Week 7 Flashcards
What is the age range of a newborn?
birth - 24 hours
What is the age range of a small infant?
Under 3 months
What is the age range of a Large infant?
3-12 months
What is the age range of a Small child?
1-4 years
What is the age range of a medium child??
5-11 years
What is the weight of a newborn?
3.5kg
What is the weight of a 3-month-old?
6kg
what is the weight of a 6-month-old?
8 kg
what is the weight of a 1-year-old?
10kg
what is the weight formula for children aged 1-9?
Age x 2 +8
what is the weight formula for children aged 10-11?
Ages x 3.3
What are some airway differences with paeds?
- Under 6 months - nasal breather
- larynx higher and more anterior
- narrower airway
- Age 3-8 may experience adeno-tonsillar hypertrophy
What are some breathing differences with paeds?
- relies heavily on diaphragm
- ribs lie more horizontaly and contribute less to chest expansion
- muscles fatigue quicker
- WOB contributes to 1% of metabolic demand
- high metabolic requirements and oxygen consumption
- high resp rate
What is the tidal volume of a paed?
5-7 ml/kg
What are the circulation differences of paeds?
- At birth - both ventricles ar esame size
- by age 2 RV is half diameter as LV
- Relative circulating volume is higher than adults but overall vol is low
-
What are the differences with the paediatric immune system?
- immature at birth
- maternal antibodies provide limited protection but decline after 6 months age
- breastfeeding provides smoe increased protection from resp and gastro diseases
What is the HR and BP & RR of a newborn?
110-170
>60
25-60
What is the HR and BP & RR of a small infant?
110-170
>60
25-60
What is the HR and BP & RR of a large infant?
105-165
>65
25-55
What is the HR and BP & RR of a small child?
85-150
>70
20-40
What is the HR and BP & RR of a medium child?
70-135
>80
16-34
What are signs of resp distress with a paediatric?
- tachypnoea
- chest wall retration
- nasal flaring
- use of accessory muscles
- trachael tugging
- abdo protrustion
What is the verbal response section of the pad GCS (<4)
5 - appropriate words/smile 4 - cries but consolable 3 - persistently irritable 2 - moans to pain 1 - none
What are the skin changes in paeds?
- large body surface area leads to greater risk of heat and fluid loss
- thinner skin and less karatin
- more affected by topical toxins
- smaller burns more likely to be serious
what are the GIT differences in paeds?
- more likely to have reflux and regirgitation issues
- stomach emptying time increased
- large liver - 4% of body weight at birth
what are the skeletal differences in paeds?
limited ossification of bones
- not complete until over 20 years of age
what is the sensorimotor stage?
age 0-2
Infant explores worls thorugh direct sensory and motor contact
- object perminence
- seperation and anxiety develop
what is preoperational stage?
2- 6 years
child uses symbols to represent objects but does not reason logically
- ability to pretend
- egocentric
what is the concrete operational stage?
6-12 years
Can think logically about concrete objects
- understands conversation
- can add and subteact
What is the formal operation stage?
12 - adult
reason abstractly and think in hypothetical terms
What are the physical milestones from birth - 4 months?
- moves whole body
- reacts to sudden loud noises
- eyes shut in birth light
- able to lift head and chest when lying on stomach
- begins to roll from side to side
- able to grasp object in hands
What are the physical milestones from 4-8 months?
- can sit up
- rasies head when on stomach
- tries to crawl
- rolls from back to stomach
- turns head to sounds of voices
What are the social milestones from 4-8 months?
- responds to name
- recognises familiar people
What are the cognitive milestones from 4-8 months?
- explores objects by looking and mouthing
- shakes and stares at toys
What are the language milestones from 4-8 months?
babbles and repeats sounds
What are the physical milestones from 8-12 months?
- pulls to standing position
- rasies self to sitting
- steps using furniture
- crawls quickly
- uses hands to feed themselves
What are the language milestones from 8-12 months?
- responds to name
- responds to family
- says words like dada and mama
What are the physical milestones from 1-2 years?
walks
climbs
runs
What are the language milestones from 1-2 years?
understands and follows questions commands
- says first name
- says many words
What are the physical milestones from 2-3 years?
uses pencil to draw/scribble
- gets dressed with help
- able to open doors
What are the language milestones from 2-3 years?
uses two to three words together
What are the physical milestones from 3-5 years?
dresses with little help
hops, jumps and runs
toilet trained
What are the language milestones from 3-5 years?
speaks in sentances
How does absorption pharmikokinetcs change with paeds?
alteref fat absorption and active absorption alters drug bioavailability
- GIT transit times change across age groups
How does intramuscular pharmikokinetcs change with paeds?
muscle perfusion is highly variable in neonates making IM unreliable
How does distribution pharmikokinetcs change with paeds?
- higher % of body water in paeds results in greater distribution of hydrophillic drugs
- higher % of fat leads to greater area of distribution for liophilic drugs
How does membrane permeability pharmikokinetcs change with paeds?
at birth blood-brain barrier is underdeveloped
How does metabolism pharmikokinetcs change with paeds?
- livermakes up larger % of body weight
- liver tuns drugs into more water soluble cmpounds aiding excretion
How does excretion pharmikokinetcs change with paeds?
reneal excretion lower in neonates but higher in pre-school aged children
Cardiac arrest in paeds is usually caused by
- hypotension
- hypoxia
- acidosis
What are the key ECG findings seen with paed cardiac arrest ?
- bradycardia
- PEA
- asystole
what are the structural causes of sudden cardiac arrest in paeds?
- cardiomyopathies
- coronary artery abnormalities
- AAA - marfans syndrome
- Myocarditis
- Valvular diseases
- Congenital heart disease
what are the electrical causes of sudden cardiac arrest in paeds?
- long QT syndrome
- Wolff-Parkinson-White syndrome
- Brugada
- 3rd degree heart block
what are the other causes of sudden cardiac arrest in paeds?
- drug use
- commotio cordis
What are the warning signs for sudden cardiac arrest with paeds?
- dizziness
- chest pain
- syncope
- palpitations
- dyspnea
- family hx of unexplained deaths
What are the various bvm sizes in ml for adults/paeds/infants?
adult - 1600ml
paed - 500ml
infant - 240ml
What is the compression/ventilation rate for paeds and why?
15:2
- higher ventilation rates
- different aetiology of cardiac arrest
What is the compression/ventilation rate for neonates and why?
3:1
FIRST 24 hours - only during intra-uterine to extra-uterine transition
What current do you shock a paed at for cardiac arrest?
4j/kg
What does the COACHED approach stand for in high performance CPR?
C - continue compressions O - Oxygen away A - All other away C- Charging H - Hands off E - Evaluate rhythm D - defib or disarm
What are the reversible causes of PEA?
- hypovolaemia
- tension pneumothorax
- pericardial tamponade
- electrolyte abnormalities
