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)