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Archived - Pediatric Advanced Life Support (PALS) 2020 > 1 - Respiratory Distress and Failure > Flashcards

1 - Respiratory Distress and Failure Flashcards

1
Q

Gas exchange

A

Air taken in during inspiration –> O2 diffuses from alveoli –> into blood (some dissolves into plasma) –> most O2 is attached to hemoglobin

As blood passes through the lungs –> CO2 diffuses from the blood –> into alveoli –> exhaled

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2
Q

Lung parenchyma

A

Portion of lungs involved in gas exchange

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3
Q

02 consumption per minute for adults vs infants

A

Adults 3 to 4 ml/kg per minute

Infants 6 to 8 ml/kg per minute

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4
Q

Early Signs of Tissue Hypoxia

A
  1. Tachypnea
  2. Inc respiratory effort - nasal flaring, retractions
  3. Tachycardia
  4. Pallor, mottling, cyanosis
  5. Agitation, Anxiety, Irritability
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5
Q

Late Signs of Tissue Hypoxia

A
  1. Bradypnea
  2. Inc resp - head bobbing, seesaw resp, grunting
  3. Bradycardia
  4. Pallor, mottling, cyanosis
  5. Dec LOC
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6
Q

atmospheric pressure during inspiraration

A

intrathoracic is less than atmospheric pressure

Mainly diaphragm, intervcostal muscles, accessory muscles

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7
Q

atmospheric pressure during expiration

A

less than intrathoracic pressure. Relaxation of the inspiratory muscles and elastic recoil of lung and chest wall

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8
Q

What happens when the diaphragm is flattened..

A

Contraction is less forceful and ventilation is less efficient. (eg acute asthma)

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9
Q

3 things that control breathing

A
  1. Voluntary
  2. central and peripheral chemoreceptors
  3. Brainstem resp centers
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10
Q

Spontaneous breathing is controlled by..

A

a group of resp centers located in the brainstem

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11
Q

Voluntary breathing is controlled by…

A

Cerebral Cortex

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12
Q

Central chemoreceptors respond to changes in…

A

Hydrogen ion of CSF

largely determined by PaCO2

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13
Q

Peripheral chemoreceptors respond to changes in…

A

Decrease in PAO2

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14
Q

Upper airway obstruction location

A

Outside the thorax

Nose, Pharynx, Larynx

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15
Q

Signs of upper airway

A

Stridor (insp)
Hoarseness, Cry, Barking Cough
Drooling, Snoring, Gurgling Sound

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16
Q

Sings of lower airway

A

Wheezing (exp)

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17
Q

Lung Tissue Disease explanation

A

Disease involving the substance of the lung
Child’s lungs become stiff
Fluid accumulation in alveoli, interstitum

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18
Q

Signs of lung tissue disease

A

Grunting, Crackles

Trying to increase end-expiratory pressure

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19
Q

Signs of disorder control of breathing

A

Child is “Breathing funny”

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20
Q

Reasons for disorder control of breathing

A

CNS infections, seizures, brain tumor, OD, metabolic abnormalities`

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21
Q

2 lower airway obstruction causes

A
  1. Asthma

2. Broncholitis

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22
Q

Lung tissue disease causes

A

Pneumonia, pulmonary contusion, bacterial, viral, aspiration

23
Q

What is respiratory arrest

A

The absence of respirations with detectable cardiac activity

24
Q

Specific Upper Airway Obstruction by Etiology (3)

A
  1. Croup
  2. Anaphylaxis
  3. Foreign-body airway obstruction (FBAO)
25
Q
  1. Croup Managment
A

Nebulized epinephrine

Corticosteroids

26
Q
  1. Anaphylaxis Managment
A

IM Epinephrine
Albuterol
Antihistamine
Corticosteroids

27
Q
  1. Aspiration Foreign Body
A

Allow position of comfort

Specialty Consulation

28
Q

Lower Airway Obstruction by Etiology (2)

A
  1. Bronchiolitis

2. Asthma

29
Q
  1. Bronchiolitis Managment
A

Nasal Suctioning

Bronchodilator Trail

30
Q
  1. Asthma Management
A 
Albuterol
Corticosteroids
Subcutaneous Epi
Magesium Sulfate
Terbutaline
31
Q

Lung Tissue Disease by Etiology (2)

A
  1. Phenumonia/Pneumonitis (Infectious, Chemical, Aspiration)

2. Pulmonary Edema (Cardiogenic, Noncardiogenic)

32
Q
  1. Pneumonia/Pneumonitis Management
A

Albuterol
Antibiotics
CPAP

33
Q
  1. Pulmonary Edema Management
A

Ventilation support / PEEP
Vasocative support
Consider Diuertic

34
Q

Disordered Control of Breathing Etiology (3)

A
  1. Inc ICP
  2. OD/Poisoning
  3. Neuromuscular Disease
35
Q
  1. Inc ICP Management
A

Avoid hypoxemia
Avoid hypercarbia
Avoid Hyperthermia

36
Q
  1. OD/ Poisioning Managment
A

Antidote

Contact Poison Control

37
Q
  1. Neuromuscular Disease
A

Consider noninvasive / invasive ventilatory support

38
Q

3 Risks of hyperventilation

A
  1. Air enters the stomach (Gastric Distention)
  2. Risk of pneumothorax
  3. Severe air trapping
39
Q

Magensium Sulfate can be used w/ asthma as a

A

Bronchodilator

40
Q

2 uses for Terbutaline

A
  1. Bronchodilator

2. Tocolytic - anti-contraction to delay preterm labor for up to 48 hours

41
Q

What is cardiogenic pulmonary edema

A

high pressure in pulmonary capillaries causes fluid to leak into the lung interstitial and alveoli

42
Q

Most common cause of cardiogenic pulmonary edema is

A

Left ventricular myocardial dysfunction

43
Q

What type of ET is used to reduce glottic air leak

A

Cuffed ET tube

44
Q

Inc ICP fluid rate

A

20ml/kg IV isotonic crystalloid

45
Q

What drug to avoid w/ children w/ neuromuscular disease

A

Succinylcholine

46
Q

Rate of suction force needed for airway secretions

A

-80 to -120mm Hg

47
Q

OPA is used on an

A

unconscious no gag reflex pt

48
Q

Nasal Cannula oxygen rate

A

0.25 to 4 L/min

49
Q

Simple O2 mask rate

A

Minimum 6L

50
Q

Non-rebreathing mask rate

A

10 to 15 L/min

51
Q

High Flow Nasal Cannula

A

4 to 40 L/min

52
Q

DOPE

A

Displacement of the tube
Obstruction of the tube
Pneumo
Equipment Failure

53
Q

After DOPE is checked and things are still unchanged…

A

It may be due to agitation, pain, or excessive movement
Analgesia
Sedation
Neuromuscular block agents

Archived - Pediatric Advanced Life Support (PALS) 2020 (23 decks)

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