Paedatric Considerations Flashcards
What are abnormal signs of breathing in children.
Tachyponea Nasal flaring Indrawing Use of accessory muscles Grunting
What are abnormal signs of circulation in children?
Tachycardia Mottled skin Pale Cold Slow capillary refill time
Why is tachyponea and early sign of respiratory distress in children?
Because children rely heavily on the rate of respiration to compensate for respiratory difficulty. This is because they are unable to draw their diaphragm further done against their abdominal organs.
Why are children more prone to hypoxia?
They have a lower functional residual capacity than adults. This results in lower oxygen reserves.
Children also have narrower airways with higher resistance than adults. The dominant use of the diaphragm makes them more prone to fatigue.
What are signs of respiratory distress in children?
Tachyponea Nasal flaring Grunting Weak cry Indrawing or retraction. In the supraclavicular, intercostal and substernal sites. Accessory muscle use Stridor Abnormal positioning such as sitting forward, sniffing, tripod position, refusing to lie down. Head bobbing
What are signs of hypoxia in children?
Tachycardia Agitation Drowsiness Pallor Cyanosis is a late sign along with a falling heart rate which shows the child is peri arrest
What is the eye component of the paediatric GCS?
Spontaneously
To voice or to touch
To pain
None
What is the verbal component of the paediatric GCS?
Smiles, babbles, coos Cries normally Cries only to pain Moans or grunts None
What is the motor component of paediatric GCS?
Normal spontaneous movement Localises Withdraws Flexes Extends None
How do we estimate weight in children?
Under 1 - 5kg
1 - 10 - 2x(age in years + 4)
11 - 14 - 3x age in years
In what circumstances do we use PEEP in cardiac arrest?
In neonatal resuscitation. PEEP is used at 5cmh2O without added oxygen
What do you do if heart rate rises above 100bpm in a neonatal resuscitation?
Stop ventilation.
Dry baby and keep warm
Do not give oxygen
Continually monitor breathing and the heart rate
Be prepared to support breathing again if required
What do you do if heart rate is 60-100 bpm in neonatal resuscitation?
Focus on ventilation
Continually monitor heart rate
Continue to focus on ventilation and add oxygen if the heart rate fails to improve
Consider placing an LMA if the heart rate fails to improve
What do you do if the heart rate fails to less than 60bpm during a neonatal resuscitation?
Start CPR at a rate of 3:1 Continue to focus on ventilation Consider placing an LMA Gain IV Or IO access but good CPR takes priority Administer 80ml of 0.9%Nacl
What are signs of abnormal activity in children?
Inactive. Lethargic Abnormal or absent cry or speech Failure to interact with people Floppy
