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Lecture notes Acute Care (SHN2004)

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Lecture notes on ABCDE-Breathing

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  • April 24, 2024
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SHN2004 - Breathing



Breathing
Paediatric Respiratory System


 Large head, small mandible, small neck
 Large, posteriorly placed tongue
 High glottic opening
 Small airways
 Presence of tonsils, adenoids




What does normal respiration involve?
 Respiration refers to the mechanisms for obtaining oxygen
from the air and delivering it to the tissues, while eliminating
carbon dioxide from the body.
- Inspiration (ventilation – ACTIVE)
- Gas exchange between alveoli and blood
- Transportation of carbon dioxide
- Gas exchange between blood and alveoli
- Expiration – PASSIVE

Respiratory rate – normal range

, SHN2004 - Breathing


Assessing breathing
 Look
 Listen
 Feel
 Dyspnoea – derived from a Greek word which means ‘difficulty with breathing’ – is
extremely distressing for patients.
 Patients describe it a ‘suffocating’, ‘tightness’, a feeling of impending doom.
 When assessing a patient breathing, we are looking for signs of respiratory distress or
inadequate ventilation.
Respiratory distress
 Respiratory distress describes many of the symptoms related to breathing problems.
 There can be many causes of respiratory distress in children, but usually it’s causes by
infections, chronic illness, or a blocked airway

Respiratory Emergencies

Laryngotracheobronchitis – Croup
Croup: Pathophysiology
 This is the most common cause of upper air obstruction in children aged 6 months to 6
years.
 Viral in origin, usually caused by parainfluenza virus.
 Characterised by subglottic inflammation and narrowing.
Croup: Signs/Symptoms
 Initially, the symptoms of croup are similar to those of the common cold:
- A sore throat
- Runny nose
- Raised temperature cough
- The characteristics symptoms of croup develop a few days later.
- The child will develop a barking cough, hoarse voice, and noisy breathing (stridor).
- The symptoms tend to be worse at night. They also worsen when the child cries or is
upset.
Croup Management




Asthma

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