Pediatric Respiratory Assessment Part 2

Assessment

·         Respiratory rate

·         Respiratory mechanics

·         Air entry

·         Level of consciousness

·         Skin color

Respiratory rate        bpm

·         Newborn               40 -60

·         Toddler                 24-40

·         Preschool              22-34

·         School age            18-30

·         Adolescent            12-16

Abnormal Respiratory Rate

·         Tachypnea

·         Bradypnea

·         Apnea

Note:   A consistent respiratory rate of < 10 or > 60 bpm in a child of any age is abnormal and suggests the presence of a potentially serious problems

Tachypnea

·         Increased rate of breathing

·         Often first sign of respiratory distress

·         May be a normal physiologic response to stress

Quite Tachypnea

·         Increased breathing rate without signs of respiratory distress

·         Usually a physiologic response to maintain normal blood pH

·         Other causes:  Fever, sepsis, CHF, severe anemia, some congenital heart defects

Bradypnea

·         Breathing rate that is slower than normal

·         Frequently accompanied by an irregular breathing pattern

·         Causes:  respiratory muscle fatigue, CNS injury or infection, hypothermia, medications

Apnea

·         Cessation of breathing for > 20 seconds

·         Cessation of breathing for < 20 seconds when accompanied by bradycardia, cyanosis, or pallor

·         Agonal gasps do not produce effective ventilation and oxygenation

Note:  Central apena is caused by an abnormality or suppression of the brain and spinal cord

Obstructive apnea is occurs when the airflow is partially or completely blocked

Mixed apnea is a mixture of both central and obstructive apnea.

Source:

Pediatric Advanced Life Support Provider Manual by Leon, M.D. Chameides, Ricardo A., M.D. Samson, Stephen M., M.D. Schexnayder and Mary Fran, RN Hazinski (Oct 12, 2011)