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    Child With Fits in ED - Srl.

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    azeem
    This document summarizes a self-reflective learning activity by Dr. Muhammad Azeem Imran about managing children with fits in the emergency department. He spent 1 hour studying management of fits using lecture slides and the APLS manual. This learning will help him better manage fit patients by knowing appropriate drug doses for different age groups and differentiating between febrile and non-febrile fits. He lists 7 key learning points about investigations for fits and managing prolonged or continuing fits, including giving benzodiazepines, phenytoin, paraldehyde, or thiopental. He will share this knowledge with colleagues in a WhatsApp study group.

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    Child With Fits in ED - Srl.

    Uploaded by

    azeem
    6 views2 pages
    This document summarizes a self-reflective learning activity by Dr. Muhammad Azeem Imran about managing children with fits in the emergency department. He spent 1 hour studying management of fits using lecture slides and the APLS manual. This learning will help him better manage fit patients by knowing appropriate drug doses for different age groups and differentiating between febrile and non-febrile fits. He lists 7 key learning points about investigations for fits and managing prolonged or continuing fits, including giving benzodiazepines, phenytoin, paraldehyde, or thiopental. He will share this knowledge with colleagues in a WhatsApp study group.

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    Child With Fits in ED.srl.

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    This document summarizes a self-reflective learning activity by Dr. Muhammad Azeem Imran about managing children with fits in the emergency department. He spent 1 hour studying management of fits using lecture slides and the APLS manual. This learning will help him better manage fit patients by knowing appropriate drug doses for different age groups and differentiating between febrile and non-febrile fits. He lists 7 key learning points about investigations for fits and managing prolonged or continuing fits, including giving benzodiazepines, phenytoin, paraldehyde, or thiopental. He will share this knowledge with colleagues in a WhatsApp study group.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    6 views2 pages

    Child With Fits in ED - Srl.

    Uploaded by

    azeem
    This document summarizes a self-reflective learning activity by Dr. Muhammad Azeem Imran about managing children with fits in the emergency department. He spent 1 hour studying management of fits using lecture slides and the APLS manual. This learning will help him better manage fit patients by knowing appropriate drug doses for different age groups and differentiating between febrile and non-febrile fits. He lists 7 key learning points about investigations for fits and managing prolonged or continuing fits, including giving benzodiazepines, phenytoin, paraldehyde, or thiopental. He will share this knowledge with colleagues in a WhatsApp study group.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    London GEM Self Reflective Learning

    Full name Of Doctor Dr Muhammad Azeem Imran

    Date of Learning/studying August 07,2022

    Sunday

    How many Hours 1

    Topic Studied Management of Child with Fits in ED.

    Relevance to Emergency Fits are one of the common presentation in ED and it’s disabling as
    Medicine well as life threatening condition.

    Resources used , Name of book,  Dr Faisal Cheema Lecture slides


    online resources , page number ,  APLS manual 2016 edition
    web link

     Now after learning about fits and its management I will manage
    How this clinical learning activity patients better
    will change your practice  Now I know appropriate doses and DOC for different age
    groups.
     Now I can differentiate between febrile and non febrile fits and
    their management

    Write 5 learning points from this 1. Investigations for Fits:-


    self-reflective learning.  Check bedside strip measurement of venous/ capillary
    BMG, and treat hypoglycaemia with glucose IV 0.2g/kg
    (2mL/kg of 10%).
    First fit
    Refer for investigation of possible causes. U&E, blood glucose,
    Calcium,Mg,FBC, and urinalysis will be required.
    Subsequent fit
    If appropriate, check serum anticonvulsant level and arrange
    for follow-up at the GP/outpatient clinic to receive the results
    and adjust the dose appropriately.
    2. Managing the child with fits:-
     Open and maintain airway, and give O,
     Do not rise open clenched teeth-consider a nasopharyngeal
    airway.
     Rapidly obtain venous access, and check BMG.
    3. If convulsion continuing at 5min
     If the fit has lasted for 5min, give lorazepam 0.1mg/kg
    IV/10 over 30-60s, or if venous access is unsuccessful,
    give buccal midazolam (0.5mg/kg, max 10mg) or PR
    London GEM Self Reflective Learning

    diazepam (0.5mg/kg).
     Treat hypoglycaemia with glucose 2mL/kg IV of 10%.
     Apply pulse oximeter and send blood for investigations
    Investigation.
     Check T°-if >38°C, give paracetamol 15mg/kg PR.
    4. If convulsion continuing after a further 10min
     Repeat lorazepam 0.1mg/kg IV/10 over 30-60s. Do not
    give >2 doses of benzodiazepines, including prehospital
    treatment.
     Get senior help and call for senior ED/anaesthetic/PICU
    help.
    5. If convulsion continuing after a further 10min
     Start phenytoin 20mg/kg IVI over 20min (monitor BP and ECG),
    or if already on phenytoin, consider instead phenobarbital
    (20mg/kg IV over 20min) or levetiracetam or sodium valproate.
     Whilst preparing to give phenytoin IVI, consider giving a dose
    of PR paraldehyde (0.4mL/kg) mixed with an equal volume of
    olive oil (thus making a total volume of 0.8mL/kg of the
    paraldehyde + oil mixture).
    6. If convulsion continuing after a further 20min
     Paralyse, intubate, and ventilate using IV thiopental
    (induction dose 4mg/kg), and consider a thiopental
    infusion. Alternatively, consider midazolam IVI (0.1-
    1mg/kg/hr) if this fails to control the fit, usethiopental.
     Transfer to ICU/PICU.
    7. Febrile Fits:-
     Grand mal seizures lasting <5 min and secondary to
    pyrexia of febrile illness.
     By definition, children already diagnosed as epileptic do
    not have febrile convulsions, but 'further fits'.
     Refer for admission children with one or more of the
    following:
    a. Age <2y.
    b. A first febrile fit.
    c. Underlying serious infection.
    d. An unknown cause or pyrexia.

    By Sharing this knowledge in my whatsapp study group.


    How you shared this knowledge
    with fellow colleagues ,

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