Week 2.1 - Peds Assessment Flashcards
(58 cards)
What is the ABCDEFG assessment?
Airway
Breathing
Circulation
Disability (Neuro)
Exposure
Fluids
Glucose
What are the three aspects of the pediatric assessment triangle?
Appearance
–> Tone, interactiveness, consolability, abnormal gaze, abnormal speech/cry
Work of Breathing
–> Abnormal sounds or position, retractions, flaring, apnea/gasping
Circulation to Skin
–> Pallor, mottling, cyanosis
What combination of the triangle assessment would indicate CNS or metabolic issues?
Altered appearance
–> Tone, consolability, interactivness, gaze, speech/cry
What combination of the pediatric assessment triangle would indicate shock?
Issues with circulation to skin with or without changes in appearance
What changes in the pediatric assessment triangle would indicate respiratory distress?
Changes in work of breathing
What combination of findings in the pediatric assessment triangle would indicate respiratory failure?
Changes in work of breathing and appearance
What changes in the pediatric assessment triangle indicates cardiopulmonary failure?
Changes in appearance, circulation to skin, and work of breathing.
How does the pediatric airway differ from the adult airway?
The airway is smaller and softer
–> Edema causes a significant difference is airway patency
+tongue is larger, prominent occiput, higher larynx
What kind of behaviour might be seen with a partially obstructed pediatric airway?
Agitated or drowsy
Tripod/sniffing position
What are some signs of a partial upper airway obstruction in a pediatric patient?
Stridor
–> on exertion is mild, at rest is moderate, with exhaustion is severe
Drooling, gurgling, snoring
Changes in colour, behaviour, tripod
What are some signs of a partial lower airway obstruction in a pediatric patient?
Wheezes
–> End expiratory is mild, expiratory is moderate, ins/ex is severe
Crackles
–> May be fine or coarse
Decreased Air Entry
Increased Respiratory Effort
Does loudness of airway noises have significance?
Not necessarily.
A quiet wheeze means that not much air is entering the lungs
Should you use head tilt-chin lift with an infant?
No, can cause airway obstruction d/t shape of head
what is the most common cause of cardiac arrest in the pediatric population?
Hypoxia secondary to respiratory arrest
Children are abdominal breathers, what does this mean?
Rely on diaphragm as principal muscle to breathe
What is the normal respiratory rate for an newborn (0-3 months)
30-60 rpm
Why should breathing in children be assessed over 60 seconds?
Breathing in children is irregular
What is considered apnea in children?
Cessation of breathing for more than 20 seconds
What is considered bradypnea and tachypnea in children?
RR less/more than the normal range for age - normal ranges are age dependent
What should we assess about the quality of pediatric breathing?
Effort to breathe
–> Work of breathing
Efficacy of breathing
–> Effective gas exchange
Why is pediatric grunting a sign of increased resp effort?
To slow the rate of expiration and decrease alveoli surface tension, prevent alveoli collapse, to decrease effort of inhalation
(Positive end expiratory pressure)
Which age group does not have enough surfactant and struggles to prevent alveoli collapse?
Pre-term babies
The following:
Agitated/confused behaviour, drowsiness, being unable to talk/cry /eat, grunting, severe recessions, and changes in colour, and significantly increased respiratory rate apnea lasting longer than 20+ seconds
Are signs of what in pediatric patients?
Severe respiratory distress
–> Hypoxia not corrected with oxygen
Intermittent irritability, difficulty talking/crying/eating, and nasal flaring are signs of what in pediatric patients?
Moderate respiratory distress
–> Mild hypoxia that can be corrected with oxygen
Also might be associated with moderate increase in resp rate and moderate retractions
