Albert #1 Flashcards
Why is body surface area important in peds?
It parallels metabolic rate
Weight difference of PEDS?
1/21 of adult
Surface area difference of PEDS?
1/9 adult
Length difference if PEDS
1/3 adult
What are some upper airway difference with PEDS?
- Small mouth
- Large tongue
- Narrow epiglottis
Where does the airway start in PEDS?
C3-4
What is the narrowest part of a PEDS airway?
cricoid cartilage (funnel shaped)
Unique about peds cords?
the slope
Peds ribs differences?
- More horizontal
- Less mechanical
- more cartilage = more pliable
Peds have a higher portion of _______ muscles vs. ________ muscles.
- Type 2 (fatigue)
- Type 1 (endurance)
What is significant about large head size in peds.
Greater heat loss
Additional flexion of head in PEDS __________ of intubation
increases difficuty
50% of airway resistance in PEDS comes from where?
Nose
Respiratory rate of peds is ____ and O2 consumpton is ______ and tidal volume is _______ of an adult.
3X
2-3X
Same
Peds have higher ______ and _______ volumes.
Residual
Closing
Fetal HgB is _____ at birth and gone by ____ months.
80%
6
What is the significance of fetal HgB?
- Higher affinity for O2
- Less is released at tissues.
What affect does does hypoxia have peds?
Decreases RR and may cause apnea
Why is edema more concerning in PEDS?
You get the same amount of edema, but start with smaller openings.
Hypoxia and acidosis can cause what?
Return of Right to left shunt at the atrium (foramen ovale)
What does racimic epi do?
Shrinks the inflammed mucosa, allowing for more air passage
Fetal cardiac muscle is ____ contractile compared to _____ in adults.
30%
60%
Lower contractile mass results in what?
Lower compliance
Only way to increase CO in peds is to increase what?
HR
Adequate ________ hydration is key in peds cardiac output.
Volume
Name the 2 afferent temperature input fibers.
A-delta for cold
C for Warm
Efferent cold temperature response in peds.
-Non-shivering thermogensis (brown fat) -Shivering (non-effective) -Vasoconstriction (non effective) -Behavioral - (parent dependent)
When is Brown fat available?
At birth
Gone by 2 years
How can newborns double metabolic heat production?
Brown Fat
Why are newborns unable to shiver?
- Immature musculoskeletal system
- Small muscle mass
Why is vasoconstricion for heat loss in peds ineffective?
Takes hours to reach max benefit
What type of vasoconstrion is more powerful in peds central or peripheral?
Central
4 routes of heat loss
- Radiation
- Conduction
- Convection
- Evaporation
How does anesthesia effect body temperature?
- Lowers threshold to compensations
- Vasoconstriction begins w/ lower temp
- Non-shivering thermogensis inhibited
4 cutaneous warming methods
- Lamps
- Blankets
- Forced air warmer
- ↑ room temp
Warm IV fluids ________ loss, but does not ________ patient.
Prevents
Warm
ETT size equation
Age + 18 / 4
