Respiratory CIS high yield handout 1 Flashcards
sudden stridor in a child makes you think of what
foreign body aspiration
what would indicate concern for CF and how would you test for it
poor height and weight clubbing foul smelling stools (evidence of malabsorption) recurrent pneumonia edema failure to thirve
test with sweat chloride
when is the time to intubate an asthmatic
btwn irritable and obtunded
what are common findings on a CXR in a child with astma or reactive airway disease
atelectasis
hyperinflation of both lungs
perihilar thickening
brassy or barking cough
anatomical airway abnormality
bronchoscopy, imaging
what are some examples of common triggers for asthma
virus allergies exercise cold air cigarette smoke exposure
treatment for asthma
albuterol
ICS
oral corticosteroids
oxygen
what is the best way to obtain blood gases in a pediatric pt
what are the caveats of ordering it this way
capillary blood gases fairly common in children
-quicker and less distressing than arterial gas
can’t use Pa)2 from them
useful only for pH and CO2
why don’t you want to intubate asthmatics
they can’t exhale so you force breaths in with vent, they get fuller and fuller until they get bilateral pneumothorax or acute right heart collapse and ide
which population of asthmatics has the highest mortalitiy
adolescents bc they don’t carry their rescue inhaler with them
choking with feeds
recurrent aspiration
modified barium swallow, barium esophagram
options for maintanence IVF in children
whats added to IVF in peds
1/2 NS in >1 yo or 1/4 NS <1
NS is reserved for bolusing
in peds usually potassium is added to IVF
neonatal onset of cough
congential anatomic defect
what is a common cause of wheezing in kids
viral infections
clearing throat, allergic aslute, worse when recumbent
postnasal drip/allergic rhinitis
antibiotics
capillary refill in heathy child vs one with asthma or reactive airway disease (RAD)
if cap refill is at 2 sec then concerning
over 2 very concerning
healthy kid refill almost instantaneous
O2 options to consider
NC up to 5 L simple face mask at 5-6L NRB at 10-15L/min (100% O2) bag valve mask bipap intubation
what time of the day is more suggestive of asthma
coughing that is worse in the middle of the night (midnight to 3 am)
signs of respiratory distress in a respiratory (ped) pt
inspiratory and expiratory wheezing
nasal flaring and tachynpnea
subcostal intercostal and suprasternal retractions
stridor
sniffing or tripod positioning
decreased air movement (after albuteral hear wheezing, means improvement)
hemoptysis
bronchiectasis, cavitrary lung disease, CHF, hemosiderosis
wheezing, atopy: diagnosis, test
asthma
allergy test
PFTs
bronchial hyperresponsiveness
new symptom, onset after choking episode
foreign body
neck radiography, bronchoscopy
wet or productive cough
persistent endobronchial infectionbronchiectastsis, foreign body, recurrent pneumonia, CF, primary ciliary dyskinesia
what are some risks for developing asthma
RSV infection prior to 6 months of age increases risk of asthma
pt history of family history of any atopy
what potential treatments should be added for asthmatic prior to intubation
terbutaline drip mg theophylline subcut epinephrine heliox (breathing gas with helium and oxygen) Bipap
progressive cough, weight loss, fevers
chronic infection
mantoux test
plain radiography
bronchoscopy
where should a pediatric pt with asthma exacerbation be admitted
PICU
dry cough, breathlessness
intersitial lung disease
spirometry
HRCT scan
autoimmune markers
lung biopsy
paroxysmal cough
pertussis or parapertussis
culture, pcr, sderology
