21. respiratory distress in children 2007dr. amalia
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RESPIRATORY DISTRESS IN CHILDREN
RESPIRATORY DISTRESS IN CHILDRENDepartment of Child HealthFaculty of Medicine Universitas Gadjah MadaYogyakarta
1Upon completion of this lecture, you will be better able to:Define the most common types of respiratory emergencies in childrenList the steps in assessing a child who is experiencing respiratory distressDescribe the proper interventions for selected respiratory emergenciesLEARNING OBJECTIVES22 types of breathing emergencies*Respiratory distress*Respiratory arrestBoth conditions are life threateningResp. distress is a condition in which breathing becomes difficultResp. arrest occurs when breathing stopsBy recognizing resp.distress and taking immediate action prevent resp.arrest
BREATHING EMERGENCY3InfectionAirway obstructionTraumaCongenital conditionsAllergic conditionsNeurologic: GBSCAUSES OF RESPIRATORY EMERGENCIES
4Respiratory rateIncreased early, decreased late NOTE: A slow respiratory rate is an ominous sign in children
Respiratory observationsNasal flaring Retraction
Use of accessory muscles
Coughing
SIGNS AND SYMPTOMS OF RESPIRATORY DISTRESS5Abnormal Breath SoundsWheezing - hallmark sign of lower airway obstructionInspiratory Stridor - hallmark sign of upper airway obstructionDecreased, absent, unequal breath soundsExpiratory Grunting - LATE signColorPale, flushed & bluish skin colorCyanosis is a late signLevel of consciousnessSomnolence/lethargy is a late signIncrease heart rate
SIGNS & SYMPTOMS6Signs of Respiratory Distress
Cyanosis is alate sign ofrespiratorydistress7
Seesaw Respiration8Hypoxia signs & symptoms of respiratory failureDiagnosis : Blood gas analysis sometime not available ..?Early detection clinical manifestation of Potential Respiratory Failure
CLINICAL MANIFESTATION OF RESPIRATORY FAILURE9Distress respiration- Work of breathing* Tachypneu* Accessories muscle* Chest wall retractin* Nasal flare- Consciousness & respons to pain- Weakness of muscle tones- Cyanotic
CLINICAL MANIFESTATION
10CLINICAL MANIFESTATIONRespiratory effortAgain, observe how much energy the patient is putting into breathingSkinpallor and diaphoresis indicate fight or flightcyanosis indicates hypoxia (peripheral, then central)
Chest wallRetractions & accessory musclesSymmetrySigns of traumaDont forget to look posterior!
11Head bobbingGrunting : pulmonary oedema, pneumonia, HMD, atelectasisSeesaw respiration inefficientStridor : upper airway obstruction macroglossia, laryngomalacia, vocal cord paralyse, mass, infection, oedema, foreign bodiesRespiratory effort12Wheezy on expiration lower airway obstruction- Bronchial asthma, bronchiolitis, pulmonary oedema, foreign bodies
Entry of air breathing- Compliance of chest wall tidal volume 6 L/min)Low FiO2Variability in actual FiO2
Nasal Canula47Thank You48