Readers should be aware that professionals in the field may have different opinions. Because of this fact and also because of regular advances in medical research, we strongly recommend that readers independently verify facts. Ultimately it is the readers' responsibility to make their own professional judgements. Description or reference to a product or publication does not imply endorsement of that product or publication and in which case is subject to the relevant disclaimers.
Spotting the Sick Child
Resources
Glossary
A
[ ^ Return to Top ]
Absence Seizure (Petit Mal Convulsion)
Brief, temporary loss of awareness (e.g. staring spell) without change in tone or posture. A form of childhood epilepsy.
Accessory Muscles
Non-respiratory muscles that are recruited when breathing is difficult. Examples are neck muscles or abdominal muscles.
Acidosis
Abnormally high level of acid in the body (or abnormally low pH). When caused by inadequate respiration, termed respiratory acidosis whilst any other cause of acidosis is termed metabolic.
Amnesia
Lack or loss of memory, inability to remember past experiences.
Analgesia
Painkiller/painrelief, e.g. Paracetamol.
Antipyretic
Agent which will reduce a high temperature, e.g. Paracetamol or Ibuprofen.
Apnoea
An apnoea describes unnaturally long pause in breathing. During an apnoea, the muscles in the throat relax and can cause a total blockage of the throat's airway. An apnoea commonly resolves after around 10 seconds.
Appendicitis
Appendicitis is an inflammation and swelling of the appendix of the colon. The appendix is a small pouch that is connected to your colon in the lower right side of your abdomen (stomach). In children, appendicitis commonly causes initially central abdominal pain before getting progressively worse and moving to the right lower side quadrant of the abdomen (right iliac fossa). It usually requires surgical treatment (appendectomy).
Asthma
Asthma is a long-term inflammatory condition in which airways tend to produce more thick secretions (mucus) and are narrower than usual. This makes breathing more difficult.
AVPU
Acronym of a source used to describe the level of consciousness of a patient. A - Alert; V - responds to Voice; P - responds to Pain; U - Unresponsive or Unconscious.
B
[ ^ Return to Top ]
Benzodiazepine
Class of drug which acts on the brain as a sedative and is used to control seizures e.g. Diazepam, Lorazepam.
Breath- Holding Attack
Episode when child - usually a toddler - will take a deep breath and stop breathing for a few seconds. This may cause facial colour change (cyanosis). The episode is usually precipitated by a sudden shock such as banging their head, immunisations, or high emotions.
Bronchiolitis
Bronchiolitis is a common respiratory infection, usually caused by the RSV virus, that affects babies and young children. The smallest airways in the lungs, called the bronchioles, become infected and inflamed, leading to a build-up of mucus. This makes it harder for the child to breathe and causes the typical wheezing sound. Breathing difficulties subsequently causes feeding difficulties.
Bullae
Bullae are blisters filled with clear fluid larger than 1 centimeter wide. If they are smaller they are called vesicles.
C
[ ^ Return to Top ]
Capillary Leak
Extravasation of plasma fluids out of the capillaries into the extravascular space. May cause profound hypovolaemia and inadequate oxygenation. May occur in bacterial sepsis.
Capillary Refill Time
A measure of tissue perfusion. it describes the time it takes for blood to re-enter capillaries after it has been squeezed out. Measured by pressing the skin firmly for 5 seconds and the counting until the normal skin colouration returns. Can be measured peripherally or centrally.
Cerebral Oedema
Brain swelling, for example caused by head injury. May cause altered behaviour, decreased conscious level or abnormal action of individual nerves.
Colic
A syndrome occurring in early infancy characterized by excessive crying and abdominal pain (legs may be drawn up), usually after feeding. This common condition occurs from 2-3 weeks of age until about 3-4 month and is not associated with abnormal physiology or examination findings. Growth is normal.
Concussion
Form of brain injury which may range from just appearing dazed to amnesia with or without a transient loss of consciousness.
Constipation
Infrequent or difficult evacuation of faeces. A relatively common occurrence in childhood and may cause abdominal pain.
Croup
Croup is an infection that affects the voice box (larynx) and the airway to the lungs (trachea). The scientific name for croup is laryngotracheitis. It causes a hoarse voice, stridor and a barking cough.
CT scan
Computerised radiographic technique which uses x-rays to create a cross-sectional image of the body.
D
[ ^ Return to Top ]
Diabetic Ketoacidosis
A form of metabolic derangement and acidosis caused by lack of insulin. In the absence of insulin the body breaks down fat for a fuel resource. A by-product of this are ketones. This presence of raised ketone levels is known as diabetic ketoacidosis. In severe untreated cases this can lead to coma and death.
Dipstick
Quick and easy bedside reagent strip which tests for presence of proteine, nitrites, leucocytes (white cells) or glucose in urine.
