SAQ 398 – Paediatrics – infant seizure and non-accidental injury

A mother brings her 5-week-old term infant to a major children's hospital because the baby is difficult to wake, has not fed normally, and vomited once. The baby was well yesterday but slept through overnight without waking for a feed. The infant weighs 3.9 kg and begins seizing for at least five minutes. After the seizure stops, the child is post-ictal, pale, and grunting. Repeat primary survey shows bruising over the occiput and back.

Observation	Result
Weight	3.9 kg
Initial heart rate	180/min
Initial systolic BP	80 mmHg
Initial respiratory rate	25/min
Initial oxygen saturation	92%
Initial temperature	36.5 C
Post-ictal heart rate	150/min
Post-ictal systolic BP	80 mmHg
Post-ictal respiratory rate	6/min, shallow
Post-ictal oxygen saturation	86% on room air

List four (4) potential causes of seizure activity in this infant.

(Marked out of 4.0)

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List your initial management.

(Marked out of 4.0)

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You proceed to intubate. Complete the airway equipment and drug table for a 3.9 kg infant.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Equipment/drug</th> <th>Size or dose/route</th> </tr> </thead> <tbody> <tr> <td>Cuffed ETT</td> <td></td> </tr> <tr> <td>Laryngoscopy blade</td> <td></td> </tr> <tr> <td>Induction agent</td> <td></td> </tr> <tr> <td>Paralytic</td> <td></td> </tr> </tbody> </table> <p>

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List four (4) historical features and four (4) examination or radiological features commonly associated with non-accidental injury.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Historical features</th> <th>Examination or radiological features</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> <tr> <td>3.</td> <td></td> </tr> <tr> <td>4.</td> <td></td> </tr> </tbody> </table> <p>

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Total Score: 0 / 16

Percentage: 0%