Broncho-pulmonary Dysplasia Foreign Body Aspiration Apnea/ALTE Lower Respiratory Considerations o Alveoli maturity 32-36 weeks gestation o Respiratory smooth muscle more mature after 5 months old Bronchiolitis o Inflammation, mucus filling of smallest airways o Caused by bacteria or virus, most often by respiratory syncytial virus (RSV ) o Highly contagious o Increases mucus production o Cough o Fever o Irritability, loss of appetite o Wheezing, coarse lung sounds Bronchiolitis: Respiratory Syncytial Virus o Season is October-March o Generally, the younger the child, the more severe the case o Severity can range from mild cold-like symptoms to respiratory failure o Symptoms can last up to a month
o Virus can live on surfaces for over 6 hours o Isolation: Contact/Droplet o ***BREAST MILK = HUGE protection against RSV and other dx Use saline when suctioning babies with wall suction so not to dry out membranes o RSV is particularly dangerous for: Age < 24 months History of chronic lung disease Congenital heart disease Premature birth Synagis is an RSV vaccine for those at high risk *not really a vaccine – has antibodies to protect against RSV Given monthly – costs 1500-2000/month – way cheaper than being admitted to ICU o Bronchiolitis: Diagnosis Nasopharyngeal culture Chest x-ray Hyperinflation Atelectasis o Bronchiolitis/RSV Treatment antibiotics, if indicated (usually viral) Frequent saline, suction – only when needed. Causes irritation and swelling Suction before they eat (nose breathers) If retractions or having problems Oxygen, if indicated IVFs/tube feeding, if indicated Respiratory support – ventilator if needed Antipyretics Bronchodilators – albuterol not helpful against RSV, will give anyway Decongestants? Cough syrups? DO NOT GIVE ANYTHING until 6yrs old Give Tylenol, motrin, humidifiers, Over 12 months of age – can give honey (under = possible botulism) Prevention Pneumonia o Inflammation or infection of the bronchioles and alveolar spaces of the lungs o Can be viral or bacterial or due to aspiration o Cause fever, cough, abdominal and chest pain, coarse lung sounds o Pneumonia: Diagnosis Based on history and physical CXR may show areas of consolidation o Pneumonia: Treatment Oxygen Humidification Hydration Antibiotics Antipyretics Prevention Bronchodilators – albuterol Pulmonary Toileting – Incentive spirometer, blowing bubbles Pertussis o “whooping chough” o Caused by bacteria bordetella pertussis o Resistant strains are developing and many children are going unvaccinated o Leads to severe coughing spells , respiratory distress, and apnea o Starts with 1-2 weeks of mild cold symptoms followed by up to 4 weeks of severe coughing o Can lead to pneumonias o Up to 2 months old – most at risk
o ***Mucus MUCH thicker than RSV, upper airway narrowing
You've reached the end of your free preview.
Want to read all 26 pages?
- Spring '17
- Mucus, pain scale