A large proportion of pediatric emergencies are a result of respiratory distress and failure, which if not treated quickly and appropriately can result in cardiopulmonary arrest. Early recognition and treatment of respiratory problems is therefore of primary importance to improve the outcome of pediatric emergencies.
There are four main respiratory problems that must be addressed for the management of pediatric respiratory distress and failure. These include upper airway obstruction, lower airway obstruction, lung tissue disease, and disordered control of breathing.
After reviewing this page thoroughly, use the links below to review important aspects and specific interventions of each problem.
- Upper airway obstruction
- Lower airway obstruction
- Lung tissue disease
- Disordered control of breathing
General Management Interventions:
There are general management interventions that you will initially be using that apply to all of the above-listed respiratory problems. The application of the general interventions is for the purpose of stabilizing the condition of the patient.
Once oxygenation and ventilation have been stabilized, targeted interventions are used to reverse and treat the problems listed above.
The general management interventions are carried out as you use the “Evaluate, Identify, and Intervene” Sequence to address Airway, Breathing, and Circulation. General management interventions for Airway, Breathing, and Circulation are listed below.
General AIRWAY Interventions:
- Maintain an open airway, and if necessary open the airway. This is accomplished with the head tilt-chin lift. If cervical spine injury is suspected, use the jaw thrust maneuver to open the airway. However, if the jaw thrust does not adequately open the airway, use the head-tilt chin lift or jaw thrust with slight head extension.
- Clear the airway if necessary. Let your evaluation guide your interventions. If the evaluation reveals secretions or a visualized foreign body obstruction, use the appropriate intervention to clear the airway.
- Consider basic airway adjuncts such as an oropharyngeal airway (OPA) or nasopharyngeal airway (NPA) to reduce the risk of developing airway obstruction and improve airway patency.
General BREATHING Interventions:
- Monitor the oxygen saturation level using non-invasive pulse oximetry.
- Administer oxygen and titrate to keep the oxygen saturation > 94%. Use appropriate oxygen delivery methods for the situation, and for severe respiratory distress/failure use a delivery method that will provide high concentrations of oxygen. A non-rebreathing mask is an example of a high-concentration delivery device.
- Provide assisted ventilations using a bag-valve mask device.
- Administer inhaled medications to help improve breathing.
- Prepare for the possibility of endotracheal intubation.
General CIRCULATION Interventions:
- In the pediatric patient, heart rate, rhythm, and blood pressure can be early indicators of how your interventions are affecting the patient. Therefore, it is important to monitor heart rate, heart rhythm, and blood pressure as you proceed with the Evaluate-Identify-Intervene Sequence.
- Establish IV or IO access. Many pediatric emergencies require the administration of fluids and medications for the treatment of problem-specific conditions.
Once oxygenation and ventilation are stabilized using the initial general interventions discussed above, identification of the specific respiratory problem will help guide further problem-specific interventions. Use the links below to review the four types of respiratory problems that facilitate targeted management.
I really appreciate the layout of the information for ACLS. I used this site in 2017 and was successful in passing ACLS written as well as the megacodes. I am currently using this site to study for PALS. This will be my first time taking PALS, so thank you for all the information and the feedback you provide.
Candace Stephens says
I am so pleased with this site and the information and assistance that you put into it. Thank you so much for all the help.
Jeff with admin. says
Thanks for the encouragement Candace. I’m so glad that the site has been helpful for you. Kind regards, Jeff
Manon Saulnier says
I got 92% on my ACLS writing exam while the entire class averaged 78%!
Now studying for PALS. Your site is worth every penny. Thank you!!!
Thanks for this systematic method of learning. I have to do ACLS & PALS back to back & this site has clarified so much – makes everything so much less confusing. I like the video music too!
Jackie K says
Thank you for this site! I was recently subscribed to prepare for my initial ACLS certification and your website was a major contributing factor to my passing scores! I’m glad to see you have already started to compile and organize the PALS certification preparation course! Your work makes an incredible difference in easing the load of learning so much information! TWO THUMBS UP!!
Jeff with admin. says
Thanks so much for the encouragement. I’m working to make both ACLS and PALS training the easiest to understand available on the web. Kind regards, Jeff