Introduction to paediatric physiotherapy

Question 1

AIMS

Answer 1

• Describe anatomical and physiological cardiorespiratory differences between infants and
adults.

• Describe common cardiorespiratory conditions in infants.

• Explore and justify different physiotherapy management of
cardiorespiratory conditions in infants

Question 2

What is Bronchiolitis?

Answer 2

Acute LRTI causing inflammation of the bronchioles

Question 3

What is Chronic Lung Disease?

Answer 3

Long term breathing and lung condition in premature babies

Question 4

What is Croup?

Answer 4

URTI caused by a virus my commonly Parainfluenza. Causes swelling to the upper airways.

Question 5

What is Asthma?

Answer 5

Caused by spasm in the bronchi of the lungs causing difficulty breathing, usually connected to allergic
reaction or other forms of hypersensitivity

Question 6

What is Whooping cough?

Answer 6

A highly contagious RTI cause by a bacterial infection Bordetella Pertussis

Question 7

What is Pneumonia?

Answer 7

Inflammation of the lung tissue (primarily alveoli) cause by viral and/or bacterial infection

Question 8

What is Inhaled foreign body?

Answer 8

The lodging of an object in the airways

Question 9

What is Sickle Cell disease?

Answer 9

A group of inherited red blood disorders which causes the small blood vessels to become hard, sticky and
C-shaped

Question 10

For patients who are intubated and ventilated why might they have an impaired cough?

And what treatment options are there?

Answer 10

• Sedated
• Muscle relaxed

treatments:
• Suction - ETT/trache/OP/NP
• Percussion
• Postural drainage
• Manual Hyper Inflation
• Vibs
• Saline lavage

Question 11

For patients who are self-ventilating why might they have an impaired cough?

And what treatment options are there?

Answer 11

• Fatigue
• Neurological impairment
• Children who are immobile / immobile after surgery
• Pain

Treatments:
 Percussion and suction
• Bouncing on gym ball/trampoline
• Playing/exercise dependent upon age
• Bubble PEP
• ACBT
• Autogenic drainage
• Cough assist – very helpful in those neuromuscular very weak
and therefore very poor cough e.g. SMA, Duchenne's

Question 12

Why may some patients need a home programme?

And what treatment options are there?

Answer 12

• Chronic condition

Common treatment techniques used:
• Airway clearance and exercise
• Airway clearance adjuncts can include, acapella, flutter,
aerobika, theraPEP, astraPEP, bubblePEP, pari PEP
• Vest, bouncing on a swiss ball, autogenic drainage

Question 13

What physio treatment options are there for Bronchiolitis?

Answer 13

Treatment generally involves: prone lying, suction, percussion and other manual techniques, saline lavage

Question 14

What physio treatment options are there for Chronic Lung

Disease?

Answer 14

Acute treatment is only used for this condition if there are additional respiratory symptoms being experienced e.g. an infection.

Question 15

What physio treatment options are there for Croup?

Answer 15

Minimal Physiotherapy need as does not affect the LRT.

Usually secretions get trapped behind the upper airway swelling, once intubated this is more easily cleared.

Question 16

What physio treatment options are there for Asthma?

Answer 16

If the patient is suffering from an infective exacerbation Physiotherapy is indicated.

If self-ventilating: exercises, bubble PEP, ACBT

If intubated: lavage, DNAse.

Question 17

What physio treatment options are there for Whooping

cough?

Answer 17

Little evidence for the benefit of physiotherapy treatment.

It may be indicated if they have very thick secretions due to secondary infections therefore assessment is indicated.

Question 18

What physio treatment options are there for Pneumonia?

Answer 18

Usually fit and well children do not often need intervention.
Those who are immobile, with underlying conditions or weak cough may need intervention.

Question 19

What physio treatment options are there for inhaled foreign

body?

Answer 19

ONLY ONCE THE FORIGN BODY IS REMOVED.
If the object was organic it is more likely to disintegrate and therefore more likely to initiate a more significant infective progress
requiring secretion clearance.

Question 20

What physio treatment options are there for Sickle Cell disease?

Answer 20

Maintaining joint range and mobility.
Preserving respiratory function and preventing chest infections.
Incentive spirometry.
Bubble PEP