Pediatric emergency medicine trisk 2763 2763

TABLE 99.2
RESTING RESPIRATORY RATE BY AGE
Age

Breaths per minute

Neonate
2–12 mo
12 mo–2 yrs
2–12 yrs
Adolescent

30–50
30–40
22–30
16–24
12–20

TABLE 99.3
DIAGNOSIS OF ACUTE RESPIRATORY FAILURE FROM
PULMONARY CAUSES IN CHILDREN
Clinical findings
Vital signs: tachycardia, tachypnea or bradypnea, hypoxemia
General appearance: cyanosis, diaphoresis, confusion, restlessness, fatigue,
shortness of breath, apnea, grunting, stridor, retractions, decreased air entry,
wheezing
Blood gas abnormalities
PaCO 2 >50 mm Hg with acidosis (pH <7.25)
PaCO 2 >40 mm Hg with severe distress
PaO 2 <60 mm Hg (or SaO 2 <90%) on 0.4 FIO 2
Pulmonary function abnormalities

Vital capacity (<15 mL/kg)
Inspiratory pressure (<25–30 cm H2 O)
Patients at risk for acute respiratory failure must be quickly identified and
managed to prevent deterioration. In general, patients presenting with significant
respiratory distress (i.e., grunting, gasping, and severely increased work of
breathing) are at risk for respiratory failure.
Additionally, neonates, patients with cardiac disease, and those with worrisome
trajectories and/or tiring despite therapy are considered at risk of respiratory
failure. Other concerning clinical findings, blood gas abnormalities, and
pulmonary function abnormalities commonly present in the setting of respiratory