A-E assessment in children Flashcards

1
Q

Overall, how are children different in terms of the A-E assessment?

A
  • anatomy & physiology
  • developmental abilities, social context of childhood
  • spectrum of illness
  • response to illness & injury
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2
Q

How do we know the airway of a baby/child is patent?

A

crying, making noises, colour (blueness), talking (if age-appropriate)

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3
Q

What are some differences in babies & children in terms of the airway?

A
  • tongue larger in proportion to mouth
  • large occiput (back of head), which affects airway position when opening the airway
  • smaller pharynx
  • larger, floppy epiglottis
  • larynx is more anterior & narrowest at the cricoid
  • trachea is less rigid & narrower, thus swelling has more of an impact compared to adults
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4
Q

What is the airway opening manoeuvre for babies & children?

A

Babies: neutral position
Children: head slightly back, but not all the way back like adults

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5
Q

How do we know if a baby/child’s breathing is normal?

A

sounds of their breaths, effort required to breathe, respiratory rate, effect of breathing on the rest of their body, visual appearance (discolouration, do they look comfortable?)

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6
Q

What are some differences in babies & children in terms of breathing?

A
  • faster respiratory rate = more rapid fatigue
  • smaller lungs
  • shorter trachea, which is less rigid
  • division of trachea into the bronchi is called the carina, which can stimulate the cough reflex
  • fewer collateral ventilator channels, so it’s more difficult for children to cope with blockages in airways
  • flatter diaphragm
  • increased demand for oxygen
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7
Q

Between what age is critical for lung development? When are the lungs anatomically mature?

A

3-4 years
8 years

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8
Q

How do we know a baby/child’s circulation is normal?

A

colour, heart rate (brachial pulse) & rhythm, capillary refill time (fingernails, foot, sternum)

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9
Q

What are some differences in babies & children in terms of circulation?

A
  • possibility of undiagnosed cardiac anomalies (most common is PDA- hole in the heart)
  • increased risk of endocarditis in CHD
  • position & size of the heart
  • lower circulating volume
  • healthy children have an excellent physiological reserve, means they can compensate, leads to shock
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10
Q

What are the 3 main causes of circulatory failure in children?

A

hypovolaemia (low volume state), fluid maldistribution, cardiac failure

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11
Q

How do we know a baby/child’s conscious level is normal?

A

crying (for a reason), alertness, how they interact with surroundings, ask the parent if they are doing anything different to normal

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12
Q

What are some differences in babies & children in terms of disability (in the A-E assessment)?

A
  • major brain & nervous system structures present at birth
  • possibility of congenital neurological disorder- hydrocephalus
  • newborn brasin is about 20% of body weight, adult brain is 2%
  • rapid growth & development between birth & 2 years –> nerve connections developing in response to stimuli
  • brain susceptible to change in circulation (delicate tissues)
  • motor & postural reflexes may be present until 2 years
  • brain uses up to 20% of oxygen at any one time
  • blood glucose may impact
  • impairment can be very subtle
  • unfused skull sutures may change presentation of symptoms/ later onset
  • may struggle to describe or localise pain
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13
Q

What can be a diagnostic feature in terms of disability?

A

the pitch of a baby’s cry

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14
Q

What do we look for in babies/children in terms of the exposure element of the assessment?

A

normal temperature, weighing a baby allows for the once over (check for rashes etc.)

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15
Q

What are the normal values for heart rate in children?

A

<1 –> 110-160
1-2 –> 100-150
2-5 –> 95-140
5-12 –> 80-120
>12 –> 60-100

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16
Q

What are the normal values for respiratory rate in children?

A

<1 –> 30-40
1-2 –> 25-35
2-5 –> 25-30
5-12 –> 20-25
>12 –> 15-20

17
Q

What are the normal values for systolic blood pressure in children?

A

<1 –> 70-90
1-2 –> 80-95
2-5 –> 80-100
5-12 –> 90-110
>12 –> 100-120