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Anyone know the answer to these questions ....google has mixed answers ?

 

Hi All

 

Does anyone know the cut off in the UK for time spent below 89% Sat for a toddler before treatment is issued and is oxygen therapy the usual first line treatment?

 

What is the definition of Bradycardia while asleep in a toddler ? Can it be the reason for apnea or part of the symptoms produced ?

 

Thanks in advance

Carol

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Oh Carol, you have such a job on your hands seeking out all these answers, which due to lack of knowledge by even many medics, is a challenge for you in itself.  I hope you find the answers, and your family are lucky to have you fighting their corner, and hopefully will help others too :) 

 

I had a similar experience, which I wrote about on a different discussion, in finding out why my husband kept having fainting/fit episodes regularly whilst eating or drinking.  Google helped me in finding out he had the rare condition 'Swallow Syncope' and he had an emergency pacemaker fitted back in August.  Good luck!

Hi kath

 

If they all had the same info it wouldnt be so frustrating !!! And protocols :)

I often find that I try to educate myself as much as possible though alot of medical professionals think I perhaps know to much and it intimidates them I spent 18mths trying to convince ENT that my child had obvious obstruction they did not even scope him and at one appointment told me to teach him to blow his nose !!!  as each time we went to outpatients he didnt sound like a typical tonsil or adnoid child ( I asked him what they sounded like and he said heavy mouth breathers ) my teen had recently had his tonsils removed and I can never remeber him sounding like a heavy breather unless he had a cold .

My toddler through home pulse ox he had many and they always had great saturations a few dips nothing out of the norm however 18mths later he finally got a proper sleep study which showed he was severly obstructing and retaining high levels of CO2 no wonder he couldnt move of a chair when he got up each day he effectively was poisoning himself when he slept :( I videoed him sleeping he had sternal resessions and still as he presented as normal in clinic I had to prove and fight for them to believe me Im so glad for the WWW it has helped me in so many ways .

 

Another positive is my husband has been a CPap user since October as I knew that his snoring was abnormal and bought a pulse ox that gave a print out and timed his pauses went to the gp with the evidence who had told him it was his double chin loose weight and he would stop snoring :( with evidence in hand and some knowledge  he got referred for a sleep study and came home with CPAP ..........Im thankful I have knowledge from the net as if not my hubby and childrens quality of life would still be below par .  My husband has lost 2.5st since being on cpap he had no energy to do anything prior to using his Cpap no wonder he piled on the pounds and the quality of his sleep probably meant he didnt get restful sleep he would eat Ibruprofen for headaches constantly he was also put on antidepressants !!  His headaches are now minimal and he is a different person :)

 

Gosh glad Google is around as it sounds like your husband has been helped by your quest for knowledge well done :)

 

They say to much knowledge can be dangerous I believe lack of it is

 

Thanks for this site as there really isnt alot out there to assist with apnea questions in UK

 

Oh while I am on my soap box I have MR10 monitors for both my boys which there is a vast shortage of in the area I am from I have the SCBU phoning me each month to see if I still need them ....believe me when I dont I will give them back as I know how precious those boxes are to parents ..... So once I get organised I am going to raise funds to purchase monitors for parents to borrow as often they have to buy them themselves :( we waited 4 months for one and inbetween we bought one ... I just need to work out how best to arrange it all

 

 

 

This is very interesting Carol - the fact that your husband's sleep apnoea was discovered AFTER your child's, as I normally hear it's the other way around.  Good on you for observing all of this to protect your little family.  It's great that you're arming yourself with as much knowledge as you can, even if it does sometimes cause intimidation to certain people.  There are also many medics out there who'd be impressed with you, rather than feel intimidated, so keep up the good work :)

 

Great to hear your intentions to help with the MR10 monitors too.

http://www.aasmnet.org/practiceparameters.aspx?cid=100

 

http://www.aasmnet.org/Resources/PracticeParameters/reviewfullpolys...

 

Section 4.4.6. states that normal rules toward oxygen apply to peds.

 

 http://www.aasmnet.org/Resources/clinicalguidelines/040210.pdf

 

AASM Rule 4.4.5.1 Supplemental o2 should be added if the patient's o2 falls below 88% for more than 5 minutes.

 

I have worked in labs where they required 30 minutes below 88% or 15 minutes below 85%. I personally like the 5 minutes <88% for children.

http://emedicine.medscape.com/article/804613-overview

 

Tachycardia is an abnormal rapidity of heart action that usually is defined as a heart rate more than 100 beats per minute (bpm) in adults. In children, the normal heart rate is age dependent, and the definition of tachycardia varies, as shown below.[1]

  • Age 1-2 days - 123-159 bpm
  • Age 3-6 days - 129-166 bpm
  • Age 1-3 weeks - 107-182 bpm
  • Age 1-2 months - 121-179 bpm
  • Age 3-5 months - 106-186 bpm
  • Age 6-11 months - 109-169 bpm
  • Age 1-2 years - 89-151 bpm
  • Age 3-4 years - 73-137 bpm
  • Age 5-7 years - 65-133 bpm
  • Age 8-11 years - 62-130 bpm
  • Age 12-15 years - 60-119 bpm

Posted the above as a reference. According to the Mayo Clinic and my personal physician any rhythm under 60bpm in peds is considered abnormal.

Thank you for the replies

 

Rock : very helpful and lots of reading getting through it all though :) huge thanks for that

You are very welcome Carol. If I had my way I would only do ped studies.
Is there big demand for paediatric studies over there Rock, as I don't think they've cottoned onto the risk to them over here yet?

We are beginning to do more and more ped. studies. With obesity on the rise and OSA as a huge source the demand for these studies are on the rise.

I truly believe that OSA awareness and sleep education needs to begin very early in our schools. This would help both our kids and the adults. Quite often the parents learn as much from the children as the revearse.
Too true!  Over here, Respironics have started going into schools to educate the children.  Here's a link to their Facebook page where they've reported it https://www.facebook.com/philipsrespironicsuk

In Scotland we have 2 hospitals that are licenced to do PSG on paediatrics Yorkhill Glasgow and Edinburgh Sick Kids

The list is long Travis went on the list 2nd February and we have an appointment for 25th May so 16 weeks :( there isnt enough equipment or trained staff

 

 

My wife and I have a 1 year commitment in Colorado. We are talking about crossing the pond to experience socialized medicine after that.

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