Acute Paediatrics Flashcards
How does the airway of children differ from adults?
Large head to body size Short necks Large tongue Obligate nasal breathers Nasal passages easily obstructed Compressible floor of mouth and trachea High anterior larynx
How does breathing of children differ from adults?
Small total surface area of air tissue interface
Lower airways small - easily obstructed
Diaphragmatic breathing
Fewer type I (slow twitch) fibres - easy fatigue
Soft non-calcified bones - v. compliant chest wall - recession and in-drawing
Horizontal ribs - less expansion
How does the respiratory system of children differ to adults?
Higher metabolic rate/oxygen consumption
Oxygen dissociation curve shifted left in neonates (HbF predominance) so neonates tolerate slightly lower saturations
Immature lung vulnerable to insult
Apnoea may occur in babies
How does the cardiovascular system of children differ to adults?
Lower circulating volume - 70-80ml - small loss = big difference
Circulation changes from in utero to ex-utero (PDAs and PFOs may remain open for several months)
ECG features change with age
Stroke volume increases with size (HR higher and falls gradually)
Systemic vascular resistance progressively rises from birth (BP lower and rises)
Falling BP is a late sign (maintained well in children!)
Bradycardia indicates life-threatening pathology (also seen in anorexia)
Manage as arrest if no response/poor perfusion
Why are children more prone to hypothermia?
Bigger surface area to weight ratio - rapid heat loss
Why are babies more prone to infections?
Immature immune system at birth
What is the normal BP, HR and RR of a <1y?
HR: 110-160
RR: 30-40
Systolic BP: 80-90
What is a normal BP, HR, and RR of a 1-2y?
HR: 100-150
RR: 25-35
Systolic BP: 85-95
What is a normal BP, HR, and RR of a 2-5y?
HR: 95-140
RR: 25-30
Systolic BP: 85-100
What is a normal BP, HR, and RR of a 5-12yo?
HR: 80-120
RR: 20-25
Systolic BP: 90-110
What is a normal BP, HR, and RR of a >12?
HR: 60-100
RR: 15-20
Systolic BP: 100-120
