PAEDIATRICS
EMPYEMA
Prompt
ResponseLarge L sided opacification with meniscus/pleural effusion
Consolidation of the lung (primarilly lower lobe)
R sided mediastinal _ tracheal shift
R sided perihilar opacification
R lower zone air bronchogram
L hemigiaphragm obliterated
Dx = large L sided pneumonia with parapneumonic effusion (Or L sided empyema)
Consolidation of the lung (primarilly lower lobe)
R sided mediastinal _ tracheal shift
R sided perihilar opacification
R lower zone air bronchogram
L hemigiaphragm obliterated
Dx = large L sided pneumonia with parapneumonic effusion (Or L sided empyema)
PromptInvestigations
ResponseVBG
Blood cultures
Pleurocentesis - Diagnostic + therapeutic
EUC - assess for multi organ failure in context of sepsis
BSL - Seek and treat hypoglycaemia in context of reduced intake
Blood cultures
Pleurocentesis - Diagnostic + therapeutic
EUC - assess for multi organ failure in context of sepsis
BSL - Seek and treat hypoglycaemia in context of reduced intake
PromptManagement of empyema
ResponseOxygenation aiming for saturations >94%
IV ceftriaxone 50 mg/kg and clindamycin 15mg/kg
Retrieval to tertiary centre for PICU/Surg/cardiothroacic opinion
IV ceftriaxone 50 mg/kg and clindamycin 15mg/kg
Retrieval to tertiary centre for PICU/Surg/cardiothroacic opinion