What are some signs of respiratory obstruction?
- inspiration stridor (upper respiratory)
- hoarse voice
- expiratory wheeze (lower respiratory)
- drooling
- restlessness
- mottled colour (cool and blueish)
What is Obstructive Sleep Apnoea (OSA)?
- it is a significant upper airway obstruction resulting in oxygen desaturation &/or sleep fragmentation.
What are signs of respiratory distress?
- nasal flaring
- head bobbing
- tachycardia
- grunting
- tripod position
- tracheal tug
- accessory muscle use
- tachyponea
- intercostal, subcostal or sternal recessions
In a Pediatric respiratory Assessment what are we assessing?
- ABCD
- airway
- breathing
- circulation
- disability
What is asthma?
Asthma is a chronic disorder characterised by bronchial constriction, hyper-responsive airways and airway inflammation
List some triggers for asthma
- allergy
- food additives
- viral upper and lower respiratory infection
- drugs(NSAID)
- exercise
- environmental (pollution, smoking…)
What are some clinical manifestations for asthma?
-rapid laboured respiration so
-nasal flaring
-intercostal recessions
-accessory muscle use
-productive cough
-decreased air movement
-respiratory wheeze
-child may complain of chest tightness
-anxiety
-prolonged expiratory phase
-
What focused assessments would we be conducting on a child with asthma?
- checking vital signs
- working of breathing
- ability to talk - sentences, phrases, single words
- chest examination
- chest auscultation
What is hypoxia and how would it present in a child?
- Hypoxia is a lower than normal amount of oxygen in the tissues.
- Can present as behaviours from wide eyed agitation to lethargic irritability in a child.
What does an Asthma Management Plan outline?
- what medication to take every day (even if pt is feeling well)
- how to tell if their asthma is getting worse
- what the pt should do if their symptoms are getting worse
- what to do if the pt has an asthma attack.
What is Cystic Fibrosis and what changes can occur to the body systems?
- CF is a common inherited autosomal recessive disorder of the endocrine glands
- it can lead to changes in the respiratory, GI and reproductive systems.
What is the treatment for Cystic Fibrosis?
- chest physiotherapy 1-3 times a daily to facilitate the removal of secretions from the lungs
- frequent prolonged courses of antibiotics for infections may be prescribed to improve pulmonary function, exercise tolerance and “quality of life”
What are some differences of a paediatric airway?
- large head and short neck
- large tongue
- narrow nostrils- compressible floor of mouth
- horse-shoe shaped epiglottis
- high anterior larynx
- short soft trachea
- loose teeth
What is the paediatric airway position for an infant below 12 months of age?
The neutral head position.
What is the paediatric airway position for a small child 1-8 years of age?
The sniffing position
What is the paediatric airway position for a larger child that is 9 years and above?
The backwards head tilt with pistol grip
What are you look, listening and feeling for in relation to breathing?
Look= at the rise and fall of the chest; Symmetry Listen = for breath sounds Feel = breath on your cheek
What is the choking management plan for a conscious child that is NOT coughing?
- 5 back blows between the shoulder blades
- assess for foreign body
- 5 chest thrusts
- assess for foreign bodies
What is the choking management for a child that is not coughing and is unconscious?
- open airway
- 2 rescue breaths
- CPR 15:2
What is the choking management for a child that is coughing?
Encourage coughing until clear foreign body
The four main symptoms of asthma are?
1) wheeze
2) SOB
3) cough
4) chest tightness
The narrowing of the airways in an asthma attack is caused by?
- smooth muscle contraction of the airways
- mucosal oedema
- increased mucus secretions
List the 3 changes that take place in the airways during an asthma attack:
- bronchospasm
- inflammation of the bronchial mucosa
- increased bronchial secretions
A child presents with an acute episode of asthma. Describe the signs and symptoms of an acute asthma attack?
- pale with flushed cheeks and ears
- tripod stance
- mouth breathing
- nasal flaring
- use of accessory muscles
- recession
- cycanosis
- anxious facial expression
