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PAR2011 - ALS > Week 6 > Flashcards

Week 6 Flashcards

1
Q

why do paeds have a higher resp rate?

A
  • greater metabolic rate
  • higher O2 consumption
  • Tidal volume of only 5-7ml/kg
  • relatively few fatigue-resistance muslce fibres and tend to tire easily if work of breathing increased.
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2
Q

why are paeds at increased respiratory failure ridk?

A

decrease respiratory reserve + increase o2 demand

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3
Q

How long does it take for pulmonary physiology to mature to that of an adult?

A

8 years

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4
Q

what are the issues surrounding young infants being obligate nose breathers?

A

nasal secretions or malformations can eaily obstucty airflow and conteibute to resp distress

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5
Q

Why is chest wall compliance reduced in infants and young children?

A

Due to cartilaginous and flexible body structure of the chest wall

  • intercostal muslces are also relatively soft
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6
Q

how do the ribs differ in infants than adults?

A

Lay more horizontal which limits the volume

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7
Q

what % of total oxygen consumption is taken up by normal breathing in paeds?

A

25 %

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8
Q

Why do paed respiratory muslces fatigue quicker?

A

less glycogen stores and fewer fatigue-resistance muscles

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9
Q

What is important to note about the abdominal covity when treating paeds?

A

Distension with gas more prone to vomiting on assisted ventilations

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10
Q

What is the difference between a paed and adult larynx?

A

Larynx is higher and more anterio in paed.

Sits at the level of 2nd - 3rd cervical vertebrae in paed…. 6-7th in adults

positioning is harder to visualise in paed airway

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11
Q

How c an tonsils be an issue in paed airway management?

A

tonsils in toddlers and young children may be enlarged, contributing to airway obstruction.

makes endotrachael tube more difficult

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12
Q

How can a soft cartilaginous trachae be an issue with paeds?

A

more subject to collapse and obstruction

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13
Q

What is the issue with paeds having a large tongue?

A
  • obstructs airway

- difficult to visualise larynx

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14
Q

How is the epiglottis different in paeds?

A

Differently shaped

  • adult is broader, axis parallel to trachea
  • infant is omega shaped and angled away form axis of trachea
  • more difficult to lift an infants epiglottis with curved laryngoscope blade

-

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15
Q

Detail head positioning for a child ages 1 - 14

and an infant (one month to 1 year)

A

1-14
Best left supine without towel or cushion

infant
managed with small towel under shoulders

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16
Q

why are infants less tolerant to demands of respiratory problems?

A
  • smaller airways with high resistance to airflow
  • Ventilation is the product of the respiratory
    rate and tidal volume. Infants normally have less TV and lower
    residual capacities, which provide minimal reserves of oxygen.
  • Children have relatively few fatigue resistant muscle fibres, and
    tend to tire quickly with increases in the work of breathing
    – Children can quickly go into respiratory failure
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17
Q

What are the signs of impending respiratory failure?

A 
 Increase work of
breathing
 Tachypnea/tachycardia
 Nasal flaring
 Drooling
 Grunting
 Wheezing
 Stridor
 Head bobbing
 Use of accessory
muscles/retraction of
muscles
 Cyanosis despite O2
 Irregular breathing/apnea
 Altered
consciousness/agitation
 Inability to lie down
 Diaphoresis
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18
Q

What group of children have the highest risk of choking?

A

Under 4.

  • smaller airways
  • put shit in their mouth
  • swallowing mechanisms are less developed
  • infants cannot easily change their body position
  • cant avoid or clear own obstruction
19
Q

What are the parts of the Paed Assessment triangle?

A

Appearance

  • tone
  • interactiveness
  • consolability
  • look/gaze
  • speech/cry

Breathing

  • Abnormal breath sounds
  • Abnormal positioning
  • Retractions
  • Nasal flaring

Circulation to the skin

  • Pallor
  • Mottling
  • Cyanosis
20
Q

What is the age range classification for a small infant?

A

Under 3 months

21
Q

What is the age range classification for a Newborn?

A

24 hours

22
Q

What is the age range classification for a large infant?

A

3 - 12 months

23
Q

What is the age range classification for a small child?

A

1 - 4 years

24
Q

What is the age range classification for a medium child?

A

5 - 11 years

25
Q

What are the indications for cardiac arrest management in paeds

A

Pulseless
HR <40 - children
HR <60 - Infant

26
Q

What is the normal perfusion for a small infant?

A

110-170 HR

>60 SBP

27
Q

What is the normal perfusion for a large infant?

A

105 - 165 HR

>65 SBP

28
Q

What is the normal perfusion for a small child?

A

85-150 HR

>70 SBP

29
Q

What is the normal perfusion for a medium child?

A

70-135 HR

>80 SBP

30
Q

What is the normal resp rate for a newborn?

A

25-60

31
Q

What is the normal resp rate for a small infant?

A

25-60

32
Q

What is the normal resp rate for a large infant?

A

25-55

33
Q

What is the normal resp rate for a small child?

A

20-40

34
Q

What is the normal resp rate for a medium child?

A

16-34

35
Q

What are the GCS difference for children under 4?

A 
Verbal response scale:
5 - appropriate words/social smile
4 - cries but consolable
3 - persistently irritable
2 - moans to pain
1 - none
36
Q

How many weeks does it take for foetus to start producing surfactant?

A

24 weeks

37
Q

How many weeks does it take for foetus to producing sufficient surfactant?

A

35 weeks

38
Q

What is the oxygen consumption of an infant?

A

6ml/kg/min

compared to

3ml/kg/min for adults

39
Q

What is the tidal volume of a paed?

A

5-7ml/kg

40
Q

What is minute alveolar ventilation more dependant on for paeds?

A

more on resp rate than tidal volume

41
Q

How is a Paeds airway different to an adults?

A
  • funnel shaped larynx
  • larynx sits anteriorly
  • angled vocal chords
  • small airways
42
Q

In paed cardiac arrest when do you provide adrenaline and how much?

A

Adrenaline for a shockable rhythm:

  • After 2nd shock, and every 2nd loop
  • 10mcg/kg

Non shockable rhythm:

  • Immediately, then every second loop
  • 10mcg/kg
43
Q

In paed cardiac arrest when do you provide amiodarone and how much?

A

Only shockable rhythms

  • after 3rd shock
  • 5mg/kg

PAR2011 - ALS (11 decks)

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