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Erstellt von Elizabeth Then
vor etwa 6 Jahre
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Frage | Antworten |
Definitions of paediatric patients | Premature - born before 37 weeks Newborn - just born Neonate - less than 4 weeks old Infant - less than 1 years old Child - 1 - 8 years Adolescent - 10 - 17 years |
Differences cardiac system | removal of placenta from circulation increasing systemic vascular resistance decreasing pulmonary vascular resistance true closure of PDA 2-3 weeks - critical transitional circulation Myocardial cell mass less developed - prone to biventricular failure, volume loading, poor tolerance to afterload, heart rate dependent CO - true for young infants |
Differences Respiratory system | Small airway diameter - increased resistance little support from ribs and cartilage more pliable chest wall collaspe increased with negative intra thoracic pressure diaphragm and intercostals dont achieve adult muscle fibres until 2 yrs Obligate nasal breathers Atelectasis more common - decrease residual capacity, number of alveoli alveolar ventilation/FRC - infants 5:1 increase RR |
Differences - airways | large tongue higher located larynx epiglottis short and stubby, angled over inlet angled vocal cords, |
Body surface area | not proportioned same as adults - heat loss massive via head |
Types of surgical procesures | elective - ENT, general, plastics, ortho Emergency - immediately after birth, result of trauma |
Anaesthetic implications | environment - aesthetics and parent involvement Equipment - smaller agents - dose changes approaches - GA, regional or both |
Theatre implications | warm ++++, difficulty with maintaining temp, smaller instruments, smaller dressings |
Postanaesthetic recovery considerations | purpose of PARU - monitoring, detection, prevention of complications, parent involvement, discharge criteria |
Psychological considerations | frightening and isolating, child-friendly, child's previous experience, anxious, fear of handing over child |
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