Emergency Med, Crit Care, PALS, BLS Flashcards
Pediatric blood pressure during emergency per age
Neonates: > 60
1 mo- 1 yo: >70
1-10 yo: > 70 + (2 x age)
> 10 yo: > 90
most common precipitating event for cardiac instability in infants and children
respiratory insufficiency
factors known to cause bradycardia: 6 Hs and 5 Ts
H’s
Hypoxia, hypovolemia, hydrogen ions (acidosis), hypokalemia/hyperkalemia, hypoglycemia, hypothermia
T’s
Toxins, tamponade, tension pneumothorax, thrombosis, trauma
wide QRS duration
> 0.09 s
characteristics of a high quality cpr
push hard —> depth (1.5 in - 2 in)
push fast —> 100-120 compressions per minute
allow complete chest recoil
minimize interruptions
avoid excessive ventilation
choice of vasopressors after cardiac arrest
Epinephrine or Norepinephrine
Cerebral arterioles are maximally _____ at lower blood pressures and maximally ______ at higher pressures so that cerebral blood flow does not vary during normal fluctuations
dilated, constricted
hallmark of severe TBI
coma
peak ICP generally is seen at ____ hour
48-72
first tier therapy for increased ICP in a child with severe TBI
Elevation of the head of the bed
Ensuring midline positioning of the head
Controlled mechanical ventilation
Analgesia and sedation
Neuromuscular blockade
CSF drainage
Osmolar agents: HTS, Mannitol
second tier therapy for increased ICP in a child with severe TBI
Barbiturate infusion
Decompressive craniectomy
Mild hypothermia
Hyperventilation
Lumbar CSF drainage
most common cause of shock in children worldwide
Hypovolemic shock
4 criteria included in SIRS
Temp: >38.5 or <36
Heart rate: >2 SD or unexplained persistent elevation over 0.5-4 hr or persistent bradycardia over 0.5 hr
Respiratory rate: >2 SD or need for mech vent
Leukocyte count: elevated/depressed or >10% immature neutrophils
Submersions ___ min are associated with a favorable prognosis whereas those ___ min are generally fatal
less than 5 minutes, >25 minutes
Most pediatric drowning victims should be observed for at least __ hours
6-8
burn pattern which should raise suspicion of child abuse
glove or stocking burns of the hand and feet
single-area deep burns on the trunk, buttocks, or back
small full-thickness burns (cigarette burns) in young children
indications for hospitalization for burns
Burns affecting >10% of BSA
Burns >10-20% of BSA in adolescent
3rd-degree burns
Electrical burns caused by high-tension wires or lightning
chemical burns
inhalational injury
inadequate home or social environment
suspected child abuse or neglect
burns to the face, hands, feet, perineum, genitals or major joints
burns in patients with preexisting medical conditions that may complicate the acute recovery phase
associated injuries (fractures)
pregnancy
% BSA that require tetanus prevention
> 10%
what is parkland formula
4 cc PLR x kg x %BSA burned
half is given over the 1st 8 hours
remaining is given over the next 16 hours
Patients with GCS score of ___ require aggresive management, generally including stabilization of the airway and breathing with endotracheal intubation and mech vent
GCS <8
If patient has no pulse and breathing, what is the ratio of breathing and compression if 1 or 2 rescuer
1 rescuer: 30 compressions - 2 breaths
2 rescuer: 15 compressions - 2 breaths
If patieht has no normal breathing and has pulse, how do you provide rescue breathing
Old guidelines: 1 breath every 3-5 seconds or about 12-20 breaths/min
2020 guidelines: 1 breath every 2-3 seconds or 20-30 breaths/min
Medications to be given if bradycardia is persistent after CPR
Epinephrine (0.01 mg/kg or 0.1 mL/kg of 1:10,000 concentration) or Atropine (0.02 mg/kg, max dose 0.5 mg)
HR for Sinus tachycardia in infants and children
Infants: <220 bpm
Children: <180 bpm
HR for Supraventricular tachycardia
Infants: >220 bpm
Children >180 bpm
most common cause of choking in infants, and toddlers and older children
infants: liquids
toddlers and older children: small objects and food
Dose of synchronized cardioversion done in SVT
0.5 - 1.0 joule (J) / kg
Once advanced airway is established during cardiac arrest, how many breaths are given?
Old guidelines: 1 breath every 6-8 seconds or 8-12 breaths per minute
2020 guidelines: 1 breath every 2-3 seconds or 20-30 breaths per minute
