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Questions and Answers
What anatomical difference in infants can lead to respiratory distress if nostrils fill with mucus?
What anatomical difference in infants can lead to respiratory distress if nostrils fill with mucus?
- Small nostrils (correct)
- Large tongues
- Large heads
- Loose teeth
Cyanosis refers to the blue discoloration of skin due to adequate oxygenation.
Cyanosis refers to the blue discoloration of skin due to adequate oxygenation.
False (B)
What does the P.A.T. acronym stand for in the context of assessing a child's condition?
What does the P.A.T. acronym stand for in the context of assessing a child's condition?
Pain, Alertness, Temperature
The infant airway is much smaller than that of an adult, which can lead to __________ obstruction.
The infant airway is much smaller than that of an adult, which can lead to __________ obstruction.
Match the following signs with what they indicate:
Match the following signs with what they indicate:
Which of the following is NOT a sign of serious respiratory compromise?
Which of the following is NOT a sign of serious respiratory compromise?
Infants can breathe through their mouths from birth.
Infants can breathe through their mouths from birth.
How much does an infant's head size compare to its adult size?
How much does an infant's head size compare to its adult size?
What is the primary aim of management in cases of bronchiolitis?
What is the primary aim of management in cases of bronchiolitis?
Asthma is very common in children under 5 years of age.
Asthma is very common in children under 5 years of age.
What is a common feature of respiratory illness in children?
What is a common feature of respiratory illness in children?
Signs of ______ include cyanosis, bradycardia, and altered mental status.
Signs of ______ include cyanosis, bradycardia, and altered mental status.
Match the following respiratory illnesses with their descriptions:
Match the following respiratory illnesses with their descriptions:
Which of the following is a sign of bronchiolitis?
Which of the following is a sign of bronchiolitis?
In bronchiolitis, household members do not exhibit similar features.
In bronchiolitis, household members do not exhibit similar features.
What is a pre-terminal sign of serious illness in a child?
What is a pre-terminal sign of serious illness in a child?
Infants with bronchiolitis typically peak in symptoms around the age of ______ months.
Infants with bronchiolitis typically peak in symptoms around the age of ______ months.
What respiratory rate indicates distress in a child aged 2-5 years?
What respiratory rate indicates distress in a child aged 2-5 years?
Which of the following is a feature common to all respiratory illnesses in children?
Which of the following is a feature common to all respiratory illnesses in children?
Hypoglycaemia is a sign of deterioration in a child.
Hypoglycaemia is a sign of deterioration in a child.
What is a common viral cause of bronchiolitis in infants?
What is a common viral cause of bronchiolitis in infants?
The perception of decreased __________ can indicate respiratory distress in children.
The perception of decreased __________ can indicate respiratory distress in children.
Match the following signs with their associated conditions:
Match the following signs with their associated conditions:
What is the initial action recommended when managing a child in respiratory distress?
What is the initial action recommended when managing a child in respiratory distress?
Bronchiolitis is a type of chronic respiratory disease.
Bronchiolitis is a type of chronic respiratory disease.
What does AVPU stand for in assessing a child's level of consciousness?
What does AVPU stand for in assessing a child's level of consciousness?
The peak age for bronchiolitis symptoms is around ______ months.
The peak age for bronchiolitis symptoms is around ______ months.
Which of the following is NOT typically associated with the management of bronchiolitis?
Which of the following is NOT typically associated with the management of bronchiolitis?
What does cyanosis in infants indicate?
What does cyanosis in infants indicate?
Infants cannot breathe through their noses until they are 6 months old.
Infants cannot breathe through their noses until they are 6 months old.
What anatomical feature of infants can lead to serious respiratory issues if nostrils are obstructed?
What anatomical feature of infants can lead to serious respiratory issues if nostrils are obstructed?
The large _____ of infants is a significant anatomical difference from adults that affects airway management.
The large _____ of infants is a significant anatomical difference from adults that affects airway management.
Which of the following signs indicates shunting of blood away from the skin?
Which of the following signs indicates shunting of blood away from the skin?
Match the following skin color indications to their meanings:
Match the following skin color indications to their meanings:
Loose teeth cannot cause airway obstruction in infants.
Loose teeth cannot cause airway obstruction in infants.
What is the significant risk associated with infants having a smaller airway compared to adults?
What is the significant risk associated with infants having a smaller airway compared to adults?
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Study Notes
Objectives
- Recognize serious illness in infants and children.
- Assist clinicians in managing severely ill infants and children.
Anatomical and Physiological Differences
- Infants have proportionately larger heads; at birth, the head is 2/3 adult size.
- Infants are obligate nasal breathers until about 6 months; blockage by mucus can cause respiratory distress.
- Loose teeth can lead to airway obstruction due to smaller airway size compared to adults.
Airway Differences
- Infants possess a prominent occiput and a smaller facial structure.
- Narrow nostrils contribute to respiratory compromise, especially during labored breathing.
