Cyanosis resident survival guide (pediatrics): Difference between revisions

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* '''Exposure to toxic gases :''' Exposure to certain gases and smoke can cause cyanosis. Nitrates containing food can also cause methemoglobinemia.<br>
* '''Exposure to toxic gases :''' Exposure to certain gases and smoke can cause cyanosis. Nitrates containing food can also cause methemoglobinemia.<br>
* '''Medication Induced Cyanosis:''' Certain medications such as amiodarone can be a cause of cyanosis.<br>
* '''Medication Induced Cyanosis:''' Certain medications such as amiodarone can be a cause of cyanosis.<br>
* '''Co-existing Pulmonary Pathology :'''<br>
* '''Co-existing Pulmonary Pathology :''' Conditions such as asthma or bronchopulmonary dysplasia can result in cyanosis.<br>
* '''History of Congenital Heart Disease :'''<br>
* '''History of Congenital Heart Disease :Central cyanosis can be caused by a number of cyanotic congenital cardiac conditions and may result in shock.'''<br>
* '''History of Neurological Disease :'''<br>
* '''History of Neurological Disease :'''Respiratory depression due to drug or toxin ingestion, CNS lesions, a history of seizures, breath-holding spells in infants , and neuromuscular disease should be asked and rule out while pursuing causes of cyanosis. <br>
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Revision as of 05:39, 9 October 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usman Ali Akbar, M.B.B.S.[2]

Cyanosis resident survival guide (pediatrics) Microchapters
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life-Threatening Causes Pulmonary Causes Congenital Cardiac Conditions Hematological Causes Peripheral Cyanosis
Decreased inspired FiO2
Upper airway obstruction

Pulmonary vascular disorders

Other Causes

FIRE: Focused Initial Rapid Evaluation

Patients presenting to the emergency department with cyanosis and respiratory distress require emergency supplementation of O2, use of pulse-oximetry and airway, breathing, and circulation support.

  • A Focused Initial Rapid Evaluation (FIRE) should be performed to identify the patients in need of immediate intervention].
 
 
 
 
 
 
 
 
 
Patient present with cyanosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
No Respiratory Distress
 
 
 
 
 
 
 
 
 
 
 
 
Respiratory Distress
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Peripheral Cyanosis
 
Central
 
Differential Cyanosis
 
 
 
No Obstruction
 
 
 
Obstruction
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Reassurance & Warming
 
Hypoxia Test
 
Cardiac Evaulation
 
 
 
Hyperoxia Test
 
 
 
Give O2 and Positive Pressure Ventilation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PaO2<100
 
PaO2 100-150
 
PaO2 <100
 
PaO2 100-150
 
PaO2 >150
 
ENT Evaluation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cardiac Evaluation
 
Persistent Pulmonary hypertension of newborn ,Cardiac Evaluation
 
Cardiac Cause
 
Persistent Pulmonary hypertension of newborn
 
Respiratory management, Give O2 and positive pressure Ventilation

Complete Diagnostic Approach

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

 
 
 
Patient presents with cyanosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
History
  • Age: Certain conditions are more common in neonates than the older children such as cyanotic heart conditions and polycythemia
  • Presence/Absence of Fever : A history of fever shows the presence of existing infection
  • History of Trauma : Chest wall trauma can cause central cyanosis.
  • Exposure to toxic gases : Exposure to certain gases and smoke can cause cyanosis. Nitrates containing food can also cause methemoglobinemia.
  • Medication Induced Cyanosis: Certain medications such as amiodarone can be a cause of cyanosis.
  • Co-existing Pulmonary Pathology : Conditions such as asthma or bronchopulmonary dysplasia can result in cyanosis.
  • History of Congenital Heart Disease :Central cyanosis can be caused by a number of cyanotic congenital cardiac conditions and may result in shock.
  • History of Neurological Disease :Respiratory depression due to drug or toxin ingestion, CNS lesions, a history of seizures, breath-holding spells in infants , and neuromuscular disease should be asked and rule out while pursuing causes of cyanosis.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pysical Examination
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References