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Jamie Ranse: Critical Care Education Coordinator, Staff Development Unit, ACT Health.
RECOGNISING THE CHILD WITH RESPIRATORY DISTRESS
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• Effort of breathing• Efficacy of breathing• Effects of respiratory inadequacy• Respiratory status assessment• Respiratory alterations management
overview
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• Respiratory Rate• Recession
– Mild: sub-costal– Severe: sternal
• Accessory muscle use• Grunting• Alar nasal flare• Child’s position• Respiratory noises
– Stridor / wheeze
effort of breathing
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effort of breathing: respiratory rate
Age (yrs) Resp Rate (breathes/min)
<1 30-40
2-5 25-30
5-12 20-25
>12 15-20
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effort of breathing: breath sounds
• Inspiratory stridor– upper airway pathology
• Expiratory wheeze– lower airways pathology
Exhaustion is a pre-terminal sign
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• Chest expansion• Air entry• Pulse oximetry
efficacy of breathing
A silent chest is a pre-terminal sign
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• Heart rate• Skin colour• Level of consciousness
Pre-terminal signs:• Bradycardia• Central cyonosis• Unconsciousness
effects of respiratory inadequacy
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respiratory status assessment
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respiratory alterations management
• Airway obstruction• Swelling• Bronchospasm• Pulmonary oedema• Non-specific respiratory disease• Hyperventilation due to anxiety