Pediatric anatomical differences Flashcards
How is the head different in a child from an adult, and what is the narrowest part of the pediatric airway
The head is 1/3 the size of an adult head. Children also have a shorter neck with undeveloped neck muscles and narrow nasal passages. The narrowest part of the pediatric airway is the cricoid ring
How does the airway differ in a pediatric patient
The trachea is less rigid and shorter while the glottis is cephalad (higher up) and anterior. The larynx is also more anterior and superior.
Why does hypoxia occur much more rapidly in a pediatric patient compared to an adult
The intercostal muscles are poorly developed at a young age. The alveoli are small, and limited in number (10% of that of an adult) and have 2 times the oxygen consumption of an adult (higher respiratory rate). There is a decrease in functional reserve capacity, vital capacity and tidal volume, increasing the chance of hypoxia.
How do you treat bradycardia and how does this happen in children
Children have a vagal response to many stimuli, and hypotension can lead to bradycardia, which needs 100% oxygen to treat.
Why is it not ok to give a child anesthetic medication if they have a respiratory tract infection
Children have increased secretions, and this can exacerbate secretions in a RTI. If you take anatomical differences and pulmonary physiologic differences into consideration, this can increase breathing difficulty and possibly cause hypoxia if not taken care of immediately
What is the heart rate and respiratory rate of a newborn, a child 1-4 years old, 5-10, and 11+
A newborn should be at 110-120 bpm and respiratory rate 30-50. Up to 4 years should be 100-160 bpm and respiratory rate up to 40. 5-10 years should be 80-130 bpm and less than 30 breaths per minute. 10 and so on should be up to 90 bpm and 20 breaths.
What are hepatic and renal functions and why can it affect the metabolism and excretion of drugs
Hepatic involves the liver and renal involves the kidneys. In children, these organs are immature, resulting in decreased glomerular filtration rate (filtering of blood) increasing the half life of medication
What can hypothermia result in if not treated properly
Hypothermia can cause delayed awakening, cardiac irritability, respiratory depression and altered drug response. Pediatric patients also have poorly developed temperature regulatory mechanisms with thin skin, low fat content and the ratio of surface are to body mass is much greater in a child, resulting in greater heat loss.
What is Young’s rule
adding 12 to children’s age, dividing the sum by the child’s age, then divide this by the adult dose
What is Clark’s rule
children ages 2 and older-weight in pounds divided by 150 times the normal adult dose
Which of clark’s and young’s rule is more accurate and why
Young’s rule is more adequate because it calculates the dose based on surface area rather than weight and height, which is more conservative
What routes can be used for pediatric anesthetic
Oral, nasal, IM, IV, IV inhalation, rectal and local anesthesia. Local anesthesia overdose can occur easily, so calculations based on weight need to be made for a maximum dosage
What are 3 commonly used IV anesthetics
Ketamine (dissociative), propofol and breviate
What are advantages and disadvantages of Rectal administration
Disadvantages include variable absorption, time consuming, and can act as an enema. The advantages are no needles and no masks required, and patients can fall asleep rapidly
What are 3 inhalation anesthetics and what do you need to look out for while using these anesthetics
Sevoflurane, Desfllurane, and Isoflurane. They all have a rapid induction and are titrated (slowly increased) to the desired effect. Blood pressure in infants are more sensitive to hemodynamic effects of inhalation anesthetics. Care must be taken to avoid overdose.
