Lecture 6 Respiratory distress/Vaccines
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Lecture 6 Respiratory distress/Vaccines
Respiratory Distress Vaccines
What would you look for in a child in respiratory distress?
What would you listen in a child in respiratory distress?
What would you check for in a child in respiratory distress?
Sudden change in behavior
Which are the early signs of impending airway obstruction?
Intercostal, suprasternal, substernal retractions
Increased restless ness
Which are the late signs of impending airway obstruction?
Sudden agitation or sudden quietness
child w sever asthma who suddenly stops wheezing
What protects infants and children from respiratory infections?
IgG from the mother
Antibodies are delivered which provide immediate protection against infection, this does not confer lasting immunity.
Forms of passive immunity
Transplacental - IgG (3rd trimester)
Breastfeeding - IgA (Colostrum)
Ig Injections - Given to pts. who have recently been exposed to infection
They stimulate antibody production in the host w/o causing clinical disease
Forms of Active Immunity
Advice for children and caregivers with respiratory infections:
Don't share cups, towels, washcloths
Try to avoid children who are well
Use tissues and dispose them properly
Caregivers - Try not to touch your eyes or nose
How long can RSV survive in the hands?
For 1 hour
What put infants at risk for respiratory infections?
Immature immunity -
Children lack of complete Humoral Immunity until 6 yo
Prematurity - Baby lacks of IgG
Anatomy of the respiratory tract -
Airway is short and narrow
Inherited conditions - CF
At what age is FBO most common?
1- 3 yo
Which foods are most dangerous for FBO?
Intervention for choking?
Birth to 1 yo
5 back blows
5 chest thrusts
If infant becomes unconscious, start CPR
Interventions for choking?
1 yo and up
Interventions for FBO in the lower airways?
FBO, sudden onset of symptoms?
Sudden coughing or sudden onset of respt. distress
No fever or other symptoms of illness
What are the respiratory symptoms of Cystic Fibrosis?
Dry, non-productive cough
Frequent respiratory infections
What is the diagnostic test for CF?
Sweat chloride test
What is the tx for CF?
CPT (at least 1 hr Before meals)
Why is Surfactant important?
It is a phospholipid produced by the alveoli
It peaks at 35 wks gestation
It keeps alveoli open and allows for a normal breathing
Who is at most risk?
Signs of RDS?
Preterm infants are at most risk
How can RDS be prevented?
Try to prevent preterm deliveries
Give the mother dexamethasone (steroids)
Give the preterm newborn (<35 wks) surfactant
What is Apnea of prematurity
Lack of spontaneous breathing for more than 20 sec.
Tactile stimulation may be helpful
It can be treated with theophylline or caffeine
What are the signs of Theophylline toxicity?
Name 4 respiratory emergencies
Define Status asthmaticus
Patient with asthma in severe respiratory distress that does not respond to standard treatments
Can develop slowly or quickly
Often there is an underlying problem (pneumonia)
What is the treatment for status asthmaticus?
B2 Agonist (Albuterol, Bronchodilator)
Epinephrine (B1 and B2 Agonist, Bronchodilator)
Mention some common asthma triggers
Asthma is an inflammatory response that causes:
Thick tenacious mucus
What are the signs of Epiglottitis?
Child wakes up with sore throat and high fever
Sits in a tripod position
What are the don'ts for Epigottitis or Croup (LTB)?
Don't try to open the mouth
Don't try to insert any objects or visualize the epiglottis
Don't try to get a throat culture
It may cause a laryngospasm
What are the do's for Epiglottitis and Croup (LTB)?
Get ready for intubation or tracheostomy
What is the most common causative organism of Epiglottitis?
HiB (Haemophillius Influenza B )
What is croup?
Laryngotracheobronchitis - Inflammation of the larynx and trachea
It is caused by a viral infection of the
It starts slowly as an upper respiratory tract infection and progresses slowly over a period of days
What are the signs of Croup?
Toddler starts out with a runny nose
What vaccines are given at 2 mo. of age?
HiB - Haemophillius Influenza B - Prevents Epiglottitis
Hep B - Prevents Hepatitis B
PCV - Pneumococcal Conjugate Vaccine - Prevents Pneumonia
DTaP - Diphtheria/Tetanus Toxoids/ Acellular Pertussis
IPV - Innactivated Polio Vaccine - Prevents Polio
Name two live vaccines
Varicella and MMR (Mumps/Measles/Rubella)
When is Varicella vaccine given?
When is MMR given?
at 1 yr and 4 yrs
When is MMR vaccine contraindicated?
In pregnant women
Pts. allergic to Neomycin
4 Points to remember about vaccination:
2 vaccines can be given in the same extremity
They can be administered even if the child has:
Low grade fever
Had recent exposure to an infectious disease
Is taking antibiotics
How is Varisella (Chickenpox) spread?
Direct contact w