Paediatrics Flashcards
Age of an infant
birth to 1 year
age of a toddler
1-2 years
pre-school age
2-5 years
School age
5-12 years
teenager age
puberty to 18 years
Dealing with sick children
*Take your time and be patient
*Try to adapt your approach
*Uniform can be frightening
*Sit or kneel to their eye level, take time to know them and listen to them.
*Be honest, never tell lies
*Whenever possible involve parents / carers
*Parents must give consent treatment (where possible)
Pathways to cardiorespiratory arrest
either compensated resp or cardio failure
either decompensated resp or cardio failure
Cardio respiratory failure
Cardio respiratory arrest
airway differences
less than 6 months only nasal breather
funnel shaped larynx
epiglottis larger and floppier
face is smaller
occiput is protuberant
small mouth
compressible floor of mouth
larynx is higher and anterior
narrowest at cricoid cartilage
airways narrower and smaller
trachea more flexible
more airway differences
- The head is large in relation to the rest of the body and the neck is short,
- They have narrow nostrils
- A relatively large tongue,
- Loose teeth
- The floor of the mouth is easily compressible.
- The cricoid ring is the narrowest part of the airway;
- The trachea is short and soft
- The carina angles are symmetrical.
how to align an infants airway
neutral position
breathing differences
*Alveolar numbers increase throughout childhood.
*Infants rely mainly on diaphragm to breath.
*Respiratory muscles underdeveloped and tire easier.
*Compliant chest wall.
*Kinetic energy is transferred to thoracic organs.
*Ribs difficult to fracture (underlying damage).
*Tidal volume increases with body weight.
more breathing differences
- At birth alveolar area 3 m2, adult 70 m2
- Infants have a relatively greater metabolic rate and have an increased
O2 consumption and CO2 production. - Reason for an increased respiratory rate. Higher metabolic rate = higher
oxygen consumption. - 10 fold increase in number of small airways from birth to adulthood
- The lungs are relatively immature at birth and the number of airways
increases as they grow. - The tidal volume will remain unchanged throughout life at 4-6 MLS / KG.
- Both the upper and lower airways are relatively small in size
- The ribs lie more horizontally in infants and contribute less to chest
expansion, which is why infants rely on diaphragmatic breathing
normal ranges for breathing rates in children.
Infants: 25 breaths per minute
Children 1-8 years old: 20 breaths per minute
Children 8-12 years old: 15 breaths per minute
Children >12 years old: 10-12 breaths per minute
circulation differences
- At birth the neonate’s ventricles are of a similar size,
- At 2 months the left ventricle becomes more dominant with ECG changes (left
ventricular dominance) showing at around 4-6 months. - RV dominance is evident on the ECG, when this diminishes with age,
the PQRST and PR interval all increase with age - Fixed-stroke volume
- To increase cardiac output, infants are limited to increasing their heart rate as
they are unable to increase stroke volume.
heart rate for children
UPTO 1 YEAR 110-160 bpm
1-2 YEARS 100-150 bpm
2-5 YEARS 95-140bpm
5-12 YEARS 80-120bpm
12 plus 60-100bpm
