the ABCs are
• Appearance/gestalt look: TICLS (tone, irritable/interactive, consolable, look/gaze,
speech/cry)
•
work of Breathing: Sounds, HOUNDS o Head position, o bObbing ▪ Head bobbing (the use of neck muscles to assist respiration) and seesaw breathing (ineffective breathing pattern, in which the abdomen moves outward while the chest moves inward during inspiration) are signs of impending respiratory failure. o Uncooperative o Nasal flaring o Drawing/retractions ▪ suprasternal, supraclavicular, intercostal, and subcostal areas o Snoring / Seesaw o “abnormal respiratory patterns may provide clues about a nonrespiratory illness. Effortless tachypnea may be a sign of shock from any cause, whereas deep rapid breathing without other auscultative findings may be compensation for a metabolic acidosis.” - Rosen’s 9th edition, Ch 160 •
Circulation to skin o PCPC (pallor, delayed cap refill, petechiae, cyanosis, mottling) ▪ See Rosen’s Fig 160.5 for mottling vs. cutis marmorata ▪ Cutis marmorata is a normal finding in young infants in a cool environment. In contrast to infants with mottling, infants with cutis marmorata will be otherwise well-appearing, and the skin findings will diminish or disappear if the infant is placed in a warm environment. CrackCast Show Notes – General approach to the pediatric patient – April 2017 www.can
work of Breathing: Sounds, HOUNDS o Head position, o bObbing ▪ Head bobbing (the use of neck muscles to assist respiration) and seesaw breathing (ineffective breathing pattern, in which the abdomen moves outward while the chest moves inward during inspiration) are signs of impending respiratory failure. o Uncooperative o Nasal flaring o Drawing/retractions ▪ suprasternal, supraclavicular, intercostal, and subcostal areas o Snoring / Seesaw o “abnormal respiratory patterns may provide clues about a nonrespiratory illness. Effortless tachypnea may be a sign of shock from any cause, whereas deep rapid breathing without other auscultative findings may be compensation for a metabolic acidosis.” - Rosen’s 9th edition, Ch 160 •
Circulation to skin o PCPC (pallor, delayed cap refill, petechiae, cyanosis, mottling) ▪ See Rosen’s Fig 160.5 for mottling vs. cutis marmorata ▪ Cutis marmorata is a normal finding in young infants in a cool environment. In contrast to infants with mottling, infants with cutis marmorata will be otherwise well-appearing, and the skin findings will diminish or disappear if the infant is placed in a warm environment. CrackCast Show Notes – General approach to the pediatric patient – April 2017 www.can
No comments:
Post a Comment