PAEDIATRICS
RESPIRATORY
PromptSigns of work of breathing
ResponseRetractions (intercostal, suprasternal, costal margin)
Accessory muscle use eg nasal flaring, sternocleidomastoid contraction (head bobbing), forward posturing (Tripoding)
Grunting
Accessory muscle use eg nasal flaring, sternocleidomastoid contraction (head bobbing), forward posturing (Tripoding)
Grunting
PromptSeverity
RCH Sept ‘24
RCH Sept ‘24
ResponseGood table here:
https://www.rch.org.au/clinicalguide/guideline_index/assessment_of_severity_of_respiratory_conditions/
Note rch no longer references feeding/hydration as part of severity determinate but states “it is important to assess feeding and hydration as these may be affected early in respiratory illness
Effortless tachypnoea may be compensation for metabolic acidosis (Eg sepsis/DKA) or congenital heart disease
https://www.rch.org.au/clinicalguide/guideline_index/assessment_of_severity_of_respiratory_conditions/
Note rch no longer references feeding/hydration as part of severity determinate but states “it is important to assess feeding and hydration as these may be affected early in respiratory illness
Effortless tachypnoea may be compensation for metabolic acidosis (Eg sepsis/DKA) or congenital heart disease
PromptWork of breathing - Mild
ResponseNormal to slightly increased HR, RR, WOB
Normal behaviour (Can vocalise normally) , normal colour, saturations, BP
Normal behaviour (Can vocalise normally) , normal colour, saturations, BP
PromptWork of breathing - Moderate
ResponseIntermittent irritability, reduced activity, limitations on speech
Pallor
RR increased
WOB moderate
HR mildly increased
BP mildly increased
Pallor
RR increased
WOB moderate
HR mildly increased
BP mildly increased
PromptWork of breathing - Severe
ResponseIncreasing irritability and or lethargy, single words
Pallor/cyanosis
RR increased
WOB marked
<90% RA (or any oxygen requirement in croup)
HR significantly increased or bradycardia
BP increased
Retractions - intercostal suprasternal, costal margin, nasal flaring, SCM use, Head bobbing, tripoding
Pallor/cyanosis
RR increased
WOB marked
<90% RA (or any oxygen requirement in croup)
HR significantly increased or bradycardia
BP increased
Retractions - intercostal suprasternal, costal margin, nasal flaring, SCM use, Head bobbing, tripoding
PromptWork of breathing - Life threatening
ResponseDrowsy/unconscious, non verbal
Cyanosis
Marked increase in RR or may be bradypnoea or apnoea
Severe accessory muscle use >> poor respiratory effort
Hypoxic
Arrhythmia/bradycardia
hypotension
Cyanosis
Marked increase in RR or may be bradypnoea or apnoea
Severe accessory muscle use >> poor respiratory effort
Hypoxic
Arrhythmia/bradycardia
hypotension