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Hello. My name is Jack Emails, and I'm one of the practice educators at Surpassed in Children's Hospital. This presentation is going to talk about the systematic assessment of a sick child. Yeah, this presentation is aimed. Those nursing staff more familiar with caring for adults, it seems to demonstrate the difference in the infant in child, highlighting particular consideration and explaining the physiology behind in a to assessment on the sick child based this presentation on the recognition of the signs and symptoms associate ate it with spiritually and circulatory failure. As with the adults, you need to consider what treating first, what kills first with Children. And this is most prothom Italy on most commonly high pox ear due to respond to failure. Unlike adults, most Children have very healthy hearts, and so pump management of the spiritually failure is paramount. This slide will show you the anatomical difference is in the airway between the adult and the young child. To some of eyes, the infant in Young Child has an airway of which the diameter is proportionally narrower than that of the older child. In adult, they're tongue that lotus and tonsils are proportionally larger and so any swelling converted to obstruction of the airway. And these creases in secretions due to spiritually infection such as ours be can cause significantly high levels of morbidity due to airway obstruction babies up to the age of about six months off preferential nose breathers. This is obviously beneficial when they were feeding. But any airway obstruction will compromise this with this in mind when looking after your baby. If you're concerned they have significant Risperdal distress on, they have a nasogastric tube in place. You may want to consider changing this to a one to believe obstruction caused by the tube. Please give your mind that the infants head is larger with very flexible, too. Care over extension of this may cause a partial occlusion of care, but in the supine position, as you need to maintain their head and neck in a neutral position, this is optimal for insuring. The airway is open. Moving on, we will consider. The difference is you do when you do an airway assessment on a child. On relate these previous discussion about physiological differences. Consider any noise being made by your baby. All those crying can be stressful acquired baby descent, Denton straits that you have an open airway. Strider is an upper airway noise, and it's common in babies who have a passion. Obstruction of their upper airway management involves the correct position of the baby. Unless we've already said, baby needs to be in a neutral position to prevent further obstruction of the airway because babies their nose breathers think about any obstruction which you can actually remove. Clear any obvious six secretions. This could be performed of nasal found your suction as required. However, routine sexually is not recommended as it can cause irritation and for swelling with increase in secretions leading to further obstruction. I talk so generally administered initially by a facial mask, it's required. This is the initial treatment for Baby, whose displaying low oxygen saturations obviously providing that basic life support is not required at this stage to give you an idea of size difference and lung capacity. The air alveola surface where gaseous exchange takes place is 3 m squared in a Ninfa UNT, compared with 70 m squared in an adult. Hence increased secretions. Consolidation and collapse will lead to a significant reduction in oxygen diffusion increasing hypoc CIA babies, ribs, a cartilaginous which contributes less to respectfully effort in infant. Therefore, the diaphragm becomes the main muscle of aspiration. A full stomach compromise. This so you may need to consider empty the stomach virus. Gastric tube When I spoke to distress is evident. Infants have, ah high respect to wait with increased oxygen consumption and carbon dioxide production, the Risperdal weight increases to reflect this making respiratory rate the most sensitive determinant of respiratory deterioration in Children. Do two elasticity of lungs and chest cavity. Recession is more pronounced in young Children, and we will talk about this more in the next slide. When you're assessing work of breathing of your baby, you need to look, listen and fail. You need to count. There was supposed to wait for a minute. The's this way of doing this on a small baby is actually to put your hand on this stomach and that she see the rise and fall. You need to consider their work of breathing and taking two account into cost. A recession, sternal recession and sub cots. Storm recession. You need to look for any use of accessory muscles, a baby who is struggling my well head Bob and they may also display Track your tuck. Okay, Nasal flaring is also a sign off. Increased work of breathing. A newborn baby has approximately 80 mils per kilogram circulating volume, which equates to approximately 280 mils in a term baby. Consequently, relatives relatively small losses are significant. Being unable to increase stroke volume, infants will increase the heart rate to improve output. Tachycardia is the first circulator a response to hypoc CIA. The baby's heart rates is easiest to measure, with a stethoscope listening to the heartbeat and counting for one minute. The pews chance available will actually differ with age, as a heart rate of the newborn baby is approximately between 121 140 office least slows as the child becomes older. When assessing circulation's signs off. An inadequate circulation are a floppy listless baby tachycardia a week posts a sunken fontanelles in a baby under a year. Low BP and cool skin temperature and color with regard to reduced wet snap peas. A urine output of less than two mils per kilogram per hour in a baby or one milk Picula gram power in an older child older than the year is considered inadequate. A prolonged capillary refill time is indicative of poor skin perfusion. It should be formed by applying cutaneous pressure for five seconds onto the center of the sternum on moving of pressure. Blanching should disappear within two seconds. Hypoc See a causes. There's a constriction. Your child will deteriorate to becoming pale, modeled and then sign Ozden. When considering disability. It's important to note your child's interaction with the parents and their surroundings when completing an after school. Consider whether they're alert whether they respond to voice, whether they respond to pain or whether they are unresponsive. You need to think about the posture on the muscle tone, and you need to consider pupil size and reactivity of pupils. The final stage of your 80 assessment is to really experience your infant looking for any potential injury or signs of illness. You need to think here feli about heat loss. An infant surface area to mass spatial is very high, and they could lose heat very quickly, particularly from their heads. They have low levels of adipose fat tissue storage on an immature liver. For Glaxo gyn storage, this means the blood sugar level controlled quickly if they haven't had a regular feet. And so this needs to be a consideration always have safeguarding as a possible concern. Any unexplained bruising needs, consideration and discussion in summary. During this presentation, we have looked at the physiological differences between an infant and adult. When you were caring for child. You need to have the confidence to work in partnership with their family. Your parents will be your history givers. Your child would want them with them at all times. Listen to the parents as they know their child best.