Glossary

Brief, temporary loss of awareness (e.g. staring spell) without change in tone or posture. A form of childhood epilepsy.

Non-respiratory muscles that are recruited when breathing is difficult. Examples are neck muscles or abdominal muscles.

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.

Lack or loss of memory, inability to remember past experiences.

Painkiller/pain relief, e.g. Paracetamol.

Agent which will reduce a high temperature, e.g. Paracetamol or Ibuprofen.

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. Apnoea is defined as lasting more than 20 seconds, or more than 10 seconds with accompanying desaturation and/or bradycardia.

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. 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 (appendicectomy).

Asthma is a long-term inflammatory condition in which airways tend to produce more thick secretions (mucus) and can constrict and become narrower. This makes breathing more difficult.

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.

Class of drug which acts on the brain as a sedative and is used to control seizures e.g. Diazepam, Lorazepam.

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 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 are blisters filled with clear fluid larger than 1 centimeter wide. If they are smaller they are called vesicles.

Extravasation of plasma fluids out of the capillaries into the extravascular space. May cause profound hypovolaemia and inadequate oxygenation. May occur in bacterial sepsis.

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.

Brain swelling, for example caused by head injury. May cause altered behaviour, decreased conscious level or abnormal action of individual nerves.

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 months and is not associated with abnormal physiology or examination findings. Colic does not affect growth.

Form of brain injury which may range from just appearing dazed to amnesia with or without a transient loss of consciousness.

Infrequent or difficult evacuation of faeces. A relatively common occurrence in childhood and may cause abdominal pain.

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.

Computerised radiographic technique which uses x-rays to create a cross-sectional image of the body.

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. raised ketones make the blood more acidic. The combination of high blood glucose, elevated ketones and significant acidosis is known as diabetic ketoacidosis. In severe untreated cases this can lead to coma and death.

Quick and easy bedside reagent strip which tests for presence of protein, nitrites, leucocytes (white cells) or glucose in urine.

Outermost (and toughest) of the three membranes (meninges) which cover the brain and spinal cord.

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.

Eczema is a chronic skin disorder that involves dry skin and scaly and itchy rashes.

Polysaccharide toxin particle found on cell wall of certain bacteria. These toxins are responsible for many of the virulent effects of certain bacteria.

Redness of the skin caused by dilatation of capillaries therefore blanching on pressure.

Space inside the skull but outside the dura membrane.

A seizure associated with a fever, usually in toddlers.

See partial seizure.

The soft spot at the junction between an infant's skull bones, before full ossification of the skull has occured.

Acute infection of the lining of the stomach and intestines, causing nausea, vomiting and diarrhoea.

Seizure in which the child loses consciousness.

Numerical score used to describe level of consciousness. Based on eye opening, limb movement and verbal response to stimulation.

A noise made by infants through partially closing their glottis in order to generate positive airway pressure which keeps the small airways open.

Involuntary contraction of the abdominal muscles felt when the abdomen is examined. Usually accompanies severe abdominal tenderness and often indicates peritonitis.

Localised collection of blood into tissue or an organ.

A bleed.

The bobbing movement of an infant's head and have an increased breathing effort and tachypnoea. This is caused by use of accessory muscles to help support breathing.

Abnormal elevation of the blood sodium level. May be associated with dehydration.

A surgical opening in the ileum (part of the small intestine) to the outside of the body to provide a new route of waste to exit.

Lower part of abdomen, above the groin. On the right side the iliac fossa overlies the appendix.

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.

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.

A flat, red area on the skin that is covered with small confluent, palpable bumps. This rash is blanching.

Inflammation and infection of the meninges, or membranes that surrond the brain and spinal cord.

A tube inserted via the nostril in to the back of mouth to keep the airway open.

Method of delivering inhaled drugs in droplet form via an oxygen mask.

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.

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.

Tube inserted in the mouth in order to keep airway open.

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.

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.

The percentage of haemoglobin in the blood which is attached to oxygen. In most people, saturations of 94% and above are acceptable. In people with certain conditions e.g. heart problems, acceptable ranges can be different.

These are solid, raised lesions (hence palpable) up to 0.5 cm in diameter. If they are bigger they are called nodules.

Alteration in either movement or sensation activity caused by abnormal electrical activity in a localised area of the brain. The child is not unconscious.

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.

Tapping a body part during examination. This may help determine if peritonism is present, if the patient jumps.

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.

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 sepsis and ITP. These do not blanch on pressure.

Brief, temporary loss of awareness (e.g. staring spell) without change in tone or posture. A form of childhood epilepsy.See absence seizure.

Aggregations of papules and pustules.

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.

An electronic device with a probe placed on the skin, which measures oxygen saturations .

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 sepsis.

Circumscribed, elevated lesions of the skin containing purulent fluid.

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.

Generalized seizure caused by hypoxia, which may be precipitated, for example, by a breath-holding attack.

Indrawing of the respiratory muscles due to an increased effort of breathing. Types include intercostal, subcostal, sternal and supraclavicular indrawing and tracheal tug.

Infection of a joint. Causes fever, malaise and joint inflammation, limp or reluctance to use affected limb.

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.

Elasticity of the skin. Decreased in dehydration.

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.

An ongoing asthma attack that doesn't respond to standard treatment

Prolonged or rapidly repeated seizures, for 20 minutes or more, or recurrent seizures without waking in between.

A harsh sound coming from a narrowed upper airway, which can be heard on inspiration and/or expiration. This sound indicates an airway obstruction.

The space between the dura membrane and the skull. A bleed here causes a sub-dural haematoma.

The soft area just above the top of the sternum.

A raised pulse rate.

A raised respiratory rate.

Seizure characterized by stiffness, then repeated contraction and relaxation of muscles with loss of consciousness.

A swelling that can vary in in mobility and consistency. Bigger than a nodule.

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 (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.

Circumscribed elevations of skin containing clear fluid. They are less than 0.5 cm in diameter. If they are bigger they are called blisters.

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.

High pitched sound heard on expiration (breathing out) in for example children with asthma and bronchiolitis. It is caused by a narrowing of the lower airways, usually due to excess secretions (mucus). Typically the expiratory phase of the breathing cycle is prolonged.