Dura
Outermost (and toughest) of the three membranes (meninges) which cover the brain and spinal cord.
Dysuria
Pain, or a burning sensation during urination (micturation, passing urine). Along with fever, increased frequency of urination and abdominal pain, it may be a sign of a urinary tract infection.
E
[ ^ Return to Top ]
Eczema
Eczema is a chronic skin disorder that involves dry skin and scaly and itchy rashes.
Endotoxin
Polysaccharide toxin particle found on cell wall of certain bacteria. These toxins are responsible for many of the virulent effects of certain bacteria.
Erythema
Redness of the skin caused by dilatation of capillaries therefore blanching on pressure.
Extra-Dural (Epidural)
Space inside the skull but outside the dura membrane.
F
[ ^ Return to Top ]
Febrile Convulsion
A generalized seizure associated with a fever, usually in toddlers.
Focal Seizure
See partial seizure.
Fontanelle
The soft spot at the junction between an infant's skull bones, before full ossification of the skull has occured.
G
[ ^ Return to Top ]
Gastroenteritis
Acute infection of the lining of the stomach and intestines, causing nausea, vomiting and diarrhoea.
Generalized Convulsion
Seizure in which the child loses consciousness.
Glasgow Coma Scale
Numerical score used to describe level of consciousness. Based on eye openeing, limb movement and verbal response to stimulation.
Grunting
A noise made by infants through partially closing their glottis in order to generate positive airway pressure which keeps the small airways open.
Guarding
Involuntary contraction of the abdominal muscles felt when the abdomen is examined. Usually accompanies with severe abdominal tenderness and often indicates peritonitis.
H
[ ^ Return to Top ]
Haematoma
Localised collection of blood into tissue or an organ.
Haemorrhage
A bleed.
Head Bobbing
The bobbing movement of an infant's head when they are lying down and have an increased breathing effort and tachypnoea.
Hypernatraemia
Abnormal elevation of the blood sodium level. May be associated with dehydration.
I
[ ^ Return to Top ]
Ileostomy
An opening in the ileum to the outside of the body to provide a new route of waste to exit.
Iliac Fossa
Lower part of abdomen, above the groin. On the right side the iliac fossa overlies the appendix.
Intussusception
Intussusception describes an abdominal surgical emergency whereby there is the sliding of one part of the intestine into another causing an obstruction. It presents with episodes of colicky abdominal pain, vomiting and sometimes blood in the stools ('red-currant jelly stools'), eventually leading to signs of shock. Most common between the ages of 4 months to 2 years, but may occur at any age. Requires urgent treatment in a surgical centre before bowel necrosis and perforation occur.
M
[ ^ Return to Top ]
Macule
These are circumscribed areas of different coloured or textured normal skin. There is no skin elevation or depression ('flat disk'). They may be any size. They can not be felt.
Maculopapular
A flat, red area on the skin that is covered with small confluent, palpable bumps. This rash is blanching.
Meningitis
Inflammation and infection of the meninges, or membranes that surrond the brain and spinal cord.
N
[ ^ Return to Top ]
Nasopharyngeal Airway
A tube inserted via the nostril in to the back of mouth to keep the airway open.
Nebuliser
Method of delivering inhaled drugs in droplet form via an oxygen mask.
Nodules
Palpable, solid lesions greater than 1cm in diameter. If they are smaller they are called papules. If they are big lesions they are called tumors.
O
[ ^ Return to Top ]
Oesophageal Reflux
Condition where stomach contents regurgitate into the oesophagus. Common in infants up to 6 months of age. Symptoms include posseting and vomiting after food, and when asleep.
Oropharyngeal Airway
Tube inserted in the mouth in order to keep airway open.
Osteomyelitis
Infection of a bone. Causes fever, pain and local signs such as swelling, erythema, tenderness or reluctance to move the affected limb. Local signs may be absent, especially in newborn or very young children.
Otitis media
Inner ear infection (viral or bacterial) causing earache and fever. A young child often pulls at his ear. Causes a bulging eardrum which appears inflamed.
Oxygen Saturation
The level oxygenation in the blood.
P
[ ^ Return to Top ]
Papule
These are solid, raised lesions (hence palpable) up to 0.5 cm in diameter. If they are bigger they are called nodules.
Partial seizure
Alteration in either movement or sensation activity caused by abnormal electrical activity in a localised area of the brain. The child is not unconscious.
PEEP
Positive end-expiratory pressure (PEEP) refers to pressure in the airway at the end of expiration that is greater than the atmospheric pressure and therefore prevents the collapse of the small airways. Strictly speaking this term is only applicable to patients receiving mechanical ventilation.
Percussion
Tapping a body part during examination. This may help determine if peritonism is present, if the patient jumps.
