The 100,000 Lives Campaign:

Pediatric Rapid Response Teams

Institute for Healthcare Improvement

www.IHI.org

Dr Abdullah Alzaydi
pediatric intensivist
 respiratory failure in pediatrics

cause no 1 for Pediatric hospital admissions

Death during first year of life except for congenital abnormalities
Most pediatric cardiac arrest begins as respiratory failure
or respiratory arrest
 Pediatric Respiratory System

Large head, small mandible, small neck

Large, posteriorly-placed tongue
High glottic opening
Small airways
Presence of tonsils, adenoids
Airway Differences
 Pediatric Respiratory System

Poor accessory muscle development

Less rigid thoracic cage
Horizontal ribs, primarily diaphragm breathers
Increased metabolic rate,
increased O2 consumption
Inadequate Pediatric Breathing

Early signs

use of accessory muscle

retractions
tachypnea
tachycardia
nasal flaring
coughing
cyanosis to the extremities
grunting (creates CPAP)
Pediatric Respiratory Failure

Altered mental status

Pulse rises early then drops fast
Bradycardia
Hypotension
Irregular breathing pattern
 Pediatric Problems

Distinguish whether the airway problem is upper or lower

Stridor indicate upper airway obstruction
Usually due to edema or foreign body obstruction

Wheezing is sign of lower airway problem

Equipment for BVM Ventilations

-Suction
-Appropriate size airway adjunct
-Appropriate size bag

Newborn - 3 mo Neonatal 450 - 500 ml

Child < 30 kg Pediatric 750 ml
Child > 30 kg Adult 1000 - 1200 ml
Complications of BVM Ventilations

-Gastric distension
-Vomiting
-Increased ICP due to vagal stimulation
(Pressure over the eyes)
Evaluate BVM Ventilations

-Chest rise and fall

-Presence of breath sounds
-Skin color
-Pulse oximeter reading
THANKS