Breathing Flashcards
What are your main breathing observations?
Effort, efficacy and effects of inadequate respiration
What does RIPPAS stand for?
Rate
Inspection
Palpate
Percuss
Auscultate
Saturations
What vital signs are you assessing for in breathing?
Respiratory rate
Oxygen saturations
What are you observing when assessing respiratory rate?
Rate (high or low,) rhythm (irregular or regular) and depth (shallow or deep)
What are the normal respiratory rates for patients aged 1-9 ?
1-2 Years- 25-35bpm
2-5 Years- 25-30bpm
5-12 Years-20-25bpm
What position would you be standing in to assess your patient?
At the end of the bed
What other observations are you making in effort of breathing?
Accessory muscle usage
Recessions
Breathing sounds
What are the accessory muscles?
Head bobbing
Nasal flaring
Shoulder shrugging
Abdominal breathing
Tripod position
Name the recessions
Tracheal tug
Sternal recession
Intercostal recession
Subcostal recession
What breathing sounds are you looking for?
Grunting, Gasping, Wheezing, Stridor
What is the rationale behind grunting?
To prevent alveoli from collapsing - creating positive airway pressure
What is the rationale behind gasping ?
Trying to intake as much oxygen as possible showing there is an issue with gaseous exchange
What are you looking at when observing the chest?
Equal/bilateral expansion
Seesaw breathing
Why would you be observing skin colour in breathing?
To check for signs of cyanosis indicating inadequate perfusion OR
Skin pallor due to vasoconstriction from hypoxia
What are you observing when ausculatating?
How much air movement there is- a silent chest is very worrying
To determine equal air entry
To hear for crackles and wheeze
What are you observing when percussing?
Percuss the patient’s chest, listening to the resulting percussion note which should be resonant (deep and clear)
Dullness
Stony dullness
Hyper-resonance
What interventions would you make for a child who isn’t breathing?
5 rescue breaths via bag-valve mask connected to 15L 02
What would you do to correct low SpO2?
High flow oxygen 15L via non-rebreathe mask with reservoir (that is inflated prior to administration)
What other considerations may you make?
Steroids, nebulisers (adrenaline or bronchodilators)
Sitting the patient upright (to lower abdominal contents)
