Type of IV fluids for the following scenarios
1. 10 year old, 2 day history of diarrhoea and vomiting, very sunken eyes, skin pinch 20 seconds, GCS 9/15. Weight 15kg
2. 10 year old, 2 day history of diarrhoea and vomiting, sunken eyes, skin pinch 6 seconds, very eager to drink. Weight 15kg
3. 8 months old, history of diarrhoea and vomiting, very sunken eyes, skin pinch more than 3 seconds, weight 11kg
4. 12 years old, history of trauma plus active bleeding. Low Bps, tachycardia. Cold extremities.
5. 7 year old, 2 day history of fevers, FBC shows leukocytosis with neutrophil predominance. Low Bps, cold extremities, tachycardia
Calculate fluids in these scenarios
8 months old, history of diarrhoea and vomiting, very sunken eyes, skin pinch more than 3 seconds, weight 11kg
2 years old, history of diarrhoea and vomiting, very sunken eyes, skin pinch more than 3 seconds,. Gcs 9/15 weight 15kg
Management of a child who presents with seizures/convulsions
1. Scenario 1: for severe dehydration, the appropriate IV fluid would be Normal Saline (0.9% NaCl) with dextrose.
2. Scenario 2: for severe dehydration with features of shock, the appropriate IV fluid would be Normal Saline (0.9% NaCl) with dextrose.
3. Scenario 3: for severe dehydration in a young infant, the appropriate IV fluid would be Ringer's lactate or Normal Saline (0.9% NaCl) with dextrose.
4. Scenario 4: for a child with trauma and active bleeding, the appropriate IV fluid would be Normal Saline (0.9% NaCl) or Blood transfusion if needed.
5. Scenario 5: for a child with fever and signs of sepsis, the appropriate IV fluid would be Normal Saline (0.9% NaCl) with dextrose.
Fluid calculation for scenarios:
1. For an 8-month-old weighing 11kg with severe dehydration, the fluid requirement would be 10% of their weight in the first 8 hours, followed by maintenance fluids. So, the initial fluid requirement would be 1100ml followed by maintenance fluids.
2. For a 2-year-old weighing 15kg with severe dehydration and altered mental status, the fluid requirement would be 15% of their weight in the first 8 hours, followed by maintenance fluids. So, the initial fluid requirement would be 2250ml followed by maintenance fluids.
Management of a child who presents with seizures/convulsions would include ensuring a patent airway, maintaining oxygenation, giving IV access for medications if needed, and administering antiepileptic medications such as lorazepam or phenytoin. The underlying cause of the seizures should also be investigated and treated.