Child With MUSCLE Weakness

Child With MUSCLE Weakness

Introduction

Neurologists focus on identifying the location of the pathologic lesion as the first step in determining etiology. 

In the case of muscle weakness this would be :

• upper motor lesion - cerebral, posterior fossa, or spinal cord above the muscle groups affected spinal cord,
• lower motor lesion - anterior horn cells, motor nerves, neuromuscular junction - pre or post synaptic muscle fibers.

Cervical Spine IMMOBILISE

Cervical Spine IMMOBILISE

Patients with suspected or possible cervical spine injury must have their cervical spine properly immobilised until formal assessment occurs.

1.Any trauma patients with : 

• Unconscious
• Complaining of neck pain or tenderness or limitation of movement
• Using hands to support neck
• Has any neurological deficit
• Significant head /facial injuries

Hypertensive EMERGENCY

Hypertensive EMERGENCY

The situation is a true hypertension emergency when there is acute and life-threatening organ damage, such as hypertensive encephalopathy (headache, lethargy, seizures, coma), intra-cranial haemorrhage, aortic dissection, acute coronary syndromes (unstable angina/acute myocardial infarction), acute left ventricular failure with pulmonary oedema, or pre-eclampsia/eclampsia. The initial aim of treatment is to lower blood pressure in a rapid (within 2-6 hours), controlled but not overzealous way, to safe (not normal) levels – about 160mmHg systolic and 100mmHg diastolic, with the maximum initial fall in blood pressure not exceeding 25% of the presenting value. Too rapid a fall in pressure may precipitate cerebral or myocardial infarction, or acute renal failure.

Hypotensive agents should be administered intravenously when organ damage is potentially life-threatening. All patients should be admitted to a high dependency or intensive care bed, for continuous BP monitoring. The choice of drug will frequently depend on the underlying cause or the organ most compromised. In many instances, patients will be salt and water deplete and will require fluid replacement with normal saline in addition to antihypertensive agents.