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Questions and Answers
What anatomical feature in infants can lead to respiratory distress if obstructed?
What anatomical feature in infants can lead to respiratory distress if obstructed?
What does mottling of the skin in infants typically indicate?
What does mottling of the skin in infants typically indicate?
Which airway characteristic increases the risk of foreign body obstruction in infants and children?
Which airway characteristic increases the risk of foreign body obstruction in infants and children?
Which of the following signs indicates serious respiratory compromise in children?
Which of the following signs indicates serious respiratory compromise in children?
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An infant's head is significant in size compared to the body. What proportion of the adult head size does an infant's head generally reach?
An infant's head is significant in size compared to the body. What proportion of the adult head size does an infant's head generally reach?
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What might pallor in an infant's skin indicate?
What might pallor in an infant's skin indicate?
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What characteristic of an infant's airway can lead to increased risk during respiratory illness?
What characteristic of an infant's airway can lead to increased risk during respiratory illness?
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Which of the following factors does NOT contribute to the unique management needs of unwell infants and children?
Which of the following factors does NOT contribute to the unique management needs of unwell infants and children?
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What is a common initial sign of deterioration in an unwell infant or child?
What is a common initial sign of deterioration in an unwell infant or child?
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Which respiratory condition is predominantly caused by the respiratory syncytial virus (RSV)?
Which respiratory condition is predominantly caused by the respiratory syncytial virus (RSV)?
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What is the appropriate respiratory rate range for a child aged 2-5 years that indicates normal breathing?
What is the appropriate respiratory rate range for a child aged 2-5 years that indicates normal breathing?
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Which sign is NOT typically associated with bronchiolitis?
Which sign is NOT typically associated with bronchiolitis?
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In which age group is asthma considered very rare?
In which age group is asthma considered very rare?
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What is the primary aim of treatment in bronchiolitis management?
What is the primary aim of treatment in bronchiolitis management?
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Which of the following symptoms would indicate possible hypoglycemia in an unwell child?
Which of the following symptoms would indicate possible hypoglycemia in an unwell child?
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Tachypnoea is a feature of which condition?
Tachypnoea is a feature of which condition?
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What is a key sign that symptoms of bronchiolitis often peak at specific times?
What is a key sign that symptoms of bronchiolitis often peak at specific times?
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Which of the following is an indicator of impaired circulation in an unwell child?
Which of the following is an indicator of impaired circulation in an unwell child?
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Study Notes
Unwell Infant and Child - Component 10 Objectives
- Recognize a seriously ill child and baby.
- Assist the clinician in managing seriously ill children and babies.
Anatomical and Physiological Differences
- Infants have large heads, approximately 2/3 the size of an adult head.
- Infants have a small nose and primarily breathe through their nose up to six months, making them susceptible to breathing difficulties if the nostrils get blocked.
- Infants have loose teeth, making them susceptible to airway obstruction from foreign bodies which can pose a danger when the airway is smaller than an adult's.
Airway Differences
- Infants have a large prominent occiput, a small face and narrow nostrils.
P.A.T. - Circulation to Skin
- Pallor: white or pale skin, indicates shunting of blood away from the skin.
- Cyanosis: blue discoloration of the skin, caused by inadequate oxygenation. Note that cyanosis in hands and feet under two months of age or when exposed to a cold environment may be normal.
- Mottling: abnormal vessel tone in the capillary bed, causing patchy areas of pallor and cyanosis.
Paediatric Primary Survey
- Airway: Ensure the airway is open.
- Breathing: Check the respiratory rate by age.
- Circulation: Check the pulse, capillary refill, and skin warmth based on age.
- Disability: Use the AVPU scale, check pupils, and assess blood sugar.
- Exposure: Fully expose the patient to allow for a complete assessment.
- Reassess frequently – every 2 minutes.
Signs of Deterioration
- Increased work of breathing (recession, increased respiratory rate)
- Cyanosis
- Bradycardia
- Altered mental status or drowsiness
- Hypo or hypertonia
- Dehydration or signs of shock
- Hypoglycemia
Respiratory Illness and Emergencies
- Childhood respiratory illnesses and emergencies are common and usually self-limiting.
- Tachypnoea is a common characteristic of all respiratory illnesses.
- Common respiratory illnesses include: asthma, bronchiolitis, URTIs, LRTIs, pneumonia, croup, and epiglottitis.
Asthma
- Acute inflammation of the airways, causing wheezing, mucus plugging, hypoxia, and dehydration.
- Asthma is rare under 5 years of age.
- Respiratory Rate:
- ≤40/min ages 2-5 years
- ≤30/min aged >5 years
- Signs of deterioration:
- Hypotension
- Exhaustion
- Abnormal PaC0₂ (Normal range 4.6-6.0kPA)
Bronchiolitis
- Inflammation of the bronchioles.
- Acute, self-limiting infection usually caused by respiratory syncytial virus (RSV).
- Predominant in autumn and winter.
- Peak age 2-5 months.
- First wheezy episode.
- Worsens in the first 72 hours before improving.
- Other household members may present with similar features.
Bronchiolitis Signs and Symptoms
- Reduced SP02
- Increased RR
- Recession
- Irregular breathing
- Inspiratory crackles
- Expiratory wheeze
- Low grade fever
- Possible apnoea
Bronchiolitis Management
- Perform DR ABCDE (time-critical correct A and B before transport).
- The goal of treatment is to provide respiratory support and manage feeding/hydration.
- Administer oxygen if saturations are persistently lower than ...
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Description
Test your understanding of recognizing and managing seriously ill infants and children. This quiz covers anatomical and physiological differences, airway considerations, and signs of circulation issues. Perfect for clinicians and healthcare professionals working with pediatric patients.
