Asthma, Apnea, SIDS
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| SIDS | The sudden unexpected death of an infant in which death remains unexplained after the performance of an adequate post
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| SIDS 3 ways to Identify | An autopsy
Investigation of scene and circumstances of death
Exploration of medical history of the infant & family
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| 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
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| SIDS: 3 Major Risk Factors | Environmental, Ethnicity, Daycare
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| SIDS: 7 Environmental Risk Factors | Environmental:
Season,
Lower SES,
Time of Day,
Bundling,
Second hand tobacco smoke,
Sleep position,
Co bedding
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| SIDS: 5 Maternal Risk Factors | Maternal:
Age,
Smoking,
Lack of prenatal care,
Drug use,
Shorter inter
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| SIDS: 7 Infant Risk Factors | Infant:
Age,
Prematurity,
Twin or triplet,
LBW,
Previous ALTE,
Gender,
Siblings
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| SIDS: 3 Post Mortem Exam | Autopsy,
Death Scene Investigation,
Medical hx of infant and family
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| SIDS: 5 Systems for Differential Diagnosis | CV, Respiratory, GI, CNS, Systemic
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| SIDS: 3 Major Prevention: | DECREASE KNOWN RISK FACTORS!!, Protective factors, AAP “Positioning Statement”
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| SIDS: 4 Ways On How To DECREASE KNOWN RISK FACTORS!!: | Prevent teen pregnancy, Prenatal care, Avoid substance abuse, Stop smoking
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| 4 SIDS Protective factors | Immunizations, Pacifier, Breast feeding, Sleep Practices
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| 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
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| 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)
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| Infantile Apnea | NIH clarifies definitions in Consensus Statement (1986)
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| Apnea | cessation of respiratory airflow for 20 seconds.
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| Apnea | May be central, diaphragmatic, obstructive or mixed. Several types.
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| Central Apnea | Absence of airflow and respiratory effort
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| Obstructive Apnea | Absence of airflow but presence of respiratory effort.
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| 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.
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| Pathologic Apnea | A clinical syndrome in infancy of unexplained cessation of air flow for 20 seconds or longer
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| Pathologic Apnea | A shorter respiratory pause associated with bradycardia, cyanosis or pallor.
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| AOP: Apnea of Prematurity | Periodic breathing with pathologic apnea in a premature infant.
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| AOP: Apnea of Prematurity | Usually idiopathic and resolves by 36 weeks post conceptual age.
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| AOP: Apnea of Prematurity | Use of caffiene and methylxanthines (Monitor levels and s/s of toxicity, Nasal CPAP)
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| AOP: Apnea of Prematurity | Some may continue and require monitoring.
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| AOI: Apnea of Infancy | Pathologic apnea that usually presents with an apparent life threatening event (ALTE).
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| AOI: Apnea of Infancy | Generally occurs > 37 weeks
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| AOI: Apnea of Infancy | Idiopathic: cause is not identified.
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| 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.
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| Apparent Life Threatening Event | Near Miss SIDS or Aborted Crib Death
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| Illnesses Associated with APNEA | URI, Pneumonia, Bronchiolitis, Sepsis, Metabolic Disorders, Cardiac anomolies, Seizures, IVH, Meningitis, GER
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| ALTE: Acute Management | Hospital Admission, Protective monitoring, Thorough hx. of the event, Expedited diagnostic testing, Treatment of associated conditions, Parent Education
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| Home Monitoring Considerations | Symptomatic Infants, Family Hx of SIDS, Premature Infants, Other Illnesses, Assymptomatic Infants
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| ALTE: Parent Education: Knowledge of Equipment | Belt placement, Troubleshooting, Response to alarm, Expected utilization, Settings
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| PEDIATRIC TRACH CARE | Close monitoring…, Trach ties should be snug and allow “pinkie” to be inserted, PRN suctioning
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| 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
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| Discontinuing the Monitor | Apnea free for 2-4 months
3 full sets of immunizations
Resolution of medical indication
Remember parental response
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nursingstudent2012
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