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Anatomic and Physiologic Differences. Lesson 2. Anatomic and Physiologic Differences. There are fundamental anatomic and physiologic differences between children and adults that directly effect How assessment is performed How children respond to illness and injury

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anatomic and physiologic differences2
Anatomic and Physiologic Differences
  • There are fundamental anatomic and physiologic differences between children and adults that directly effect
    • How assessment is performed
    • How children respond to illness and injury
    • How treatment and transportation decisions are made
pediatric airway considerations
Pediatric Airway Considerations
  • More anterior than the adult
    • less head tilt to open the airway
  • Smaller diameter of airway than the adult
    • easily blocked by secretions or blood
  • Large tongue in relation to jaw size
    • likely to cause obstruction when child is unconscious
slide5

Pediatric Airway Considerations

Infants prefer to breathe through the nose.

  • Nasal obstructions can cause respiratory distress.
breathing considerations
Breathing Considerations
  • Small children are dependent on contraction of the diaphragm to breathe.
  • A child’s primary response to respiratory distress is to increase the rate and effort of breathing.
slide7
A child may have pronounced retractions of the chest wall because the chest wall is less muscular and has more flexible bones.
breathing considerations8

Pediatric Respiratory Rates

Age

Rate (breaths per minute)

Infant (birth–1 year)

30–60

Toddler (1–3 years)

24–40

Preschooler (3–6 years)

22–34

 School-age (6–12 years)

18–30

Adolescent (12–18 years)

12–16

Breathing Considerations

A silent chest is an ominous sign of low blood oxygen in the pediatric patient.

circulation considerations
Circulation Considerations
  • Children compensate efficiently in shock by increasing heart rate and vasoconstriction but then decompensate rapidly.
  • Mental state change is often an early indicator of shock.
slide10

Pediatric Pulse Rates

Age

Low

High

 Infant (birth–1 year)

100

160

Toddler (1–3 years)

90

150

Preschooler (3–6 years)

 80

140

 School-age (6–12 years)

70

120

Adolescent (12–18 years)

60

 100

Bradycardia is a late sign of low blood oxygen in the pediatric patient.

circulation considerations11
Circulation Considerations
  • Hypovolemia can develop from vomiting or diarrhea in children.
  • Blood pressure is an unreliable indicator of perfusion in the pediatric patient.
slide12

Low-Normal Pediatric Systolic Blood Pressure

Age*

Low Normal

Infant (birth–1 year)

greater than 60*

Toddler (1–3 years)

greater than 70*

Preschooler (3–6 years)

greater than 75

School-age (6–12 years)

greater than 80

Adolescent (12–18 years)

greater than 90

*Note: In infants and children aged three years or younger, the presence of a strong central pulse should be substituted for a blood pressure reading.