Paediatric Anatomy and Physiology Quiz

Anatomical and Physiological Differences

• Infants have larger head sizes, approximately 2/3 the size of an adult.
• They have small nostrils and can experience respiratory distress if nostrils are blocked with mucus.
• Their airways are smaller than adults which increases risk of foreign body airway obstruction.

Airway Differences

• Infants have a large, prominent occiput.
• They have small faces and narrow nostrils.
• Nasal flaring is a sign of respiratory distress in infants.

P.A.T.- Circulation to Skin

• Infants can exhibit pallor (white or pale skin) due to shunted blood away from the skin.
• Cyanosis (blue discolouration of skin) indicates inadequate oxygenation.
• Mottling (patchy discolouration of the skin, alternating between paleness and redness in the hands and feet) can be normal in infants under 2 months or exposed to cold environments.

Paediatric Primary Survey

• The Paediatric Primary Survey includes: Airway, Breathing, Circulation, Disability, Expose.
• The survey should be completed in under 2 minutes.

Signs of Deterioration

• Increased work of breathing: this includes recession, labored breathing and tachypnea.
• Cyanosis
• Bradycardia
• Altered mental status or drowsiness.
• Hypo or hypertonia.
• Dehydration or signs of shock.
• Hypoglycemia.

Respiratory Illness and Emergencies

• Common respiratory illnesses in children include asthma, bronchiolitis, URTIs, LRTIs, pneumonia, croup, and epiglottitis.
• Tachypnea is present with all respiratory illnesses.

Asthma

• Asthma is characterized by airway inflammation, wheezing, mucus plugging, hypoxia, and dehydration.
• Asthma is rare in children under 5 years.
• Respiratory rate:
  • ≤40/min in ages 2-5 years.
  • ≤30/min in ages >5 years.
• Other signs of asthma include: hypotension (>110 in adults), exhaustion, and abnormal PaC0₂ (Normal range 4.6-6.0kPA)

Bronchiolitis

• Bronchiolitis is an inflammation of the bronchioles.
• The infection is usually caused by the respiratory syncytial virus (RSV).
• Bronchiolitis is most frequent in autumn and winter.
• It typically presents as a coryzal baby (peak age 2-5 months) with their first wheezy episode.
• Symptoms worsen in the first 72 hours before gradually improving.
• Other household members may experience similar symptoms.

Bronchiolitis Signs and Symptoms

• Reduced SP02 levels.
• Increased respiratory rate.
• Recession.
• Irregular breathing.
• Inspiratory crackles.
• Expiratory wheeze.
• Low-grade fever.
• Possible apnea.

Bronchiolitis Management

• The management of bronchiolitis focuses on respiratory support, feeding, and hydration.
• Oxygen is administered if saturation levels are persistently low.
• The initial focus is on airway and breathing, followed by transportation.