- Allergies
- Allergic Rhinitis caused by environmental factors (ie dust mold pollen pet dander) is an over reaction of mast cells, T-Lymphocites, and eosinophils that causes inflammation in the tissue lining the nose throat and airways.
- Leads to sinusitis, cough, sore throat from post nasal drip, ear infections. Extreme cases may lead to bacterial infections such as Upper Respiratory infection or Pneumonia.
- Signs of allergies:
- Red, watery eyes
- Swollen, pale mucosa in the nose with clear drainage
- Allergic shiners (a purple hue under the eyes)
- Nasal crease (a skin crease on the bridge of the nose from frequent itchy nose rubbing)
- Mouth breathing and a "nasal" voice (due to nasal congestion)
- Treat with
- Antihistamines: Zyrtec, Allegra, Benadryl (Diphenhydramine)
- Intranasal Corticosteroid: Flonase, Nasonex, Nasocort, Rhinocort
Pediatric Respiratory System Review
Monday, July 18, 2011
Common disorders of Pediatric Respiratory System: Allergies
Lab Values and Meanings for Pediatrics
Ability to Ventilate and ability to transport the items being ventilated ie O2 or PCO2.
- Oxygen (O2)
- Healthy person should be >95%
- Compromised individuals (ie smokers, actively asthmatic...) should be above 90%.
- Always check your sensor for accuracy.
- does the patient look like they are at 60%....or are they pink with no distress.
- is the sensor properly placed..ie sensors should be perpendicular to each other
- is the patient causing artifact ie wiggling
- try testing it on yourself/comparing to another sensor. If it is not working correctly label appropriately and notify proper people.
- replace the sensor if needed.
- Carbon Dioxide (CO2)
- CO2 usually builds up due to the patient not ventilating well and thus not excreting the CO2.
- an Acid
- Reflects the respiratory component of acid base balance
- If the patient is acidic (pH is low) and PCO2 is high then the child is no longer compensating for the respiratory distress. High PCO2 is called hypercapnia.
- Hemoglobin
- Hemoglobin is a protein-iron compound in the blood cells that carries oxygen from the lungs to all cells. Carbon monoxide can bind to hemoglobin taking oxygen's place.
- Low Hemoglobin means less oxygen picked up and taken to the body thus lower O2 levels.
- Hematocrit
- The percentage blood that is made of red blood cells.
- Less red blood cells = less hemoglobin which is in red blood cells = less O2....so watch for low O2 levels.
Basic difference between adult and kids + intubation
- Airway is smaller
- Tongue is larger within oral/pharyngeal cavity
- Vocal cords have a lower attachment
- <10yrs Larynx is funnel shapped and Airway is narrowest below vocal cords
- Intubation:
- Below 8 Don't Inflate. The anatomy acts like a cuff so that when intubating you may not need a cuff especially in kids less than 8 years old.
- Endotracheal size formula: (Age(yr)/4) + 4 for example age is 7 years old then (7/4) +4=7
- Premie use 2.5, Term 3.0, 6mn 3.5, 1 year 4.0
- Laryngoscope Blade size: (straight blades for infants/toddlers)
- 1 yr=1.5
- 6mn =1.0
- Term = 0-1
- Premie = 0
- Age 2-10 yr = 2
- Age 10 yr = 3
- If no trama then NG tube placed to prevent gastric distention.
- Assessment for problems: DOPE - Displacement, Obstruction, Pneumothorax, Equipment Failure.
- >10 yrs Larynx is cylinder shapped and Airway is narrowest at glottic inlet
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