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COMMON PAEDIATRIC RESPIRATORY DISORDERS - Coggle Diagram
COMMON PAEDIATRIC RESPIRATORY DISORDERS
Bronchiolitis
Most common severe LRT disease in infancy
By human respiratory syncytial virus (RSV)
Initial presentation is common cold type symptoms --> develops into a dry irritating cough, wheezing, increase RR, & signs of respiratory distress
CXR – hyperinflation, areas of collapse or pneumonia consolidation
Auscultation – widespread inspiratory crepitation's & exploratory wheezes
MX – humidified O2, ribavirin antiviral, ventilation if required
PT – careful & regular assessment, techniques should be applied only when seating retention or mucus plugging is a problem
Chest infections – Croup
Viral infection in 6 months – 4 years
Initial presentation is common cold type symptoms
Develops into fever, harsh barking cough & horse voice, Stridor & signs of respiratory obstruction.
Severely affected may develop respiratory failure
MX – humidified O2, glucocorticoids (dexamethasone & budesonide), nebulised adrenaline, respiratory support (CPAP etc.)
PT – contraindicated in the non-intubated child, may be required should the child be intimated secondary complications e.g. sputum retention
Chest infections – epiglottis
Very dangerous condition occurring in 1 – 7 years
Caused by haemophilus influenzae (rare since introduction of Hib vaccine)
Sudden onset of severe sore throat & high-temperature. Rapid development of stridor & dysphagia with the child being unable to swallow saliva & drools. Acute & possibly fatal obstruction of airway can develop
MX – child should not be disturbed in anyway or therethrough assessed as it could lead to acute life-threatening obstruction, nasal integration or occasionally a tracheostomy
PT – contraindicated in non-intubated child, may be required should the child being intubated for secondary complications e.g. sputum retention
Chest infections – pneumonia
Different causes – Staphylococcus aureus (neonates), RSV (infant) & mycoplasma, Streptococcus pneumonia or haemophilus influenzae (child)
Present with pyrexia, dry cough, increased RR & recession of ribs & sternum
CXR – consolidation
MX – fluids, humidified O2, broad-spectrum antibiotics
PT – careful & regular assessment, appropriate airway clearance techniques
Chest infections – whooping cough
Caused by Bordetella pertussis
Last epidemic in UK in 2012
Cough becomes paroxyesmal, worse at night. Spasms of coughing may cause hypoxaemia and apnoea
At the end of coughing there is inspiratory Strider
Bouts of coughing often leads to vomiting and expectoration of sputum
Covering phase can last 6 to 8 weeks
MX – most managed home, treatment is supportive, minimal handling to reduce disturbance which may precipitate coughing spasms
PT – contraindicated during the early stages as may induce coughing, may be required should the child be intubated for secondary complications e.g. sputum retention
Cystic fibrosis
Most common inherited recessive condition in Caucasians – affects one in 2500 births
Chromosome 7 which encodes for the CF transmembrane conductance regulator is defective. This leads to problem in iron transport which result in lower abnormal salt concentration –
increased mucus viscosity
Impaired Mucocillary clearance – recurrent chest infections with gradual lung destruction. Primary areas affected are respiratory tract and digestive tracts but is a multisystem disorder
MX – MDT approach (dietician, CF nurse, PT, DRS, psychologists), drug therapy, organ transplant later in life
PT – at point of diagnosis chest clearance techniques are introduced & taught to parents/carers, education of self-management as child grows up
Primary salute dyskinesia (PCD)
Rare genetic disorder (1 in 15-30,000)
Needs to either abnormal structure of the cilia, normal structure of the cilia but abnormal function or absence of the cilia
Results in recurring infections of ears, nose, sinuses & lungs, + fertility issues
MX – drug therapy, monitoring of hearing +/- hearing aids, assisting conception may be needed in adult hood
PT – at point of diagnosis chest clearance techniques are introduced and talked to parents/carers, education of self-management as child grows up
Asthma
Increased responsiveness of smooth muscle in bronchial walls to various stimuli causing constriction & airway inflammation
Hypertrophy of mucus glands may lead to mucus plugging, airway obstruction, which may become chronic & severe
Children are more likely to develop if parents or close relatives are asthmatic or atopic
Other links are those from low socio-economic backgrounds, outdoor pollution, dietary factors & passive smoking
MX – drug therapy
PT – education of child and parents about condition, advice on exercise/exercise programs, chest clearance techniques if there is sputum