Week 4 Flashcards
(33 cards)
what are the anatomical differences between adult and paed respiratory system?
Anterior and superior larynx larger tongue Horizontal ribs smaller airways larger floppier epiglottis tonsils and adenoids less fatigue-resistant muscle fibres less developed Diaphragmatic breathers small mandible and neck
At what age does a childs rep system reach maturity?
approx 8 years old
precautions of child with resp conditions?
Children are obligate nose breathers
- nasal secretions or malformations can easily obstruct air flow
Predominately diaphragmatic breathing until 6-8 years… anything that interferes with this (pneumonia, abdo pain) can cause resp distress
what age does a baby in gestation start to generate pulmonary surfactant
24 weeks
what age does a baby in gestation generate adequate pulmonary surfactant
35 weeks
What is the O2 consumption of a child compared to adult?
Infant = 6ml/kg/min adult = 3ml/kg/min
Explain the difference in lung mechanics during inspiration and expiration between an adult and a premature infant
Adult:
Insp - diaphragm contracts down, chest wall expands out
Exp - Diaphragm relaxes up, chest wall moves inward
Prem Infant:
Insp - Diaphragm contracts down, chest wall moves inward
Esp - diaphragm relaxes up, chest wall moves outward
What is the tidal volume of a child?
5-7mls/kg
What is minute alveolar ventilation more dependent on in infants?
Increased RR rather than TV
If a radius is halved, how much does resistance increase by? (exam Q)
16x
What are some signs of respiratory distress in infants?
- Nasal flaring
- drooling
- cyanosis despite 02, pallor
- grunting/wheezing
- irregular breathing/apnoea
- inability to lie down
- diaphoresis
- stridor
- flaring
- head bobbing
- decrease conscious state
- lethargy
- floppy
- WOB +- accessory muscles
- Tachyponea
- Tachycardia initially, moving to bradycardia as late sign
What is the threshold for CPR in a paed?
Infant <60
Child <40
What are the components of the Paediatric Assessment triangle?
Appearance (TICLS)
- tone
- interactiveness
- Consoliability
- Look/gaze
- Speech/Cry
Work of breathing
- abnormal breathing sounds
- abnormal positioning
- retractions
- nasal flaring
Circulation to the skin
- Pallor
- Mottling
- Cyanosis
What are the normal values and age and weight of a newborn?
HR = 110 - 170 BP = 60 SBP AGE = 24 hours Weight = 3.5 kg RR = 25 - 60
What are the normal values and age and weight of a small infant?
HR = 110 - 170 BP = 60 SBP AGE = <3 months Weight = 6 kg RR = 25 - 60
What are the normal values and age and weight of a large infant?
HR = 105 - 165 BP = 65 SBP AGE = 3 - 12 months Weight = 6kg - 3 months / 8kg - 6 months / 10kg - 12 months RR = 25 - 55
What are the normal values and age and weight of a small child?
HR = 85 - 150 BP = 70 SBP AGE = 1 - 4 years Weight = age x 2 + 8 RR = 20 - 40
What are the normal values and age and weight of a medium child?
HR = 70 - 135 BP = 80 SBP AGE = 5 - 11 years Weight = age x 3.3 RR = 16 - 34
What accessory muscles are used by infants in resp distress?
intercostals suprasternal supraclavicular substernal subcostal
What are the signs of hypoxia in infants?
- pallor
- bradycardia
- hypotension
- apnoea
- lethargy
What are the signs of hypoxia in children?
- restlessness
- cyanosis
- tachycardia (brady as late sign)
- tachypnoea
What is Respiratory Syncytial Virus (RSV)?
presents similar to influenza and is the principal cause of bronchiolitis
- disease spectrum ranging from Rhinitis and Otitis media to bronchiolitis and pneumonia
peaks at 2-5 months. everyone would have had it by 3
what is the most common cause of lower respiratory tract infection (LRTI)?
RSV - respiratory syncytial virus
What are the symptoms of the respiratory syncytial virus
- high fever with ill appearance
- thick nasal discharge
- worsening cough or cough that produces yellow, green or grey mucus
- signs of dehydration
- trouble breathing
