1. Pediatrics Part 2 Assessment and Management of the Critically Ill Child

4. Sick or Not Sick? Why?

6. What Do You See? Alert & Responding to Environment Minimal Work of Breathing Airway is Patent and Maintained Activity is Spontaneous Skin is Pink

7. What Do You Hear? Good Air Movement No Audible Wheeze or Grunting

8. What Do You Feel? Skin is Warm and Dry to Touch Peripheral and Central Pulses are Strong and Equal Cap Refill is Brisk (< 2 seconds)

9. Case Studies

11. What Do You See? No Eye Contact Nasal Flaring Accessory Muscles Skin is Pale and Cyanotic Increased Respiratory Rate

12. What Do You Hear? Audible Wheezing Grunting

13. What Do You Feel? Cool Extremities Weak Peripheral Pulses

15. 2-week-old infant Circulation to Skin Face and trunk normal, hands and feet blue Work of Breathing Abdomen rises and falls with each breath Appearance Eyes open, moves arms and legs, strong cry

21. 9-month-old infant Circulation to Skin Pale skin color Work of Breathing No retractions or abnormal airway sounds Appearance Agitated, makes eye contact

25. 3-year-old toddler Circulation to Skin Cyanotic, mottled Work of Breathing Gurgling breath sounds Appearance No spontaneous activity; unresponsive

30. 12-month-old child Circulation to Skin Lips and nailbeds blue Work of Breathing Mild retractions Appearance Alert but agitated

36. 9-month-old infant Circulation to Skin Normal color Work of Breathing Retractions, nasal flaring Appearance Alert, looking around, crying

40. 4-year-old child Circulation to Skin Pale skin color Work of Breathing Stridor, severe retractions Appearance Unresponsive, poor muscle tone

44. 3-year-old child Circulation to Skin Normal color Work of Breathing Normal Appearance Drowsy, but interacts

47. Etiologies of Seizures What is the significance of fever in this patient? • Ingestion • Low level anti-seizure medicine • Infection • Bleeding into brain • Hypoxia • Metabolic disorder • Head trauma • Hypoglycemia • Fever

51. 4-year-old child Circulation to Skin Normal color Work of Breathing Normal Appearance Disoriented

55. 3-year-old child What is your assessment of this patient? Circulation to Skin Pale skin color Work of Breathing Tachypnea, retractions Appearance Unresponsive

60. 7-year-old child Appearance Listless, poor muscle tone Work of Breathing No chest rise visible Circulation to Skin Pale skin color

73. 2-year-old child Appearance Crying, scared, not consoled by parents Work of Breathing Normal Circulation to Skin Normal

85. Rhythm – Sinus Brady

90. Rhythm - VT

92. Case #

96. Case #

100. Case #