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Pocket Emergency Paediatric Care - part 2

Sớm công nhận và quản lý tiềm năng hô hấp, tuần hoàn, hoặc thất bại thần kinh trung ương sẽ làm giảm tỷ lệ tử vong và bệnh tật thứ cấp. Các phần dưới đây mô tả những dấu hiệu được sử dụng để đánh giá nhanh chóng của trẻ em như là một phần của việc đánh giá chính: | Recognition of the sick child Early recognition and management of potential respiratory circulatory or central neurological failure will reduce mortality and secondary morbidity. The sections below describe the signs used for rapid assessment of children as part of the primary assessment Airway Breathing Circulation Disability. Primary assessment of airway Vocalisations such as crying or talking indicate ventilation and some degree of airway patency. Assess patency by looking for chest and or abdominal movement listening for breath sounds feeling for expired air. Reassess after any airway opening manoeuvres In addition note other signs which may suggest upper airway obstruction the presence of stridor evidence of suprasternal recession tug . Primary assessment of breathing Assess Effort of breathing RECOGNITION OF THE SICK CHILD 17 Beware exceptions fatigue poisoning neuromuscular diseases Efficacy of breathing Effects of respiratory failure. Effort of breathing Respiratory rate tachypnoea - from either lung or airway disease or metabolic acidosis bradypnoea - due to fatigue raised intracranial pressure or pre-terminal. Recession intercostal subcostal or sternal recession shows increased effort of breathing particularly seen in small infants with more compliant chest walls degree of recession indicates severity of respiratory difficulty in the child with exhaustion chest movement and recession will decrease. Inspiratory or expiratory noises stridor usually inspiratory indicates laryngeal or tracheal obstruction wheeze predominantly expiratory indicates lower airway obstruction volume of noise is not an indicator of severity. Grunting seen in infants and children with stiff lungs to prevent airway collapse it is a sign of severe respiratory distress it may also occur in intracranial and intra-abdominal emergencies. Accessory muscle use in infants the use of the sternomastoid muscle creates head bobbing and is ineffectual flaring of nasal alae. 18 POCKET EMERGENCY .