Studydroid is shutting down on January 1st, 2019



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Anatomical Specifics
  • Rib cage is more elastic and flexible
  • Lung tissue is more fragile
  • Mediastinum is more mobile
  • Bones of skull are soft and separated by cartilage until 5 years of age
  • Fontanelles - anterior closes at 12-18 months, posterior closes by 2 months
  • Liver and spleen are proportionally larger and more vascular
  • Bones are softer
Physiological differences
Higher cardiac output
  • Will not demonstrate hypotension until acute blood loss is about 25%

Higher volume of distribution (VD)

Larger ratio of surface are to volume
  • Influences heat loss
Pediatric Assessment
Level of consciousness
  • Activity and responsiveness

Perfusion status
  • Color, distal pulses

Work of breathing
  • Retractions, Rate, Depth
Respiratory/Airway differences
  • Tongue is large in comparison to mouth
  • Epiglottis is short, narrow, and away from long axis
  • Larynx is higher and short chin gives more anterior relationship
  • The vocal cords have a lower attachment
  • Narrowest portion of the airway is at the cricoid cartilage if less than 10 years old
  • Oxygen consumption in infants is double that of adults
 
ETT Sizing
  • 2.5 - 3.0 = premie
  • 3.0 - 3.5 = Term neonate
  • 3.5 - 4.0 = 3months to 1 year
  • (Age+16)/4 = Older than 1 year
ETT depth
  • 6cm = less than 1000 grams
  • 7 - 9 cm = less than 2000 grams
  • 10cm = Term neonate
  • 11cm = 1 year
  • 12cm = 2 years
For greater than 2 years use either formula
  • 3x ETT size
  • (Age/2)+12
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