paeds - respiratory Flashcards
asthma most common cause of…
chronic morbidity
croup most common cause of…
life- threatening airway obstruction
pneumonia most common cause of…
death in the world
respiratory disease prevention
Prevention > Cure
- Good antenatal and postnatal care
- Encourage breastfeeding
- Good nutrition
- Daily oral zinc
- Promote immunization
- Avoid biomass fuels
- Avoid cigarette smoke
- Passive smoking = activesmoking
- Increases middle ear infections, sore throats, wheezing episodes
respiratory disease clinical signs
tachypnoea
recessions
alar flaring
cynosis
cough
stridor
wheezing
- Tachypnoea (increased RR)
<2/12 = 60 breaths per minute
2-12/12 = 50 breaths per minute
1-5 years = 40 breaths per minute - recessions
Increased muscular effort required to help
expand the lung adequately (Intercostal, subcostal, suprasternal, sternal and tracheal tug) - alar flaring
Indicates an increase respiratory drive through the respiratory center
cyanosis
- Blue discoloration of hands, feet, tongue, mouth…
- Due to inadequate oxygenation of haemoglobin
- usually perceptible when oxygen saturations <85%
- Dependent on Hb levels
cough
- Inherent defense mechanism
- Many cough receptors and many cough triggers
- Character
- Frequency
- Timing
- Duration: Acute: < 4 weeks duration
Chronic: > 4 weeks duration
stridor
- Harsh, high-pitched musical sound
- Turbulent airflow through a partially
obstructed airway
- Obstruction above level of thoracic inlet
- LTB, laryngomalacia
- FBs
wheezing
- High-pitched expiratory sound generated from turbulent airflow through partially obstructed airways
- Obstruction distal to thoracic inlet
- Asthma, bronchiolitis, aspiration, foreign body, lymph nodes
Croup
LTB - Laryngo-tracheo-bronchitis
- viral (parainfluenza virus)
- Stridor, hoarseness and barking cough
- Graded I – IV
bronchiolitis
- Acute viral illness
- Rhinitis, tachypnoea, recessions, wheezing and crackles
- Under 2s
- Worse in younger, smaller and children with underlying diseases
asthma
- Recurrent reversible airways obstruction
- Chronic disease
- Symptoms often worse at night
- Impacts on daily activities…
- Often associated with atopy / allergy
- caused acute viral infections / smoke, exercise, weather, stress, mould, dust
asthma rx medications
- Short acting beta-agonist
- Long-acting beta-agonist
- Inhaled corticosteroid
- Leukotriene receptor antagonist
- Method of delivery most important
asthma management objectives
- Relief of symptoms
- Restore normal or best possible long-term
airway function - Manage acute attacks
- Reduce risks of severe attacks
- Enable normal growth to occur
asthma rx - home
asthma action plan
asthma rx - hospital
for:
- pt with severe or life-threatening
asthma
- pt not responded to ‘at home’ treatment
- High-flow oxygen – facemask with reservoir bag.
- Beta-2 agonists: salbutamol or fenoterol (mild to mod MDI w/ spacer, severe nebuliser (hypoxia))
- steroids: prednisone & hydrocortisone
- reassess continuously
- no improvement after 15 min = IV & ventilation in ICU
pneumonia
- Major cause of death in under 5s
- Prevention possible
- HIV having huge impact
Causes of pneumonia
- Bacterial or viral infections
- Atypical bacteria
- TB
pneumonia symptoms and diagnosis
- Fever, cough, fast or difficultbreathing
- Needs oxygen saturations
