Emergency Paediatrics Flashcards
Most common cause of cardio respiratory arrest in children
Respiratory problem
Causing prolonged hypoxia
Leading to cardiac arrest
Causes of cardio resp arrest
Prolonged hypoxaemia Birth asphyxia Inhalation of foreign body Acute asthma Bronchiolitis Neurological dysfunction, opiates
Risk factors for aspiration
Decreased GCS Underlying cardiac condition Anaphylaxis Drug ingestion Neuromuscular disorder Respiratory pathology Foreign body Post-cardiac surgery Drowning Trauma Non accidental injury Anatomy
DD to cardio resp arrest
Choking
Opiate ingestion
Decreased level of consciousness due to neuromuscular disorder/ head injury
Hypoglycaemia
BLS algorithm
Unresponsive Shout for help Open airway Not breathing normally 5 rescue breaths No signs of life 15 chest compressions (HR<60~) 2 rescue breaths and 15 chest compressions 1min CPR then call rhesus team
3Ss for BLS
Safety
Stimulate
Shout
When should chest compressions be commenced?
No signs of life
No pulse
HR<60
Normal HR
0-2: <160
3-5: <140
6-12: <120
Normal BP
0-2: >70
3-5: >75
6-12: >80
Normal RR
0-2: <60
3-5: <35
6-12: <30
Adequate urine output
0-2: 1.5-2ml/kg
3-5: 1ml/kg
6-12: 0.5-1ml/kg
No signs of increased resp effort despite hypoxia
Reasons
Fatigue/ exhaustion
Neuromuscular disease
Central respiratory depression: RICP, poisoning, encephalopathy
Breathing assessment
For potential respiratory failure
Effort of breathing
Efficacy: air entry, pulse oximetry, chest expansion
Effect of respiratory inadequacy: hypoxia, tachycardia, bradycardia
Resuscitation fluid
20ml/kg NaCl
Intraosseous access
10ml/kg for DKA to reduce cerebral oedema risk
Bubbling sound
Diagnosis and treatment
Excessive secretions
Suctioning