P.A.T. - Circulation to Skin
- Pallor: Indicates shunting of blood away from the skin.
- Cyanosis: Blue skin discoloration signifies inadequate oxygenation.
- Mottling: Patchy skin appearance, normal under 2 months or in cold.
Paediatric Primary Survey
- Airway: Ensure the airway is patent.
- Breathing: Check respiratory rate according to age.
- Circulation: Assess pulse, capillary refill, and skin warmth based on age.
- Disability: Use AVPU scale, check pupils and blood sugar.
- Expose: Fully expose the child for examination.
- Reassessment should occur frequently, ideally in under 2 minutes.
Signs of Deterioration
- Increased work of breathing with symptoms like recession and tachypnoea.
- Cyanosis and bradycardia serve as grave indicators.
- Altered mental status may present as drowsiness.
- Hypo/hypertonia may indicate neurological concerns.
- Signs of dehydration and shock, including hypoglycaemia.
Respiratory Illness and Emergencies
- Common childhood respiratory issues are generally self-limiting.
- Conditions include:
- Asthma
- Bronchiolitis
- Upper Respiratory Tract Infections (URTIs)
- Lower Respiratory Tract Infections / Pneumonia (LRTIs)
- Croup
- Epiglottitis
- Tachypnoea is a hallmark feature across respiratory disorders.
Asthma
- Characterized by acute airway inflammation resulting in wheeze and mucus pluggings.
- Rare in children under 5 years.
- Respiratory Rates:
- ≤40/min (ages 2-5), ≤30/min (over 5).
- Excess of these rates signals respiratory distress.
Bronchiolitis
- Results from inflammation of bronchioles, commonly from Respiratory Syncytial Virus (RSV).
- Typically occurs in autumn and winter; primary peak at 2-5 months of age.
- Often worsens within the first 72 hours before improvement.
- Symptoms include reduced SpO2, increased respiratory rate, recession, irregular breathing, inspiratory crackles, low-grade fever, and potential apnoea.
Bronchiolitis Management
- Follow DR ABCDE protocol for time-critical interventions of Airway and Breathing, followed by transport.
- Treatment aims to provide respiratory support along with adequate feeding and hydration.
- Administer oxygen if saturation levels fall persistently.
Objectives
- Recognize serious illness in infants and children.
- Assist clinicians in managing severely ill infants and children.
Anatomical and Physiological Differences
- Infants have proportionately larger heads; at birth, the head is 2/3 adult size.
- Infants are obligate nasal breathers until about 6 months; blockage by mucus can cause respiratory distress.
- Loose teeth can lead to airway obstruction due to smaller airway size compared to adults.
Airway Differences
- Infants possess a prominent occiput and a smaller facial structure.
- Narrow nostrils contribute to respiratory compromise, especially during labored breathing.
P.A.T. - Circulation to Skin
- Pallor: Indicates shunting of blood away from the skin.
- Cyanosis: Blue skin discoloration signifies inadequate oxygenation.
- Mottling: Patchy skin appearance, normal under 2 months or in cold.
Paediatric Primary Survey
- Airway: Ensure the airway is patent.
- Breathing: Check respiratory rate according to age.
- Circulation: Assess pulse, capillary refill, and skin warmth based on age.
- Disability: Use AVPU scale, check pupils and blood sugar.
- Expose: Fully expose the child for examination.
- Reassessment should occur frequently, ideally in under 2 minutes.
Signs of Deterioration
- Increased work of breathing with symptoms like recession and tachypnoea.
- Cyanosis and bradycardia serve as grave indicators.
- Altered mental status may present as drowsiness.
- Hypo/hypertonia may indicate neurological concerns.
- Signs of dehydration and shock, including hypoglycaemia.
Respiratory Illness and Emergencies
- Common childhood respiratory issues are generally self-limiting.
- Conditions include:
- Asthma
- Bronchiolitis
- Upper Respiratory Tract Infections (URTIs)
- Lower Respiratory Tract Infections / Pneumonia (LRTIs)
- Croup
- Epiglottitis
- Tachypnoea is a hallmark feature across respiratory disorders.
Asthma
- Characterized by acute airway inflammation resulting in wheeze and mucus pluggings.
- Rare in children under 5 years.
- Respiratory Rates:
- ≤40/min (ages 2-5), ≤30/min (over 5).
- Excess of these rates signals respiratory distress.
Bronchiolitis
- Results from inflammation of bronchioles, commonly from Respiratory Syncytial Virus (RSV).
- Typically occurs in autumn and winter; primary peak at 2-5 months of age.
- Often worsens within the first 72 hours before improvement.
- Symptoms include reduced SpO2, increased respiratory rate, recession, irregular breathing, inspiratory crackles, low-grade fever, and potential apnoea.
Bronchiolitis Management
- Follow DR ABCDE protocol for time-critical interventions of Airway and Breathing, followed by transport.
- Treatment aims to provide respiratory support along with adequate feeding and hydration.
- Administer oxygen if saturation levels fall persistently.
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