Paediatric assessment

  • Created by: Louisa
  • Created on: 21-10-19 18:16
anatomy differences in children
head is large and neck is short = neck flexion and narrowing airway, small face and mandible with loose teeth, relatively larege tongue, = obstructs airway, compressible floor of mouth = can be compressed when holding the jaw
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Airways in children under 6 months
horseshoes shaped epiglottis, larynx is high and anterior, cricoid ring is the narrowest oart of the airway, trachea short and soft
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immature lungs, samll surface area, easily obstructed, infants rely on diaphragmatic breathing = muscles fatigue quickly, ribs are more horizontal and contribute less to chest expansion = compliant chest wall.
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oxygen comption is always high along with metabolic rate and increased inpedance to lung expansion, legs are dependant on surfactant
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waht remains relatively stable thorought childhood to adult hood
tidal volume (5-7 ml/kg) and percentage of metabolic rate
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respiration anatomy
immature lungs at birth, upper and lower airways are quite small, infants rely on disphragmatic breahting - susceptible to muscle fatigue, infants ribs lie horizontally = less chest expansion
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ciculation- ventrciles on the heart at birth, 2 months and 4-6 months
simialar in weight, Lv becomes more dominant, LV is dominant
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though the volume of blood is children is ... the circulation rate is...
smaller - faster
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body surafce area to weight ratio is high in children but .. and causes what(2)
decreases with age, and causes rapid heat lose and prone to hypothermia
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what is the epiphysis
the part in long bones that grows
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injury to the epiphysis results in
stimuation to excessive growth creating a temporary limb length difference
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a physeal injury results in
servere growth arresr = limb length differnce and requires treatment to correct
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what is a physeal injury also known as
a salter harris fracture
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it involves hte
physis (the growth plate)
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skeletal difference in children
their bones are more elastic that adults and a greater realtive force is needed to cause a fracture
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Psychology differnces
communication, fear, parental anxiety, explain, demo, involve parents
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global overview inclides
appearance, work of breathin and circulation to skin
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how they hold themseld, colour of skin, what they are wearing, mental appearance, look/gaze, consolability and crying
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work of breathing
chest, face, rate, breathing sounds, exhausted, muscle use, nasal flaring
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cyanosis, mottling, bleeding, pallor
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peads assessment stages
obs, general impression, severity, urgency of itervention, category, sick or not sick
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what 6 things should you observe in the assessment
airways, breathing, interation with environement, activity, posture, skin
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noisy breahting, weak or stong or abnormal cry
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unusal posture, accessory muscle use, recession, nasal flaring
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interaction with environemt
alertness, LoC, readiness to play, interest with environemt
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limb movement, spontaneous or to stimulation
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abnormal posture, breahting
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bruising, pallor, cyanosis, skin rash
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pain scale used in children
wrong baker scale
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what is big sick, little sick
how quicly we need to get onto the ambulance, and go, so how urgent care is and what aprroach we can take
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what do we have to consider with an infant
involve the parents, start with assessments requiring quiet, palpate fontanel, tenses with increased ICP/crying, shrinks during dyhyration, most assesment done though obs, oxamine to pto toe
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what do we have to consider with a toddler
similar approach, they have an increased wariness of stangers, some children won't want to be exmained, use parent for reassureance, eye level and smile, allow them to play with instruments
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hat do we have to consider with school children
communication is good or regressed with stress, past experience with healthcare staff with shape reaction, if something concerns you, ask, don't leave with regrets
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what do we have to consider with adolescents
have a high degreeof awareness of insecurities and anxieties, hidden agendas, they are distressed so don't act confrontational or humiliate, respect their wishes and medesty, to reduce anxiety
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main points to remember (5)
don't lie to children, always invovle the parent, try to keep parent and child together, don;t become angry with a child, involve a child in their care
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safety netting
includes getting GP to call back or getting an appointemnt with the GP.
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Card 2


Airways in children under 6 months


horseshoes shaped epiglottis, larynx is high and anterior, cricoid ring is the narrowest oart of the airway, trachea short and soft

Card 3




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Card 4




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Card 5


waht remains relatively stable thorought childhood to adult hood


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