Subjective: (Information from parents/guardians)
Date of visit
Reason for admission (respiratory distress, hypoxia)
History of present illness:
Onset of respiratory symptoms (fever, cough, wheezing)
Duration and severity of symptoms
Progression of respiratory distress
Recent illnesses or exposures (infections, aspiration)
Underlying medical conditions (prematurity, congenital heart disease, chronic lung disease)
Past medical history
Surgical history
Family history (respiratory illnesses, genetic conditions)
Objective:
Vital signs (temperature, heart rate, respiratory rate, oxygen saturation)
Physical exam:
Respiratory effort (tachypnea, retractions, use of accessory muscles)
Chest auscultation (rales, wheezing)
Oxygen saturation on room air and supplemental oxygen
Labs:
Blood gas analysis (pH, PaCO2, PaO2)
Complete blood count (CBC) with differential
Inflammatory markers (CRP, ESR) – if indicated
Chest X-ray (infiltrates suggestive of ARDS)
Imaging (optional):
Chest CT scan (may be used for diagnosis or to rule out other causes)
Assessment:
Pediatric ARDS based on Berlin definition (oxygenation criteria, respiratory mechanics, chest X-ray findings)
Severity of ARDS (mild, moderate, severe)
Underlying cause of ARDS (pneumonia, aspiration, sepsis, etc.)
Differential diagnoses (congenital heart disease, pulmonary embolism)
Plan:
Supportive care:
Respiratory support (mechanical ventilation if needed)
Oxygen therapy (titrated to maintain oxygen saturation goals)
Fluid management (avoiding fluid overload)
Nutritional support
Pain management
Positioning and chest physiotherapy
Treatment of underlying cause (antibiotics for pneumonia, etc.)
Prophylaxis for ventilator-associated pneumonia (VAP)
Monitoring:
Vital signs, oxygen saturation, ventilator settings (if applicable)
Blood gas analysis
Chest X-ray (serial follow-up)
Consider consultation with specialists (pulmonologist, intensivist)
Prognosis:
Discuss with parents/guardians the prognosis of pediatric ARDS, which depends on severity and underlying cause.
Explain potential complications (ventilator-associated pneumonia, multi-organ dysfunction syndrome)
Follow-up:
Depending on the clinical course, next steps will be determined:
Continued monitoring and treatment in the PICU
Weaning from mechanical ventilation
Transition to a floor bed with continued oxygen support
Discharge planning with outpatient follow-up
Note: This is a template and may need to be modified based on the individual patient’s presentation and severity of ARDS.
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of pediatric ARDS.