Cardiorespiratory paediatric physiotherapy

Anatomical difference between adult and children

• large head

• short neck

• large tongue

• large tonsiles

• high larynx

• smaller airways

• bronchila walls have more cartilage

• cilia poorly developed at birht

• alveoli smaller in size and number

• immature muscles

• chest wall rounded

larger tidal volume with limited insp/exp reserves

FRC is relatively less

more type 2 muslce fibres than type 1, hence more prone to fatigue

higher resting metabolic rate → higher O2 requirement → higher cardiac output

Signs of respiratory distress

sounds

• stridor

• difficulty vocalising

• grunting and noisy breathing

behaviour

• irritable and whiny

• difficulty eating

• drowsy

• floppy

Signs of respiratory distress

• recession

• tracheal tug

• nasal flaring

• head bobbing

auscultation:

• the smaller teh body the more difficult

• faster respiratory rate with shorter expiratroy phase

• less lung tissue for high frequency sound sto be filtered

• unable to take a deep breath on command

compare lobs of both sides:

• presence of breath sounds

• presence of added sounds