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Environmental Injuries in Children

General Principles

Larger Body Surface Area to Mass Ratio

These two objects have the same surface area, but cylinder contains more volume (mass)

Higher Metabolic Rate

Immature Blood-Brain Barrier

Thin Skin

Proximity and Behaviors

Look

Listen

Smell

Adult breath: only 10% through nose. Infant: 100% through nose (obligate nasal breathers)
Behind the Scenes: the Making of CO
Half-life of CO on room air, 100% NRB mask, in hyperbaric chamber
Relative sizes of smallest diameter of airway — in straw-size equivalents
1 mm of edema causes exponential decrease in area
1 mm of edema increases the airway resistance by 16 x
Trachea sizes by age

Selected References

ARDSNet. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000 May 4;342(18):1301-8.

Patel HN, Miyoshi T, Addetia K, Henry MP, Citro R, Daimon M, Gutierrez Fajardo P, Kasliwal RR, Kirkpatrick JN, Monaghan MJ, Muraru D, Ogunyankin KO, Park SW, Ronderos RE, Sadeghpour A, Scalia GM, Takeuchi M, Tsang W, Tucay ES, Tude Rodrigues AC, Vivekanandan A, Zhang Y, Schreckenberg M, Blankenhagen M, Degel M, Rossmanith A, Mor-Avi V, Asch FM, Lang RM; WASE Investigators. Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study. J Am Soc Echocardiogr. 2021 Oct;34(10):1077-1085.e1. doi: 10.1016/j.echo.2021.05.012. Epub 2021 May 25. PMID: 34044105; PMCID: PMC9149664.