Circulation Flashcards
What vital signs are you assessing?
Heart Rate
Temperature
Blood Pressure
Capillary refill
What considerations are you making when looking at heart rate?
Palpating centrally and peripherally
Rhythm irregular or regular
Pulse volume bounding, normal, thready or absent
What is a normal heart rate for a child ages 1-9?
1-2 years- 100-150bpm
2-5 years-95-140bpm
5-12 years- 80-120bpm
Where are you measuring temperature?
Peripherally and centrally
Where are you measuring capillary refill and for how long?
Centrally and peripherally
Cutaneous pressure on digit and centre of sternum
Press down for 5 seconds and watch for the return of colour
Normal CRT is <2s
What considerations need to be made when taking BP and what are the normal ranges for a 1-9YO?
Correct sized cuff
1-10 years- (agex2) +85
Septic shock- (agex2) +90
What is demarcation and how do we assess it?
Assessing the boundaries of where there is a change in temperature
Feel from fingers/toes up from the limb to the body
The higher the demarcation, the more unwell the child is
What exposure/neurological symptoms are present during circulation?
Skin appearance- mottled, cold and pale (due to poor perfusion),
Mental state- agitation and drowsiness due to poor cerebral perfusion
Any fluid loss i.e. blood or vomit
What is oliguria? And what is the formula for urinary output?
Inadequate urine output that is usually due to poor renal perfusion
1ml/kg/hr in a child
What would need to be put in place for circulatory intervention?
Two wide bore cannulae (IV access)
If unable to obtain in 90 seconds to use IO
When would you give fluid and what fluids would you give?
If low BP- 10mls/kg (5-10 minutes of max 500mls)
Plasmalyte, haartmans, 0.9% NaCl (crystalloid isotonic solution)
What interventions would you make if there is no improvement after 40-60mls/kg?
Consider inotropes or intubation
What interventions would you make for tachycardia presenting with a high temperature?
Broad-spectrum antibiotics
