Escolar Documentos
Profissional Documentos
Cultura Documentos
Emergencies
Structured approach to
the seriously ill infant & child
Respiratory
Obstructio
n
Foreign
body
Asthma
Croup
Respirato
ry
Depressio
n
Fluid loss
Fluid
Maldistribu
tion
Convulsion
s
Poisoning
Raised ICP
Blood Loss
Burns
Vomit/Diarrh
oea
Sepsis
Anaphylaxi
s
Cardiac
Failure
Respiratory
Failure
Circulatory
Failure
CARDIAC
ARREST
Key
differences in children
Weight
Anatomical - size & shape
Physiological cardiovascular, respiratory,
immune function
Psychological intellectual ability & emotional
response
Airway
Breathing
Primary assessment
with Resuscitation
Circulation
Secondary assessment
identification of key
features
Disability
Emergency treatment
Exposure
Stabilisation
Transfer to definitive care
Assess patency by
-Looking for chest and/or abdominal movement
- Listening for breath sounds
- Feeling for expired air
Stridor
Oxygen
Potential
respiratory failure
Potential
circulatory failure
Potential
Effort of breathing
Recession
walls)
Respiratory
Accessory
rate
muscle use
Flaring
of the nostrils
Child's
position
Age (yrs)
Respiratory rate
( breaths/min)
<1
30 -40
1-2
25-35
2-5
25-30
5-12
20-25
>12
15-20
Inspiratory
stridor
Expiratory
wheeze
Grunting
- stiff lungs to prevent airway collapse
(represents closure of the larynx
during expiration)
1. Exhaustion
2. Central
respiratory
depression
3. Neuromuscular
disease
1.
Exhaustion
2. Central
respiratory
depression
3. Neuromuscular
disease
Effort of breathing
Efficacy of breathing
Chest expansion
- reduced or absent
- symmetrical or asymmetrical
Breath sounds
- reduced or absent
- symmetrical or asymmetrical
Pulse oximetry
Effort of breathing
Efficacy of breathing
Heart
rate
Skin
colour
Mental
status
SaO2
Cyanosis
After 12 months,
Weight (Kg) = 2 x (age in years + 4)
the formula can be applied, but needs to be modified according
to whether the child is small or large compared with the average
Cardiovascular signs
Heart rate
-increases in shock
- Bradycardia may be a sign
of
imminent cardiorespiratory
arrest
Pulse volume
Capillary refill
Blood
Pressure
Age (yrs)
<1
70-90
1-2
80-90
2-5
80-95
5-12
90-110
>12
100-120
Cardiovascular signs
Respiratory rate
tachypnoea &
hyperventilation
occurs with acidosis eg. poor
tissue
perfusion
Skin
temperature/colour
poor perfusion
Mental status
Urine ouput
<2ml/kg/hour in infants
<1ml/kg/hour in a child
indicates inadequate renal
Marked tachycardia
Raised jugular venous pressure
Gallop rhythm / murmur
Enlarged liver
Absent femoral pulses
Conscious level
AVPU
Alert
Responds
to Voice
Responds
only to Pain
Unresponsive
to all stimuli
Conscious level
Posture
decorticate
decerebrate
Conscious level
Posture
Pupillary signs
Effort
Efficacy
Effects
Circulation
Heart rate
Capillary refill time
Blood pressure
Skin temperature
Disability
Conscious level
Posture
Pupils
Glucose
Values in children