Chapter 20 Management of cardiac arrest Flashcards
What is the most common cause of PEA arrest in children?
Hypovolaemia
Hypoxia
What is the dose of adrenaline in cardiac arrest?
10 mcg/kg IV or IO
What size is the bolus of saline following drug administration in cardiac arrest?
2-5 ml
What is the ventilation rate for a child in cardiac arrest once a secure airway is obtained?
10-12 breaths per minute
What rate are chest compressions given in cardiac arrest for a child?
100 -120
(though interruptions to give breaths, rhythm check mean actually compressions delivered is not 100-120 BPM)
When should an ETT be inserted in cardiac arrest of a child?
As soon as possible, most likely cause of arrest is hypoxia
What should you do with the defibrilator pads & leads if you see asytole?
Check they in the right position
What should you do with the ventilation rate once you achieve ROSC?
Increased to 12 - 24 depending on age
Should you check for a pulse if there is organised electrical activity seen during a rhythm check?
Note routinely, it takes too long. Check for ROSC by looking from normal breathing and responsiveness. Checking for a pulse may be more important in a sedated/paralysed patient
When adrenaline is given every 2nd rhythm check, about how many minute does this work out to be?
Every 4 minutes
In what situations is calcium given during cardiac arrest?
Hypocalcaemia
Hyperkalaemia
Calcium channel blocker overdose
How common are thromboembolic events in children?
Rare.
Coronary or pulmonary artery occlusion is rare cause of cardiac arrest in a child
What are the 4 H’s
Hypoxia
Hypovolaemia
Hypo/hyper electrolytes
Hypothermia
What are the 4 T’s
Tension pneumothorax
Tamponade
Toxins
Thrombosis (rare)
How does acidosis affect adrenaline and other catecholamines?
Makes them less effective
When would you give sodium bicarbonate in a cardiac arrest?
Consider in prolonged cardiac arrest, hyperkalaemia and TCA overdose
In cardiac arrest how well does arterial pH correlate with tissue pH
Very poorly.
Don’t use arterial pH to guide alkalising therapy.
what is the dose of sodium bicarbonate should you choice to use it in a cardiac arrest?
1mmol/kg
What happens if you give sodium bicarbonate through the same IVC that you gave calcium through
You make chalk.
Give at separate sites
How common is VT/VF in children? What tends to cause it in this age group?
Rare. Generally due to congenital heart disease, TCA overdose, hypothermia
How many J/kg for shockable rhythms do you give?
4J/kg
What is the dose of amiodarone in cardiac arrest?
5mg/kg
Is amiodarone helpful in VT/VF caused by arrhythmogenic drug overdose?
May do more harm than good. Discuss with poisons center first
In an AED (the type found in shopping centers), what age do you start using the adult pads?
> 8 years old
