Peds Intro Flashcards
What are some assessment challenges with peds pts
Young children may not be able to report what is bothering them
Perceptions differ from adults
Concerned parents may be challenging
Fear or pain may hamper assessment
What are the consequences of an infant having a big head
-large surface area means more mass relative to the boys and more potential for heat loss.
-higher incidence for head injury
How big is the infants head in relation to its body
1/4 of total body weight
When does the posterior fontanelle close?
4 months
When do anterior fontanelles close?
1 year
How to asses the fontanelles
Look to see if it is sunken or bulging
Why is it difficult to palpate a carotid pulse on an infant
They have short stubby necks
Is a child more prone to a/w obstruction
Yes, the a/w is much smaller leaving them susceptible to foreign body inhalation, inflammation with infection and disproportionally large tongue
What is the narrowest part of the child’s airway
The cricoid cartilage which is below the vocal cords, rather than at the vocal cords as in adults
How is the epiglottis different in an infant?
-long and floppy
-u-shaped
-narrow
-extends at a 45 degree angle into the airway
Difficult to visualize the vocal cords during intubation
A/W difference in infants
Tongue is larger in proportion to mouth
Pharynx is smaller
Epiglottis is larger
Larnyx is more anterior and superior
Narrowest at cricoid
Trachea narrow and less rigid
How does a child’s chest wall differ from that of an adults
-it is quite thin
-less musculature and subcutaneous fat to protect lungs/organs
-Easy to hear heart and lung sounds all through the chest cavity
Why are children more susceptible to chest wall injuries
Ribs are more pliable and flexible
This can lead to significant intrathoric injury with minimal external findings
Children have fewer rib fractures and flail chest events but can have substantial injuries below
In children, which thoracic injuries are common
-pulmonary contusions
-cardiac tamponade
-diaphragmatic rupture
What is the pulse rate for an infant who is compensating for an injury
200 beats per minute
When should you suspect shock in an infant
If they present with tachycardia
What indicates hypoxia
Bradycardia
Is hypotension bad in children
Yes it is a very bad sign
What are signs of vasoconstriction
-weak peripheral pulses
-delayed cap refill (younger than 6)
-pale cool extremities
Why is the abdomen distended in an healthy infant
-weak abdominal muscles
-larger solid organs
What the anatomical differences in the infants abdomen
-liver and spleen extend below rib cage in young children
-less bony protection
-rich blood supply
Why are the kidneys susceptible to injury?
-more mobile
-less well supported
Are pelvic fractures common?
No
Subarachnoid space in comparison to the adults, is this good or bad?
It is smaller, this is bad because there is less of a cushioning effect fro the brain and head momentum can cause bruising and damage
What does the paediatric brain require?
Twice as much cerebral blood flow than adults.
This makes even minor injuries significant, increases the risk of hypoxia
What can exacerbate a pedatric brain injury
Hypoxia and hypotension
What type of C-spine injuries are common in young children
C1-C2 injuries
How many breaths per min does an infant take
30-60
How does an infants high RR and O2 demand effect the effects from inhaled toxins
-proportionally larger amount of toxic fumes are typically inhaled
What muscles does an infant use to cry
Abdominal muscles
Skin differences in children
-thinner, more elastic
-larger body surface area BSA/ weight ratio
-less subcutaneous tissue
What is a larger BSA/weight ratio bad
-increased risk of injury following temperature extremes
-increased risk of hypothermia and dehydration
-increased severity of burns
What does stores are limited in children
Glycogen and glucose are rapidly depleted
Always be suspicious of hypoglycemia and always check BGL with lethargy and seizures
When can severe hypovolemia and electrolyte imbalances occur?
As a result of severe vomiting and diarrhea
What is the neonatal period
First month of life
What is infancy
First 12 months of life
What is the toddler period
Age 1 to 3
What is a pre-school age child
3 to 5 years
What is a school aged child
6-12
What is the adolescent stage
13 to 17 years
