Pediatric Respiratory Assessment Part 3


Respiratory mechanics
·         Increased work of breathing is often caused by conditions that increase the resistance to airflow or decrease lung compliance
·         Lungs are stiffer and more difficult to inflate

Respiratory Effort
·         Increased work of breathing in order to improve oxygenation, ventilation, or both
·         Signs: nasal flaring, retractions, head bobbing, and seesaw respirations, use of accessory muscles, grunting, increased inspiratory or expiratory times

Upper airway obstruction
·         Major signs occur during the inspiratory phase
·         Symptoms may include stridor, hoarseness, or vocal changes
·         Inspiratory retractions, use of accessory muscles, and nasal flaring may be present

Lower airway obstruction
·         Major clinical signs occur during the expiratory phase
·         Wheezing, tachypnea, and increased respiratory effort may be present

Parenchymal lung disease
·         Lungs become stiff requiring increased effort during both phases of respirations
·         Retractions, tachypnea, and grunting may be present. 



Abnormal control of breathing

·         Abnormal breathing is a state in which the patient is described as “breathing funny”

·         May be periods of increased effort to breath followed by periods of decreased effort breath

·         Causes may include brain tumors, brain stem lesions, or drug overdose. 



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)






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