Ch. 33 Pediatric Emergencies Flashcards
Infancy
is usually defined as the first year of life; the first month after birth is called the neonatal or newborn period
What portion of the brain is larger in small children 3 and under?
The occiput
Which fontanelles are open and why? At what age do they fully close?
The anterior and posterior fontanelle are still open to allow compression through the birth canal. At 18 months both fontanelles have fully been closed.
What can bulging and sunken fontanelle indicate?
Bulging fontanelle can indicate Intracranial pressure (ICP) and a sunken fontanelle can be indicative of dehydration.
List some differences in a child’s airway
- The childs tongue is larger in proportion to the childs oropharynx and more anteriorly located
- The epiglottis is floppy and narrow and larger than an adults
- The larynx is higher at C3 and C4
- The airway is much more narrower than and adults at all levels
- The narrowest portion of the childs airway is at the cricoid cartilage.
Tracheal Tugging
It is easily collapsable in young children therefore when they experience respiratory distress the trachea tends to draw into the neck
What is the importance of keeping the nasal passage way clear in children 4 to 6 months?
They are predominately breath through their nose and may not have the intuition to open their mouths to breathe.
Why do children breathe faster than adults?
Proportionally, their tidal volume is similar to adolescents and adults however their metabolic oxygen demand is doubled which means they will have less oxygen reserves.
What is a normal respiratory rate for a newborn?
40 - 60 breaths/min
Why is it important not to put pressure on a child’s abdomen due to their respiratory system?
Children are belly breathers and have very little use of their chest muscles while breathing so by allowing pressure in an infant or young child you can block the movement of the diaphragm and cause respiratory compromise
Pediatric Respiratory Rates
Neonate: 0 - 1 month
30 - 60 breath/min
Pediatric Respiratory Rates
Infant: 1 month to 1 year
25 - 50 breath/min
Pediatric Respiratory Rates
Toddler: 1 - 3 years
20 - 30 breath/min
Pediatric Respiratory Rates
Preschool age 3 - 6 years
20 - 25 breath/min
Pediatric Respiratory Rates
School age 6 - 12 years
15 - 20 breath/min
Pediatric Respiratory Rates
Adolescent 12 - 18 years
12-20 breath/min
Pediatric Pulse Rate
Neonate - 1 month
100 - 180 beats/min
Pediatric Pulse Rate
Infant: 1 month to 1 year
100 - 160 beats/min
Pediatric Pulse Rate
Toddler: 1 - 3 years
90 - 150 beats/min
Pediatric Pulse Rate
Preschool: 3 - 6 yrs
80 - 140 beats/min
Pediatric Pulse Rate
School age 6 - 12 years
70 - 120 beats/min
Pediatric Pulse Rate
Adolescent 12 - 18 years
60 - 100 beats/min
Things to Note for a Pediatric Nervous System
Their nervous system isn’t fully developed yet there for this system is extremely fragile. It is not as well protected as adults therefore it will take less force to damage them.
The subarachnoid space in a child is smaller than an adult therefore provides less cushioning for the brain.
The pediatric brain also requires nearly 2x the cerebral blood flow as an adult brain making minor injuries significant. This requirement increase hypoxia and hypotension
Things to Note for a Pediatric Musculoskeletal system
Bones in children and much more softer and porous therefore most fractures will be greenstick (Incomplete fractures)
Treat any sprain or strain as a fracture and splint accordingly
Injury to the epiphyseal pate may result in abnormalities in normal bone growth and development
