Key Points in Respiratory History | Cheat Sheet

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

39

Pages:

3
Author:

Mariam A. A.

Key Points in Respiratory History Dual focus Diagnosis and severity assessment Severity is judged primarily by clinical examination Supported by key points in history Age matters Some illnesses are more common at some ages URTIs peak at 2.5 years and then again 6 to 7 years Younger children deteriorate faster Infants less than 3 months More vulnerable to hypoxia and apnoea Apnoea is a red flag -> needs urgent hospital admission Risk factors for deterioration Prematurity or neonatal unit care Lower threshold for admission Underlying cardiac or respiratory disease Healthy infants may have noisy breathing due to small airways If this is always present Usually resolves by 6 months Feeding, hydration and activity Feeding difficulties are common in respiratory illness Breathlessness makes feeding harder -> increased risk of dehydration Even if they are not vomiting Vomiting may occur with excessive coughing Dehydration Indication for hospital admission Activity level General indicator of illness Quiet or clingy child may be unwell Lively, active child -> less likely to be seriously ill Fever and infection Ask about temperature A high fever -> significant bacterial infection or pneumonia Common respiratory diagnoses Bronchiolitis Usually a clear diagnosis Clinical features Snuffy nose, Noisy breathing Wheezing Wet cough Apnoea in very young children Admission criteria Poor feeding Fatigue Need for supplemental oxygen Post bronchiolitis wheeze Common for up to a year after the illness Triggered by viral URTIs Starts a few days after runny nose Does not respond well to asthma treatment Termed post-viral wheeze Wheeze and asthma Ask about: Pattern of wheeze Family history of asthma Atopy Hay fever Eczema Children above 2 often outgrow bronchiolitis related wheeze Those with atopy or an asthma family history are more likely to develop recurrent wheeze -> asthma Key points in acutely unwell wheezy children: Activity levels Eating and drinking Sleep quality Past severity ICU admission Frequent steroid use