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69 Cards in this Set
- Front
- Back
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Is the size of the babies head proportionately larger or smaller than the size of their body?
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Larger.
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What allows the head to grow even more and mold into its shape (until about age 4)
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Sutures and Fontanelles.
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Fontanelles provide protection against what?
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Increased Cranial Pressure
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What has bridging veins to the brain that can tear and bleed if an injury is sustained?
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Dura
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When do frontal sinuses develop?
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8 years of age.
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Children under the age 2 who fall usually fall on what part of the body b/c of its extra weight?
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Head
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As children gain more muscular strength and control, what do they develop?
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A neck.
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Compared to an adult, a babies neck is....
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Very short, "neck-less"
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Compared to an adult's nasal passages and airways, a baby has
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Smaller nasal passages and airways
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How do infants breath?
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Infants are obligate nose breathers
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How can infants obstruct their own airways?
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They have large tongues!
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In infants, where is the larynx placed?
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It is higher and more anterior-->making it more "available" for aspiration.
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Compared to adult BP, kids have...
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A much lower BP
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Compared to adult HR, kids have...
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A higher heart rate
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Compared to adults RR, kids have...
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Higher RR
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Compared to an adult, a babies muscles....
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Fatigue more easily
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A kid in whom the skin around the ribs is getting "sucked in" under the ribs with each breath (and above the clavicle, too) has what?
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Retractions
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What is a kid with retractions trying to do?
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They are trying to recruit accessory muscles to breathe easier
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What causes respiratory distress and if prolonged, respiratory failure?
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Retractions
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The key when looking for retractions is to what?
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Have the kids shirt off!!
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Compared to an adult, the trachea of a child is...
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Shorter with more collapsible rings
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When a baby is intubated, how must the neck be extended?
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Pull neck upward, not backward. If extend too far back, could actually fold the trachea and close off the windpipe!!
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Compared to adult, the bones a baby are...
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Softer, more bendable, and tend to fracture easier
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What is seen in an infants abdomen that is not as noticeable in adult?
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Babies are abdominal breathers.
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Compared to an adult, the spleen and liver in a child are...
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More exposed to trauma b/c sit lower in abdomen. Also, they are more vascular in a child.
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Compared to adult surface area, babies have...
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A large surface area
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The large surface area of a baby make then more prone to what illness?
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Hypothermia
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Compared to adult skin, in infants the skin is....
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Thinner, less subcutaneous fat-->will have less protection against burns
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Compared to adult chest & lungs, infants...
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-rib cage more elastic, flexible-->less vulnerable to injury, more apt to allow retractions during respiratory distress
-Lung tissue is more fragile and more easilty contused -Chest muscles tire more easily, use of accessory muscles in respiratory distress |
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In an infant, why is the mediastinum more vulnerable to tension pneumothroax than an adult?
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B/c mediastinum is more mobile and more vulnerable.
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Why are infants more vulnerable to hypoxemia?
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Higher metabolic rate and greater oxygen requirement.
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Where is the thymus located on an infant?
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In the chest.
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As age increases, what happens to respiratory rate?
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RR decreases!
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Compared to adult total circulatory blood volume, infants...
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Have a smaller total circulatory blood volume
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Even though infants have a smaller total circulatory volume, will they still loose the same amount of blood as an adult if lacerated?
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YES
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When do children do when a significant amount of blood is lost?
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They can maintain their blood pressure longer than adults, even at the point of cardiac arrest!
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What might indicate cardiac arrest?
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Bradycardia
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What happens to BP with age?
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Increases
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What happens to HR with age?
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Decreases
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How does an infants NS differ from an adult's NS?
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Infants cannot localize pain
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If less than 5 yrs old, what HR indicates urgency?
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HR>160 or HR<80
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If over 5 yrs old, what HR indicates urgency?
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HR>140
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Should a sustained tachycardia likely in the 200s) cause a sense of urgency?
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Yes
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What does bradycardia in a child indicated?
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Cardiac Arrest.
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For hypotension, a fall of how many mmHg is significant?
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10mmHg
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Poor tissue perfusion in a child is indicated by what?
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Absence of peripheral impulses.
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Absence of a central pulse means what?
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BAD!!
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Squeeze the finger or toenails untl they blanch and then watch for them to pink back up after you release. What is this test called?
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Capillary refill time.
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For a normal capillary refill time, how long should it take for color to return?
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Less than 2 seconds.
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If capillary refill time is longer than 2 seconds, what does it suggest?
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Poor perfusion, hypothermia, constricted blood flow, or dehydration (big one pediatricians are looking for)
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What does mottling, pallor, or peripheral cyanosis indicate?
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Poor tissue perfusion or respiratory distress.
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What does dimished urinary output indicate?
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Poor renal perfusion or respiratory distress.
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What are the 3 parts for the Pediatric Assessment Triangle (PAT)?
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1.Appearance
2.Work of Breathing 3.Circulation to skin |
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The toll that allows us to make a rapid, accurate assessment of EVERY child we see is called?
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PAT
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The pneumonic TICLS refers to what part of the PAT triangle?
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Appearance
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What does TICLS stand for?
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Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry
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Gurgling and Stridor are sounds from what portion of the airway?
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Upper Airway.
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What is the result of very proximal upper airway obstruction due to low muscle tone in the tongue and jaw?
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Gurgling
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What is a high-pitched whistling sound that occurs when there is partial obstruction of the trachea or vocal cords. Can be heard on inspiration/expiration.
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Stridor
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Grunting and Wheezing are problems with what portion of the airway?
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Lower portion of the airway.
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Heard when a child exhales against closed vocal cords. This is done reflexively to increase lung expansion and maximize gas exchange. It is heard in children with pneumonia, pulmonary contusion, or pulmonary edema.
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Grunting
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A high-pitched musical sound that is heard when air is pushed through partially obstructed small airways in the lungs. Most frequently heard on expiration (heard on inspiration in more severe cases). Commonly associated with asthma and bronchiolitis.
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Wheezing
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What does the "sniffing position" suggest?
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Upper airway obstruction.
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A child who refuses to lie down or assumes the tripod positio is trying to do what?
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Maximize the use of accessory muscles to breath.
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Nasal flaring suggests what?
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Moderate to severe hypoxia.
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A child that is alert and active, but has nasal flaring and retractions has what?
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Respiratory Distress
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A child with abnormal appearance and increased work of breathing has what?
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Respiratory Failure.
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A child with a history of increased work of breathing who now has abnormal appearcne but no increased respiratory effort...what should be done?
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Assisted ventilation must be started immediately.
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What are the 3 signs of inadequate skin circulation?
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1.Pallor
2.Mottling 3.Cyanosis |