Peritonitis
Peritonitis is inflammation of the peritoneum (inner lining of the abdomen) due to a bacterial, or fungal, infection. The most common symptom of peritonitis is severe abdominal pain, but also often vomiting and moderate fever. It is a sign of severe abdominal pathology, usually requiring surgery.
Petechiae
A petechia, plural petechiae, is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels). It can occur in meningitis, meningococcal septicaemia and ITP.
Petit Mal Convulsion (Abscence Seizure)
Brief, temporary loss of awareness (e.g. staring spell) without change in tone or posture. A form of childhood epilepsy.See absence seizure.
Plaques
Aggregations of papules and pustules.
Pneumonia
An inflammation of lung tissue is called Pneumonia. It's usually, but not exclusively, caused by an infection (bacteria, viruses or fungi). It causes shortness of breath, cough and fever.
Pulse Oximeter
An electronic device with a probe placed on the skin, which measures oxygen saturations .
Purpura
Purpura (from the Latin, purpura, meaning 'purple') is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin. Purpura measure 0.3-1 cm, whereas petechiae measure less than 3 mm, and ecchymoses greater than 1 cm. Purpura is a common, unspecific medical signs however the underlying mechanism commonly involves either a platelet disorder, a vascular disorder or a coagulation disorder. They commonly appear with meningitis or meningococcal septicaemia.
Pustule
Circumscribed, elevated lesions of the skin containing purulent fluid.
Pyloric Stenosis
Congenital condition in which the pylorus is thickened, obstructing the gastric outlet. Symptoms include the development of projectile (forceful) vomiting around 4-6 weeks after birth. Requires corrective surgery.
R
[ ^ Return to Top ]
Reflex Anoxic Seizure
Generalized seizure caused by hypoxia, which may be precipitated, for example, by a breath-holding attack.
Respiratory Recessions
Indrawing of the respiratory muscles due to an increased effort of breathing. Types include intercostal, subcostal, sternal and supraclavicular indrawing and tracheal tug.
S
[ ^ Return to Top ]
Septic Arthritis
Infection of a joint. Causes fever, malaise and joint inflammation, limp or reluctance to use affected limb.
Shock (Septic)
Septic shock describes a severe medical condition caused by infection (often caused by bacterial endotoxin) which results in the inadequate provision of tissue perfusion resulting in tissue hypoxaemia (not enough oxygen supply) and acidosis (see acidosis). It leads to capillary leak which causes an inadequate circulatory volume and subsequently poor cardiac output. It can lead to the disturbance of the function of multiple organs and subsequently to death.
Skin Turgor
Elasticity of the skin. Decreased in dehydration.
Spacer Device
Large plastic device into which inhalers can be plugged, to avoid having to coordinate breathing with inhaler detonation. Can be known as a Volumatic device.
Status Asthmaticus
An ongoing asthma attack that doesn't respond to standard treatment
Status epilepticus
Prolonged or rapidly repeated seizures, for 20 minutes or more, or recurrent seizures without waking in between.
Stridor
A harsh sound coming from a narrowed upper airway, which can be heard on inspiration and/or expiration. This sound indicates an airway obstruction.
Sub-Dural
The space between the dura membrane and the skull. A bleed here causes a sub-dural haematoma.
Supra-Sternal Notch
The soft area just above the top of the sternum.
T
[ ^ Return to Top ]
Tachycardia
A raised pulse rate.
Tachypnoea
A raised respiratory rate.
Tonic-Clonic Seizure
Seizure characterized by stiffness, then repeated contraction and relaxation of muscles with loss of consciousness.
Tumor
A swelling that can vary in in mobility and consistency. Bigger than a nodule.
U
[ ^ Return to Top ]
Ulcer
A break in the lining of the skin or mucous membrane. There is a disintegration and necrosis of the outer layer tissue, and often associated with pus. Various underlying reasons possible.
Urticaria
Urticaria (or hives) are a kind of skin rash notable from pale to dark red, raised, itchy bumps. It reflects a transient area of dermal oedema. Hives are frequently caused by allergic reactions; however, there are also many non-allergic causes.
V
[ ^ Return to Top ]
Vesicles
Circumscribed elevations of skin containing clear fluid. They are less than 0.5 cm in diameter. If they are bigger they are called blisters.
W
[ ^ Return to Top ]
Wheal
Wheals are firm, flat topped and elevated, hence palpable lesions of the skin. They are usually pale to dark red in colour and of variable size and shape, although usually rounded. They commonly itch or burn and represent dermal collections of oedematous fluid. Urticaria (see above) describes the itchy rash consisting of multiple wheals.
Wheeze
High pitched sound heard on expiration (breathing out) in for example children with asthma and bronchiolitis. It is caused by a narrowing of the airway, usually due to excess secretions (mucus). Typically the expiratory phase of the breathing cycle is prolonged.
