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Newborn/Pediatric Cliff notes > ACH Review (General Peds/Neo) > Flashcards

ACH Review (General Peds/Neo) Flashcards

1
Q

What safety equipment should be checked for a first assessment?

A
  1. Working JR bag
  2. Trach bag (if applicable)
  3. Chest tube (SxN pres, water lvl, balloon etc.)
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2
Q

What should the general work flow be in a patient assessment?

A

ETT->WOB->Auscultate->palpate-?cap refill->chart

  • Grab RR before waking the pt if possible
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3
Q

What topics should you keep in mind for rounds and during you assessment?

A
  • Vent settings and any changes
  • Recent blood gasses
  • Sxn trends
  • Breath sounds
  • Meds
  • concerns/suggestions
  • Samish report as handover
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4
Q

Initial Pediatric Vt goal?

A

5-8 ml/kg

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5
Q

Normal/Initial RR goals for Pediatrics:

  1. Infant
  2. Toddler
  3. Pre-school
  4. Child
  5. Teen
A
  1. Infant 30-50 bpm
  2. Toddler 24-40bpm
  3. Preschooler 20-35 bpm
  4. Child 18-30 bpm
  5. Teen 12-20
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6
Q

Normal/Initial Ti goals for pediatrics?

  1. Infant
  2. Toddler
  3. Pre-school
  4. Child
  5. Teen
A
  1. Infant 0.3-0.55 s
  2. Toddler 0.5-0.75 s
  3. Preschooler 0.6-0.8 s
  4. Child 0.7-0.8s
  5. Teen 0.8-1s
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7
Q

Normal/initial peep goals?

A

5-8 cmH2O

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8
Q

When do you use the 100ml/kg estimated for MV for peds?

A

When they’re greater than 25kg, below that stick to 5-8ml/kg and normal RR for their age group

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9
Q

Peds estimated OETT suction depth?

A

Refer to broslow or ETT ID x3

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10
Q

How do you determine ETT size?

A

(Age/4) + 4

  • you add 3.5 instead if a microcuff is used
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11
Q

How do you add 20% of a number?

for example, for your Vt alarm setting?

A
  1. Calculate 20% of the number: Multiply the number by 0.20.
  2. Add the result to the original number.
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12
Q

What do you SBT kids on for extubation?

A

Tube smaller (ETT< 3.5) = PS 8/+5

Tube bigger (ETT>3.5)= PS 6/+5

  • Once passed, return to rest settings
  • Intubated < 48hrs = 30mins
  • Intubated > 48hrs = 60-120mins
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13
Q

What equipment is needed in a pediatric extubation?

A

Extubate off the bagger with sxn and reintubation equipment ready.

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14
Q

How many ml/kg do you start a kid on HFNC?

A

2ml/kg

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15
Q

What is back to back therapy? (B2B)

A

Puffs every 20 mins x3

  • Takes about an hour
  • Drugs depend on PRAM on PRAM severity
  • reassess and stretch as tolerable
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16
Q

Asthma protocol for mild, moderate, and severe

A

Based on PRAM

  1. Mild (0-4) = Ventolin
  2. Mod (5-8) = Ventolin+Atrovent+dex
  3. Sev (9-12) = nebs for O2 and resp failure
17
Q

TBI goals for kids?

A
  • Low normal CO2 goals (35-40)
  • PaO2 > 80mmHg
  • CPP >60, ICP ideally <20
  • Reverse Trendelenburg bed
  • Sedation bolus before any procedure (sxn, position change)
  • Watch for Cushing triad
  • Mannitol and 3% saline bolus to control ICP
18
Q

Normal Saline bolus amount for hypovolemic shock/hypovolemia?

A

20 ml/kg normal saline bolus up to 100 ml/kg to improve BP

  • Once fluids don’t work, Inotropes should be used
19
Q

What is Cushings Triad?

A

Coning or increased ICP

  1. Apnea
  2. Brady
  3. Hypertension
20
Q

What can you do if Cushings triad occurs?

A

Bag them down to low CO2 bc it helps with ICP

21
Q

Salbutamol MDI Dosing for Peds?

A

Children < 20kg get 5 puffs MDI

Children > 20kg get 10 puffs MDI

22
Q

Ipratropium MDI Dosing for Peds?

A

4 puffs MDI regardless of weight

23
Q

dexamethasone dosing?

A

Starting 0.3 mg/kg, Max dose: 10mg

  • Dex is preferred over Prednisone
24
Q

Prednisone dosing?

A

Starting 2mg/kg, max 60mg

25
Q

Severe PRAM large volume neb doses for children < 20kg?

A

7.5mg salbutamol + 750mcg ipratropium into a large volume nebulizer.

  • Dilute with normal saline for a total volume of 20mL
  • Administered with 8LPM O2.
26
Q

Severe PRAM large volume neb doses for children > 20kg?

A

get 15mg salbutamol+750mcg ipratropium into a large volume nebulizer.

  • Dilute with normal saline for a total of 20ml
  • Admin with 8 LPM of O2
  • Basically, double the amount of the < 20kg kids
27
Q

ECMO rest settings?

A

10-10-10

  • PC/PS 10
  • RR 10
  • PEEP 10
28
Q
A

Newborn/Pediatric Cliff notes (12 decks)

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