Respiratory distress in children. Prepared by : Dr. MOHAMMAD Mizyed Supervised by: Dr. Nadwa Al- zohlouf -2008-. Respiratory distress in children. Respiratory distress is one of the most common chief complaints for which children seek medical care.
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Dr. MOHAMMAD Mizyed
Dr. Nadwa Al-zohlouf
- an attempt to improve minute ventilation
(tidal volume x RR) as in hypoxia.
-as a result of respiratory stimulation or depression.
-difficulty in mechanics of respiration ,typically from airway obstruction or muscle fatigue.
SOrespiratory distress must be earyrecognised because they become fatigued and decompensated early than older patients
2-Tension pneumothorax .3-Cardiac tamponade.
4- Pulmonary embolism5-Traumatic conditions as flail chest
-identification of children with respiratory distress.
-rapid assessment of respiratory status.
-identification of children who require immediate intervention (life-threatining).
-brief history while emergent treatment is initiated.
-trial to keep the child calm and comfortable.
-rapid, shallow breathing as in asthma and bronciolitis (air trapping)
-kussmal breathing as in matabolic acidosis (DKA)
-ataxic respiration as in CNS infection or injury
-subcutaneous emphysema which can be seen in pneumothorax
-increased tactile fremitus as in consolidation or decreased as in upper airway obstruction.
- hyper-resonance or dullness
-wheezes which is typically heard with asthma and bronchiolitis .unilateral wheezes indicates foreign body in lower airway.
-cracklesas in pneumonia an pulmonary edema
-pleural rub as in pneumonia and pleural abscess.
-decreased breathing sounds as in atelectasis ,pneumonia and effusion.
-the clinical evaluation usually suggest the cause of respiratory distress.
-diagnostic test should confirm the diagnosis and direct treatment, it may include; a-imaging -CXR -CT scan -Fluroscopy b-ABGs c-RBS d-cultures e-urine toxicology screen ……etc
Difficulty or pain swallowing
“Lump” in the throat
Pain in the back & shoulders upon swallowing
Difficulty breathing is an ominous complaint that signifies impending airway obstructionRetropharyngeal abscess - sxs
paroxysm of coughing, chocking & possibly airway obst.
F.B become lodged ,reflexes fatigue & immediate irritating symptoms subside.
.obstruction, erosion, or infection occurs which direct attention again to the presence of F.B
.symptoms of this stage include fever.cough,hemoptysis,pneumonia and atelectasis
-Magill forceps (if object above cords)
indicated to establish airway in upper airway obst.