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EPALS > Epals 01 > Flashcards

Epals 01 Flashcards

1
Q

Adrenaline dose
Arrest

A

10mcg/kg
0.1ml (1:10,000)

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2
Q

Fluid bolus

A

Shock = 10ml/kg
Up to 40-60ml/kg

Euvolaemic/DKA
Trauma/cardiac = 10ml/kg
Up to 20ml/kg

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3
Q

Glucose

A

2ml/kg 10%

Neonate = 2.5ml/kg

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4
Q

Defibrillation energy

A

Cardiovert
1J/kg then 2J/kg

Arrest
4J/kg

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5
Q

Amiodarone

A

5mg/kg

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6
Q

Atropine

A

20mcg/kg

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7
Q

Calcium chloride

A

10%
0.2ml/kg

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8
Q

Lorazepam

A

100mcg/kg

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9
Q

Adenosine

A

100mcg/kg

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10
Q

Adrenaline Anaphylaxis

A

<5: 150mcg
6-12: 300mcg
>12: 500mcg

Or 1mcg/kg IV adrenaline

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11
Q

D assessment

A

AVPU
Tone, posture, focal
BG
Pupils

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12
Q

Weight estimation

A

(Age+4)x2

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13
Q

Urine output above

A

Baby 6 wet nappies/day
Infant>2
Child>1ml/h

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14
Q

CVS/Resp failure

A

RR>60
HR>180 (<1y)
HR>160 (>1y)

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15
Q

Max O2 delivery
Diff equipment

A

Mouth -17%
Nasal spec - 40%
O2 mask - 60%
BMV - 90%
HFNC - 100%

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16
Q

Vent rate
Cardiac arrest
V
Resp arrest

A

Cardiac: 10-12
V
Resp arrest: 12-20
Newborn: 30

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17
Q

Ambu bag sizes

A

250ml: preterm
500: term- preschool
1000: school aged
2000: adult

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18
Q

LMA sizes

A

1 - neonate (<5kg)
2 - infant (10-20kg)
3 - children (30-50kg)

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19
Q

Resuscitation tape
Name

A

Broselow
Sandell

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20
Q

DOPES acronym

A

Intubated patient issues

Displacement
Obstruction
PNX
Equipment
Stomach

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21
Q

Trache problem
Algorithm

A

Remove inner tube
Suction
Deflate cuff
Remove tube
Rescue breaths
CPR

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22
Q

Adrenaline infusion

A

Low infusion (beta)
<0.1mcg/kg

High inf (alpha)
>0.1mcg/kg

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23
Q

Sodium bicarbonate
For TCA, prolonged arrest
Renal failure and high K

A

8.4% , 1ml/kg

Under 3m
4.2%, 1ml/kg

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24
Q

Magnesium dose
TdP

A

10%
0.5ml/kg

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25
Q

Naloxone doses

A

<5y
100mcg/kg max 2mg

> 5 = 2mg

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26
Q

ABG
Normal range
Bicarb
CO2

A

Bicarb
22-26

CO2
4.5-6

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27
Q

Childhood airway diseases

A

Laryngotracheitis (croup)
Epiglottis
Bacterial tracheitis
Bronchiolitis
Asthma
Anaphylaxis

28
Q

Moderate asthma Tx

A

10 puff salbutamol in spacer every 20min for 1h
+/- ipratropium
Steroids;
2-5; 20mg Pred
>5; 30-40mg pred

29
Q

Acute severe asthma Tx

A

Neb salbutamol 2.5-5mg
+/- iprtropium 250mcg
+/- 150mg MgSO4
Steroids

30
Q

Life threatening asthma Tx

A

As per Acute severe
+/- IV salbutamol
+/- IV hydrocortisone
+/- IV aminophyline
+/- IV magnesium

31
Q

Tx neonatal cardiac problem

A

?prostaglandin infusion
? Duct dependent issue

32
Q

Fluid refractory septic shock Tx
(60ml/kg)

A

Cold shock
- adren 0.05mcg/kg/m

Warm shock
- norad 0.05mcg/kg/m

33
Q

Status epilepticus Tx

A
  • Lorazepam 100mcg/kg x2
  • Phenytoin infusion 20mg/kg over 20min
  • RSI
34
Q

