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Paediatrics - Coggle Diagram
Paediatrics
Anatomy
Airway
Small jaw
Nasal passages no turbinates or sinuses (obligate nasal breathers)
U-shaped epiglottis
Cricoid narrowest
Large tongue
Funnel shaped
Skull/C-spine
Large occiput
HIgher larynx - moves from C3/4 to C4/5
Face increases from 1/3rd to 1/2
Number of teeth increases
Breathing
<FRC
CLosing capacity exceeds FRC until 8 yo
High metabolic rate
Ventilation primarily diaphragmatic - early decompression with NG
TV fixed - RR primary determinant of MV
Large dead space
Circulation
Right to left shunt through ductus arteriosus
High PVR
Foramen ovale
HbF greater affintiy for oxygen
Disability
Prone to hypoglycaemia
Exposure
Large surface to mass ratio
Poorly devloped
Shivering
Sweating
Vasoactive mechanisms
Pharmacology
Distribution
Neonates 80% water therefore larger volume of distribution of water soluable drugs
Metabolism
liver 5% neonates weight
Phase 1 reactions - cytochroe P450 33% of adult
Phase 2 reactions - are deficient
Excretion
Renal blood flow 15% rising to 33% in adlthood
High RAA system limits sodium excretion
Low potassium excretion
Pharmacodynamics
Brown fat increased
Muscle
Type 2 fibres intially
50:50 by birth
More susceptable to fatigue
3x less Ach
Cardiac arrest
WETFLAG
Weight = (age+4)x2
Energy = 4J/kg
Tube = (age/4)+4, Length (age/2)+12
Fluid = 20ml/kg
Lorazepam = 0.1mg/kg
Adrenlin = 0.1 ml/kg
Glucose = 2ml/kg 10% dextrose