6. Circulation and drugs Flashcards
What is the best route of access for children who are unwell but ARE responsive to pain
IV better as IO delivery of fluids and drugs can be painful
Where should an IO cannula be inserted?
2-3cm below the tibial tuberosity on the anteromedial surface of the tibia
What are potential complications of IO access?
Fat/bone embolism
fracture
Infection
compartment syndrome
skin necrosis
What is the volume of an initial fluid bolus that should be used?
10ml/kg of plasmalyte/0/9% NaCl
Guess of weight if between 1-10yrs = (age +4) x 2
Can give the 10ml/kg bolus TWICE and if this has not helped re-assess and consider blood transfusion
What drug and dose should be given in cardiac arrest with a non-shockable rhythm (PEA or asystole)
ADRENALINE immediately
0.1ml per kg OR 10mcg per kg of 1:10,000 IV or IO
Repeat every 3-5 mins as necessary
What drug and dose should be given in cardiac arrest with a shockable rhythm (VF/pVT)
ADRENALINE after the 3rd defib and then following alternative shocks (after 3rd shock… after 5th shock)
0.1ml per kg OR 10mcg per kg of 1:10,000 IV or IO
Repeat every 3-5 mins as necessary
What should always be administered after a medication?
5ml flush of 0.9% NaCl
What dose of amiodarone should be used and when should it be given?
5mg/kg
Give if VF/pVT persists after the 3rd defibrillation. You can then repeat the amiodarone dose after the 5th defibrillation if shocking has been unsuccessful.
When is sodium bicarbonate used?
For hyperkalaemia / arrhythmias associated with TCA overdose or inborn errors of metabolism
What is adenosine used for?
SVT (follow dosing guidelines)
What strength of glucose is used to treat hypoglycaemia
10% dextrose
What is atropine used for?
Bradycardia due to vagal stimulation (not bradycardia due to asphyxiation)
