APLS Flashcards by Mary Slome

JONES criteria, major

Carditis (clinical and/or subclinical), arthritis (polyarthritis), Sydenham chorea, Erythema marginatum, and subcutaneous nodules

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Which of the following congenital heart lesions shows increased pulmonary vascularity on CXR?

Transposition of the great arteries

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Infants with noncyanotic heart disease can develop hypoxia through what mechanism?

Pulmonary edema

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Pediatric Assessment Triangle

Appearance
Work of Breathing
Circulation

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PALS Dose of adenosine peds

0.1 mg/kg –> 0.2 mg/kg

Max first dose 6 mg; max second dose 12 mg

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PALS Dose of amiodarone peds

5 mg/kg IV - bolus for pulseless VT/Vfib;

give over 20-60 min for VT w/ pulse or SVT

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QRS length peds

0.09 s

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SVT infant HR >

220

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SVT child HR >

180

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Differential diagnosis of AMS in peds

AEOIU TIPS

A - Alcohol, abuse
E - Electrolytes, Encephalopathy
I - Infection
O - OD, Ingestion
U - Uremia
T - Trauma
I - Insulin, Hyoglycemia, Intussusception, Inborn error of metabolism
P - Psychogenic
S - Shock, Stroke, Shunt, Seizure

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Neonatal HR

100-160

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1y HR

100-130

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5y HR

80-110

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10y HR

70-100

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15y HR

60-80

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Systolic BP peds

90 + 2(age) = 50th percentile

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Best was to lower increased ICP peds

Mild hyperventilation

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Morphine dose peds

0.1 to 0.2 mg/kg

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The target PaCO2 for initial management of pediatric traumatic brain injury is

35 mm Hg (35-40)

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Rectal bleeding and abdominal distention in a newborn;

dx?

NEC

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Femoral head slips posteriorly and inferiorly relative to the femoral neck, dx?

SCFE

Can present as hip, thigh, groin or knee pain

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Mgmt septic arthritis children

IV abx and drain

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The three most important vital signs to monitor during neonatal resuscitation are:

HR
RR
O2 sat

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Where to put O2 monitor in neonate

Right hand bc pre-ductus

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In an apneic and bradycardic newborn being resuscitated, the most immediate indicator of effective positive pressure ventilation is

Increase in HR

HR to start chest compressions in neonate

HR < 60

Contents of umbilical cord

Two umbilical arteries and one umbilical vein

Glucose bolus dose for newborn with hypoglycemia

2 ml/kg of 10% dextrose

ASA classification of pts with mild, systemic disease

Class II ie asthma | Class III - severe systemic disease

Discharge criteria after procedural sedation

Return to baseline respiratory status

Max dose of lidocaine with epi

7 mg/kg | or 0.7 ml/kg of 1% lidocaine with epi

Sedative agent with longest acting duration

Chloral hydrate

Cushing triad

Hypertension Irregular respirations Bradycardia

Neonate RR

30-60

Infant RR

30-60

Toddler RR

24-40

School age RR

18-30

Preschool age RR

22-34

Adolescent RR

12-16

Kinds of shock

Cardiogenic Distributive - Anaphalaxis, Sepsis, Neurogenic Obstructive - Tamponade, Tension PTX, Embolism Hypovolemic - Hemorrhagic and Non-hemoorrhagic

When to add hydrocortisone for BP support

Adrenal insufficiency

PALS chest compression rate

> 100/min

T/F: AEDs can be used in infants

True

CPR chest sequence

Chest compressions, airway, breathing

Peds survival rates for out of hospital arrest

10%

Most likely treatment for DKA to cause cerebral edema

Sodium bicarb

Mgmt SIADH

Fluid restriction unless pt is comatose or seizing

Most insidious onset and progressive worsening of IEMs

Lysosomal storage disorders

Fastest way to turn around hyperammonemia

Hemodialysis

Most common lab abnormalities of IEMs

Metabolic acidosis, hyperammonemia, | hypoglycemia

Treatment of moderate hypothermia in infants

Warm air in ETT and warmed IVF

Why can ferrous sulfate not be absorbed by activated charcoal?

Iron ions are too small to be caught

Why should flumazenil not be used?

Can precipitate seizures in mixed drug toxicities

Most common EMS call in peds

Respiratory distress

Mediastinal widening and bilateral pleural effusions; | bioterrorism dx?

Anthrax

Least vulnerable organ to radiation damage

The heart (or muscle)

Why do neonates have a right axis deviation on ekg?

The two ventricles are the same size at birth, and LV 2:1 to RV at approximately 2 months

PALS epinephrine dose

0.01 mg/kg of 1:10,000 --> 0.1 ml/kg IV or IO; | a 10 kg child gets 1mL of crash cart epi

Dose blood products PALS

10 ml/kg prbc

PALS atropine dose

0.02 mg/kg Min dose 0.1mg to prevent paradoxic bradycardia; Max dose 1 mg

PALS procainamide dose

15 mg/kg IV

PALS lidocaine dose

1 mg/kg IV/IO

PALS magnesium dose

25-30 mg/kg IV/IO

PALS glucose dose

0.25-0.5 g/kg Infants D10W 2.5-5 ml/kg Children D25W 1-2 ml/kg Adolescents D50W 1ml/kg

SHANE pneumonic for the critical neonate

S - Sepsis H - Heart ie ductal dependent lesion, hyperoxia test, give prostaglandin E1 A - Abdomen N - NAT E - Errors of inborn metabolism, +/- withhold feedings, ammonia level, D10W