pediatri c respiratory system

pseudoglandular

6-16 weeks → survival not possible

canalicular

16-26 weeks -> survival viable at 24wks

some gas exchange

terminal saccular

26 to birth

blood air barrier established

UA

cold/stuffy nose

mucus is blocked easier

epiglottis: long and flappy in peds

LA in peds

immature intercostal muscles → retractions!!

grunting

keeps alveoli open → trying to get glottis to close

retractions

assist w/ventilation → substernal/intercostal/outer

head bobbing

assist w/ventilation → NOT GOOD

nasal flaring

increase diameter of air passages → c section kids

LTB

subglottic narrowing

• most common; occurs 3m-8yr

• viral infection in UA → HIB

SX: brassy cough, dyspnea, stridor, low grade fever

TX: steroids, fluids, epi

spasmodic laryngitis

occurs in 3m-3yr; often at night

SX: barking cough, afebrile, mild resp distress

TX: cool mist, no meds

pneumothorax

collapsed lung air in pleural space

SX: SOB, tracheal deviation, ↓ BP, increase HF

TX: needle decompression, chest placement

bronchiolitis

infants/young children; small airway becomes obstructed/prevents full expiration

SX:

• cough, tachypnea, wheezing

• difficult feeding

resp distress = hard to suck, swallow, breathe

epiglottitis

sudden fever, strider, drooling, tripod position

they extend neck to help get airway; acute phase 48-72 hours

ARDS

acute, diffuse, and inflammatory lung injury

• hypoxemia and noncompliant lungs (pneumothorax)

respiratory distress syndrome

• neonates NB

• results from lung immaturity and lack of surfactant

CF

SX:

• steatorrhea, rec pneumonia, failure to trhive, meconium ileum

DX:

• NB screen, sweat Chl testing

TX:

• pancreatic enzyme replacement, increase protein/fat/calorie

bronchopulmonary dysplasia

abnormal development of lung tissue; characterized by inflammation/scarring in the lungs

• mostly in preemie

• lungs are WORSE w/vent management

Hemophilia

impaired clotting

SX:

• easily bruising, prolonged bleeding

• joint bleeding/swelling/pain

prevent bleeding/trauma

sickle cell

vaso-occlusive crisis

sickled RBCs obstruct blood flow → tissue ischemia → pain

triggers:

• dehydration, infection, hypoxia, cold/stress

acute chest syndrome

major sickle cell complication

SX:

• fever, chest pain

• cough; hypoxemia

• new pulmonary infiltrate

**requires prompt assessment/intervention