Key Concepts
Introduction
Respiratory conditions are among the most common causes of pediatric hospitalization and pediatric cardiac arrest. In children, respiratory failure typically precedes cardiac arrest โ unlike adults, where dysrhythmia more often leads directly to arrest. This means early, accurate respiratory assessment by the RPN is a primary intervention in preventing deterioration to cardiac arrest. Children's respiratory anatomy and physiology differ from adults in clinically important ways. Infants are obligate nose-breathers until approximately 4โ6 months, so nasal obstruction alone can cause significant distress. The pediatric airway is narrower and more compliant: a small amount of edema produces a disproportionately large reduction in airway diameter (resistance increases with the fourth power of radius reduction). Infants rely more heavily on diaphragmatic breathing and have highly compliant chest walls that produce visible retractions with much less effort than an adult's rigid thorax would. This lesson covers the complete systematic respiratory assessment for children across the pediatric age range โ from neonates to adolescents โ with emphasis on the physical findings that signal escalating severity and the transition from respiratory distress to respiratory failure. On the...