DKA dx

A

BG>11
Ketones; 2+urine, 3+blood
Acidosis <7.3, bicarb<18

35
Q

DKA management

A

Bolus for shock 10ml/kg
Maintenance fluid + deficit over 24h
Insulin 0.1 unit/kg/h
Regular obs; BG, neuro, U+E

36
Q

Hyponatraemic seizure

A

Correct Na to 125
3ml/kg of 3% NaCl

Then 0.5mmol/h

37
Q

Hypokalaemia Tx

A

0.5mmol/kg/hr

38
Q

Trauma triad

A

Acidosis
Hypothermia
Coagulopathy (ca)

39
Q

SCIWORA

A

Spinal cord injury without radiological abnormality

40
Q

Aim PaCO2 in TBI

A

4:5-5kPa

41
Q

Bloated abdomen Mx

A

NG tube
Consider abdo path
USS, CT, surgical

42
Q

Total blood Vol child

A

70ml/kg

43
Q

AMPLE hx

A

Allergies
Medication
PMH
Last ate
Events

44
Q

Massive hameothorax
Dx and Tx

A

20ml/kg from drain

Clamp drain
Massive haem protocol
Thorocotomy

45
Q

Morphine dose

A

0.1mg/kg

46
Q

Hypothermia Tx

A

Actively reward to 32-34C

47
Q

Newborn algorithm

A

Start clock
Dry baby
Asses tone, color, RR, HR
5 inflation breaths
?Repeat inflation
Ventilate 30s
CPR 3:1
Reassess every 30s

48
Q

Weight estimation

A

(Age+4)x2
Up to age 10

49
Q

RR
<1y under xRR
<12y over xRR

A

<1y under 40RR
<12y over 20RR

50
Q

sBP
1m over xBP
1y over xBP
10y over xBP

A

1m over 50BP
1y over 70BP
10y over 90BP

51
Q

HR
Newborn min
Infant max
Child max

A

Newborn min 100
Infant max 180
Child max 160

52
Q

ETT size
1/2 sizes available

Preterm/term
Infant
Children
Adolescent

A

Preterm/term: 3mm
Infant; 4mm
Children; 5-6mm
Adolescent 7mm

53
Q

WETFLAG

A

Weight (age+4)x2
Energy 4J/kg
Tube (age/4)+4 (+-0.5)
Fluid 20ml/kg or 10
Loraz 0.1mg/kg
Adrenaline 0.1ml/kg (1:10,000)
Glucose 2ml/kg (10%)

54
Q

WETFLAG

A

Weight (age+4)x2
Energy 4J/kg
Tube (age/4)+4 (+-0.5)
Fluid 20ml/kg or 10
Loraz 0.1mg/kg
Adrenaline 0.1ml/kg (1:10,000)
Glucose 2ml/kg (10%)

55
Q

CPR method
<1yo
>1yo

A

<1yo; 2 fingers
Or encircle with thumbs above xiphi
>1yo
1-2 hands

56
Q

Airway positions
<1yo
>1yo

A

<1yo; neutral;
roll under shoulder

> 1yo; sniffing morning air
Roll under head/neck

57
Q

Cardioversion

A

1J/kg
2J/kg
Amiodarone and 2J/kg

58
Q

Mechanism for hyperventilation in brain injury

A

Reducing CO2
Causes vasoconstriction
Lowers blood flow
Reduces ICP
Aim lower end of normal

59
Q

Tracheal tube size

A

(Age/4)+4

60
Q

Blood pressure cuff width

A

Over 80% upper arm length

61
Q

CPR with intubation
Ventilation rate per age
Infant
1-8
8-12
>12

A

Infant: 25/min
1-8: 20/min
8-12: 15/min
>12: 10/min

62
Q

IO access can remain in situ for x hours

A

72h

63
Q

IO insertions points

A

Prox tib
Small child 1cm inferior and medial
Old child: 2/3cm inf

Humerus
1-2cm above surgical neck on most prominent part greater tubercle

Distal femur
Leg straight, 1-2cm above patella and medial

64
Q

IO contra indications

A

Osteogenesis imperfecta
Haemophilia
Coagulopathy
Infected skin
Fracture or distal to fracture
Previous IO within 48h

65
Q

IO complications

A

Extravasation, Compartment syndrome
Skin necrosis
Fracture
Damage to growth plate - none reported
Infection - rare
? Fat Embolism

EPALS (2 decks)

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