (eVUj !OMIYlS).

Page 11: The Critically Ill Child

61ve i5z{wb ClAd Ad ao lop] CVJ dcw8 I'e1)lJJ.

I ()/1£Ctnmo..A # Ad 10 pf'l. vr In chvtd./eM.

I (alacM/l Ch /rJIJcft - Cen ko j/eJcnaJ

- f BP ht (!) 1rcnlrachlclq g 1~/f1'1' ~ - matt f teprffAf'CtA lrJ'fi1 ~ J-Ieart 0- CRdxaI.

mCU; CCtvZ; Hecuf liJodc.

-- okU vJC IrI '1 k -f-, J (01 IT, Ca c/Jonnd POIS(fY111!'J

V~ r;2 c 10 In Ctfclt CA

{'an l:c ~lhcl<Mf (c/ve Iv QUII1/cifJ1.£ UJuz

.} t/Iid) 1~/k;J pMn'1kw

fuUp~ .

Page 12: The Critically Ill Child

'f/IP Arfetlai cannJahCM

, 1tYo7d umbUtca.l a::d~1CA> ~ Va..oo-OcdunK ('~cl&thM ~ I

. /OWf/ Umb iJcha£rvll{)( i f&nal fhromOosJS

t A/eCf'Dhu'79 el1k/ocClhtcA · Pcuaplfezo. .

" ~ do brf{}t err).. o./kAUI> CVl ~ kmb .'

· &o.cJual -0- RfYICf'al - nch CdlIaiwL ~ .' , fitko~ erntx.JlA zahCM (i{) a fisk. (oSm I/ryeeke! (6£f InJo /O.flLt-ed

ad;: Ct;l/If ~ t!YcuIt1 .I) <~ 4flaw~.(

11- CVP . au (fl/u) Ok

~ In/tchtJAA telakD 10 ~haA I * ) UJe c/f1nofn.JpeQ

• netJna/G i omb..t1ca,{ ~ a:d:/A. fhY'l/ JII1()?:J V'&>06v.s Jo(g)Q~ ~

11 fA pressue 1- 05 r6-).tOte rJ,,/fiCdk 0 tJ1Et:'d:/ /'U)~ • .~

If1Ic4lUedLd. - cal1 [)tU'fJG ~ btt rn~dL of@-/(9 Ohuw'1!t.

{ffc/AJ;le (flJrpl.k ., ~ DdPJplW M v. llAucwWc-..

'temp tnOlh ~ Clmbud.

(aye - foe It kmp ~ =- IndRJx. cif ccvdt.ac O()lputJ.

fJu/fiC rhvl11elrlj ./ /' PI:.

1/anucull:u'A!!ow ;::(),2 ond R'O:;L mon,~. -7 NaL efecInJdio 10 4g-4S~c -? ID ~aLruz Cctf:JdLcq Jj?()cc/. ---? ~<:::cI. ~cd1~ . Pt co 1.. - PDlOl.. -=: /t?cI£/X. c#' mtc.(OCt,alahCM a.ole.qJacC/.