Breathing (part 2 of 4)2 July, 2010 by: colinparker
Welcome back to more pearls on assessing breathing difficulty in children. In this episode we cover clinical tips to help distinguish different causes of respiratory signs, tachypnea, and respiratory failure: there are FOUR groups now!
Outline of this PEMcast:
ALL: Clinically distinguishing:
UAWO vs LAWO
Croup vs asthma, crasthma
Bronchiolitis vs CCF
CP: Causes of tachypnea
- Obstructive: asthma, bronchiolitis, (FB/UAWO)
- CCF (blockages, holes, bad plumbing)
- metabolic acidosis (AG vs non-AG)
- pain, anxiety
- brainstem disease
- drugs: salicylate poisoning (stimulation respiratory centre), sympathomimetics
DA: Causes of Respiratory failure
Type 1: Acute Hypoxic (airway flooding): air hunger; no response to supplemental oxygen
Type 2: Hypercapnoeic (inadequate alveolar ventilation): central, neuromuscular, chest wall, restrictive lung disease; supplemental oxygen improves oxygenation
Type 3: Peri-operative (atelectasis)
Type 4: Shock (inadequate lung perfusion)
Next time, I ask Kate about when to refer patients to the PICU for ventilatory support, and Dan tells us about basic ventilator settings and how to avoid VILI. See you there!
Meanwhile, tell us what you think about the extra 2 types of respiratory failure – leave a comment below.