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Asthma, Apnea, SIDS
| Question | Answer |
|---|---|
| SIDS | The sudden unexpected death of an infant in which death remains unexplained after the performance of an adequate post |
| SIDS 3 ways to Identify | An autopsy Investigation of scene and circumstances of death Exploration of medical history of the infant & family |
| SIDS Etiology | Many theories; largely unknown, Respiratory Control abnormalities, Prolonged apnea during sleep, Increased frequency of brief respiratory pauses, Excessive periodic breathing, Impaired response to increased CO2 or decreased O2 |
| SIDS: 3 Major Risk Factors | Environmental, Ethnicity, Daycare |
| SIDS: 7 Environmental Risk Factors | Environmental: Season, Lower SES, Time of Day, Bundling, Second hand tobacco smoke, Sleep position, Co bedding |
| SIDS: 5 Maternal Risk Factors | Maternal: Age, Smoking, Lack of prenatal care, Drug use, Shorter inter |
| SIDS: 7 Infant Risk Factors | Infant: Age, Prematurity, Twin or triplet, LBW, Previous ALTE, Gender, Siblings |
| SIDS: 3 Post Mortem Exam | Autopsy, Death Scene Investigation, Medical hx of infant and family |
| SIDS: 5 Systems for Differential Diagnosis | CV, Respiratory, GI, CNS, Systemic |
| SIDS: 3 Major Prevention: | DECREASE KNOWN RISK FACTORS!!, Protective factors, AAP “Positioning Statement” |
| SIDS: 4 Ways On How To DECREASE KNOWN RISK FACTORS!!: | Prevent teen pregnancy, Prenatal care, Avoid substance abuse, Stop smoking |
| 4 SIDS Protective factors | Immunizations, Pacifier, Breast feeding, Sleep Practices |
| SIDS: Prevention: AAP “Positioning Statement” | Infants should be placed in a non-prone position during sleep, Soft surfaces and gas trapping objects should be avoided in sleep environment, Recommendations are for healthy infants, Provide tummy time |
| SIDS: Supporting Families (Shortly after death) | Provide information on SIDS and support groups, Listen, Anticipatory guidance concerning grief process, Discuss sibling response (Understanding of death, Changes in behavior) |
| Infantile Apnea | NIH clarifies definitions in Consensus Statement (1986) |
| Apnea | cessation of respiratory airflow for 20 seconds. |
| Apnea | May be central, diaphragmatic, obstructive or mixed. Several types. |
| Central Apnea | Absence of airflow and respiratory effort |
| Obstructive Apnea | Absence of airflow but presence of respiratory effort. |
| Periodic Breathing | Three or more respiratory pauses of 3 or more seconds in duration within a period or normal respiration of 20 seconds or less. |
| Pathologic Apnea | A clinical syndrome in infancy of unexplained cessation of air flow for 20 seconds or longer |
| Pathologic Apnea | A shorter respiratory pause associated with bradycardia, cyanosis or pallor. |
| AOP: Apnea of Prematurity | Periodic breathing with pathologic apnea in a premature infant. |
| AOP: Apnea of Prematurity | Usually idiopathic and resolves by 36 weeks post conceptual age. |
| AOP: Apnea of Prematurity | Use of caffiene and methylxanthines (Monitor levels and s/s of toxicity, Nasal CPAP) |
| AOP: Apnea of Prematurity | Some may continue and require monitoring. |
| AOI: Apnea of Infancy | Pathologic apnea that usually presents with an apparent life threatening event (ALTE). |
| AOI: Apnea of Infancy | Generally occurs > 37 weeks |
| AOI: Apnea of Infancy | Idiopathic: cause is not identified. |
| Apparent Life Threatening Event | An episode that is frightening to the observer which is characterized by some combination of apnea, color change, marked change in muscle tone, and choking or gagging. |
| Apparent Life Threatening Event | Near Miss SIDS or Aborted Crib Death |
| Illnesses Associated with APNEA | URI, Pneumonia, Bronchiolitis, Sepsis, Metabolic Disorders, Cardiac anomolies, Seizures, IVH, Meningitis, GER |
| ALTE: Acute Management | Hospital Admission, Protective monitoring, Thorough hx. of the event, Expedited diagnostic testing, Treatment of associated conditions, Parent Education |
| Home Monitoring Considerations | Symptomatic Infants, Family Hx of SIDS, Premature Infants, Other Illnesses, Assymptomatic Infants |
| ALTE: Parent Education: Knowledge of Equipment | Belt placement, Troubleshooting, Response to alarm, Expected utilization, Settings |
| PEDIATRIC TRACH CARE | Close monitoring…, Trach ties should be snug and allow “pinkie” to be inserted, PRN suctioning |
| PEDIATRIC TRACH CARE, PRN Suctioning | Insert to premeasured depth (May be hyperventilated, Infant: no longer than 5 seconds, Child: no longer than 10 seconds), Stoma site care: soap and H2O; No peroxide |
| Discontinuing the Monitor | Apnea free for 2-4 months 3 full sets of immunizations Resolution of medical indication Remember parental response |
Created by:
nursingstudent2012
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