Resp in Paeds Review

Salbutamol toxicity speeds up metabolism 10 ↓ ↑ demand for energy less commonly ↑CNS eflects 8-2-R overstimulahian in skeletal m. J for glycolysis dop ↓ JB of prolacin synthesis release ↓ METABOLIC ACIDOSIS 9 neuromuscular excitability pyruvate exceeds ability of cells to e.q. in hands glucose hages cycle metabolise in kerb's ↓ FINE TREMORS instead pyruvate converted acid ed into lachic lachic acidosis HYPER PROLACTEMIA MOST COMMON When it is safe to discharge asthma ptx * bronchodilator needed every 3 hourly Cor less frequently) * given asthomce action plas parents educated on it * able to tolerate oral intake esp. fluids @ least 50-70% * no features of resp distress, adequele oxygenation doon't require oxygenation support. 795% * no eatures of delly craian. * parents given written bronchodilator weaning instrechians 90-94% may also be acceptable t child appears clinically well į thue re no othe concerning features When a preventor Tx plan is needed * nighd walking * interferance with daily activity physical achivity z missed school * bronchodilators needed more than 4 times a week * persistent wheeze on interval examination when do we call 10 * CO₂ retentices * exhusian * persistent hypoохетін * need IVI Tx * CPAP may be needed when to admit auldren with asthma * features of resp dismess * need oxyger * Spo₂ of less than 42% * the durnation to which they requine baronchodilatkar is mae 3hrs. hequently than one every * pouets weed edu * ural intake when to belform a CXR an child with suspected broncholitis *1st episode wheere * complicated courze or unore about diagnosis * have indelying cardiology or respiratory pathdogies Group *Most common physical exam hading in croup inspiratay strider * humidified air has NOT been found to make things better * when there is only a barking only a barking cough without strider then coricosteroids are NOT needed. usually considered when shidar is present @rest Clinical features of (laryngomalacia *inspiratory strider * worse with crying/leading * improves with age De cogenital softening of the laryngeal tissue causing a collapse of the supraglottic tissue above the vocal curds causes *congenital *structural abnormalit GURD * neuromuscula discurders eg crebral pusy musunlar dyschophies PNU * a common trap is that chest auscultations may be normal * crackles on auscultabicon *complications = pasapneumonic effusion. empyema ling abscess most commonly due & GBS, but other causes include e.coli, listeia, monocytogenes other vaginal flora * suputum culture is the best way for delerming what the causalive pathogen is re-occur in infants such as when the mother is infected * 485 may they may gel it from her breastmilk * maternal RF that ↑suspecion for PW= matenad feve acule bacterial intra-x amniotic infechicon of the choriem, aminion, placenta /or amishic fluid prolonged ruptue of membranes cor chaiaminoniki *IV for PUU 3rd gen cephalosporin * GBS 30% of moties havert I in 1000 live deliveries early presentation sudder deterioration with spelicemica often within 1st 24hrs cell afles 1st wk of life late presentatrices meningitis commence ABx within the 1st this of suspecting it GONLY cease once can be excluded via-ve blood cultwes when causing DN may sudden death or delerariation. may present only with tachypnea kelove maternal factors that indicate need for intrapastum ABx = → known GBS infection UTI premature membrane ruptime prematiue labor maternal fever Adult us children Airwangs * smalle cross sechoms can't generale * obligale nasal breathers much ve P * horizontal diaphgramų ribs hence easily collapse * dvedi develop until 8 * chest wall more complicut Ribs cash bago can't maintain cheat open like adeulb as they cue martly cuhlase Broncholiks * tachyprea *cough TW CFW * wheeze Tak walk * low grade feve cute Femine woman