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Okay, so, um, quick overview. Just off. Hardly approach pediatric seizures and the UTI, and then we'll have a short better you than of Ah, a simulation. Okay, so, um, principles really are a B c d. E, or we fed up first in that on the screen today. But that's, you know, just keep falling back amount for those of you here, junior, and maybe haven't been near falls or your HDLs or a last courses yet. And I suppose this might be, um you know, you've got to go off building on, but Andrea Lee is that sort of foundation. Know if I reassessed something, he's not well, and so just fall back on every every time, keeps his right. So child comes and then they're feather in your eyes. Follow on. ABC approach. You know, make sure that area is patent. Apply for oxygen. You may need to use the margins. Toe is the airway there again? Often, these these Children will have trust muscle, be bite down and contention their drawer so you may not be able to get an adult airway, and you might just have to be on the formulary Is that they're gonna suction away in a secretions that might be in the airway and then hold the airway open. Be on, assessed me. Just make sure they've gotten other put oxygenation on. Uh, you're not gonna be able to get shots on a child that's that big like a tree. A soup is looking at the color of the child on, but with the effects of breathing. Really? Now, when it comes to see you can certainly check the company full time again. You'll not be able to get a hurry it on just because of the Southern and normally get BP on base. We'll get your full back on color and cover the full time. You might try for the access it see on, But when you're there and get some blood tests off and take your routine blood tests and then also make sure you're getting a CRP and A B. C. Uh, yeah, so, um, with some cultures, okay, important in the gas, you want to see what the blood sugar is when it comes to the then you're gonna I mean their feelings. You want to get out of school or GCS, then you'll see what the good news is doing on the assessor. People's on you inquire with drugs or toxins when it comes to even even have a look, right? The child looking at the head from Exelon signs of having dreary and look on the rest of my life in rashes make you think you would see an ass infection exam that they they have to look for any other signs of trauma or almost. Okay, so and I just got the algorithm that we're gonna follow. And two halfs here is the album from a TLS. So just a recap. Airway heckle up. Then don't forget that little thought. Make sure you get vascular access. Five minutes after the start of the convulsion, you're gonna give your first dose of benzodiazepine. So that means. And I'd be there as a palm a point. Tried not putting 1 mg. But, you know, I d i o you don't have access than you could give me their buck. Um, with the Islam or rectal diazepam, uh, their 0.5 lbs for you, too. And probably tablet refer records as a problem and 80 on the bulk of it, as um is normally. And it's often more. They're asking medications that parents will have a open for for seizure, sensation of And kids. You have problematic seizures. And so after you get that first with Benzo, you're gonna get another five minutes on that. 10 minutes after the start of step ones. Those in 10 minutes after failing. You wanna see if they're still fine? No. You're going to be sent here for a punctuation scare. Monitors feel ABC assessments again. If they're still affecting that, you're gonna go in with the second dose of benzoyl. And ideally, that's gonna be a problem this time because you should have access to that stage quite often. You, Elsie, um um, senior connections. Ask him for probably high, but isn't there in the right hand side? And I think I've used it once, and actually, it was really, really good. We used it because we had it was time to his national shortage of over ASAP On on. Do we get probably why we're trying to find some and Robin, and it's just a pain to make up for the CT nurses that have the most. They will know what talking about. So it's pointy. It Males breaking you on being under 50 50. Next with always on tablet catheter type syringe that's given us a Zomig and rectal enema. Okay. Can just need to explain the parents before you, not what you're doing. And it does. Actually, it's really, really affect about that start even on then. And if what? Once you last you've given that second was the last time you think about your next step on about is even be thinking about that. A one or an apartment. Oh, okay. Due for those are both the same, which is great, because that next quite easy said both 20 mg pretty low on. Did you take that time to get ready and prepared? So it's good idea to get that student on. That should be even to give him a 20 minutes from the on self off that Okay, um on. Really? You want to pick the one that they're No. They're only on financial with. Normally, you're gonna go for the phenobarbital, and they're on like the the all phenobarbital on regularly. So it's kind of secretly before, but if they're if they're already on fentanyl yesterday, that sort of a thought that that's been an effective. So try something different and the new guidance has been a few trials or recently looking at Levitra, Saddam or Keppra. Um, it's been shown way. We know that it's, um, not inferior, very rare to find one for you, and then it is much easier. Thio and draw upon a minister show some of the guidelines are already changing towards level Trust. Time was a third option there about stage, and certainly my privates would already be heading that way. So if I was having tried it on the board on Capitol, normally I'm probably Capra rally on financial name. But the guideline that that's very beneficial to still hasn't gone yet. And so once you're you're starting the factory phenobarbital on, then they're infused over 20 minutes on need to ban a boat on what your next stage is that they're still filtering. Then the child is going have to be on put into given on the stomach. Uh huh. Just just trying on taking drawl on a vent. They damaged to the green, and you should be even toe Have that done about a 30 minute mark. Okay, And on the classic classic, cops will be a sort of classic RSI with fire pencil. Okay, But you well see, and it's confusing on the region's on T o r. So and I mean, that's really just to say, you know, like tried oat that level last time was coming. Minutes is my last year, and so you have been used on this concentration. Just be wary of the other things that might be causing your springs. Dis assume that this is epilepsy, specialized test of epilepsy to think about. You did have a known history of epilepsy, and the not seizures is only other past medical history on gravel. Think about head dramatizes, actually recycle, bleed on, have access to talk to your poisons, a sort of sepsis. Or has it been a febrile illness? Just things that might tell you that this is not a straightforward apple at the seizure. Okay, because it might be the first presentation. I will have to say it may be a federal commotion, and but that's no that, you know, it should be careful not complaining, more serious going on. And if you have a concern of that, the ones that tend to be more prone seizures anyway. you're doing that algorithm on your thinking about CT scan with other things and then, like, always, always, always like the any eye is well, Fortunately, you got China who's previously fat well on the turn up in there and stop us and with heaven Juries. Then you just keep any eye issues garden with so and I can't take any quick questions. But what about you know is have a quick video of ah, simulation way, way, way, way, way, way it goes and comes. It's not creations there said that after perfect there you can start with this amenable to see you. I think that way. Way to get the 1st 1% at four minutes nine at the time was all perfect. That's so he was like throwing up from 7 g of that around at about 3.7 already know perfect. We've given up frequency, able to go back and see approach, but I also this point here in the middle. So you are a Yes, I do. No, he's wanting to get before I forget. I think I still reasonable to be on a normal for normal saturations, which is a good sign. I'm good with difficult year good air in the chest, everything going to see you so offensive cap refill. Several country folk are 24 pressure will want it. 70 is perfect and some temperature There's well, well, 37 on the GM is perfect, so that's very important for this season. To try to work like a tension is so the terms of the citizens and temperatures higher for seizures. But that's normal for mixed prior to that, like also seizures instead of the results that you know, it'll seem fine left. It's high, but I have seven sisters. All the bedding okay, the e M 2050. In terms of the procedure, Control has to get a person at the office and way and just have the world. You have things. We've got time for that, just okay? It's a mask is enormous. And it's not just did it just get a little percent nine minutes. So get through the holiday that nine terms of the, um and she's Are you getting up to 94? So, Carl, just the way against the second ready points. So what seizure you want in five minutes, you give your first looks overall problems or, you know it's red or January and you don't you don't weigh. Want to get them. Can cash in boarders quickly this child, then you have a second. It's what? This point Then be calling from the allergist because it was like his child. And the next step would be an aunt. That medication, such as leave it here in season, finished that barbital. But these Children, when they're honest, reduced and all the medication and Silas, they often are sequence infections. And things just happen to the modern. There is well, getting more details. And we are Yes. Okay, okay. And hopeful that was helpful just to see it ever on three in real time. Um, I've got Carl with me who has been put in the spot there, and I hope you have great it quite well on drugs. Like I went, um, I think it was Well, maybe I think the schools of the priorities we wanted to identifying our aim is to make sure the airways, that Steve So we worked with an A B c D. Approach, um, untreated each problem as matters. And we were also able thio and we were aware of the algorithm and teo treat at the appropriate time. You're aware that time's very important terms of your find that it's 10 minutes and 60 minutes and under sedation in cash in between the doctors, nurses in the team. And they think, I think we asked her to dirty and also with after the first two weeks of grasses pounds asking for a little bit consultant support about the second drugs were thinking honest affects on that. Also, when we try to review any potential causes much trying to be diverse because rather than treating the seizures, you can possibly rather than treating that with the bands of my ass up, even if you could possibly have done to fire calls and treat, that probably would want to do well. So I think that they would be in the environment point Really, from the small you Absolutely. I think it was fresh. Like, uh, hopefully you'll agree with the's A quite stressful I, like worsens over the same respect. The time there's no is really uncomfortable for us. So on the situation that there aren't aren't are various to look after, so and, uh, I think it's just trying to expose ourselves too much as we can and keep ourselves on the table for all any. Any comments or questions from folk cut home for that one other thing I wanted to extract, just teasing it was and the use of the air's T piece. You might know I've seen not used before. And he could have used the pediatric Bible masters. Make sure you for the pediatric size and but on the terms of on adults, we would use the tables and see you in the water circuit about the same the infancy and device and raise us and and Children. We tend to use narrative, basically just a difference. So if you're not sure what that is, then the next time you're in on work and find some one of us a consultants or the senior nurse is on, ask them what it is now your neck up just so that you're familiar with it, but tends to be you'll be a big, greedy consultant or and the I See you take that would oscal up on when we were minding their Children. Child's airway. Okay, so we'll just move on then to the next one is there's no questions at all