Lesson 1: Foundational Concepts Flashcards
What are the 6 actions of the in-hospital cardiac chain of survival?
Surveillance and Prevention
Recognition of cardiac emergency and activation of emergency response system
Early high-quality CPR
Pediatric advanced life support
Integrated post-cardiac arrest care
Recovery
What are the six actions of the out-of-hospital cardiac chain of survival?
Prevention
Recognition of cardiac emergency and activation of emergency response system
Early high-quality CPR
Pediatric Advanced Life Support
Integrated post-cardiac arrest care
Recovery
What is the proper rate of compressions?
100-120 compressions per minute
How long should it take to complete 30 compressions?
15-18 seconds
How long should it take to complete 15 compressions?
7-9 seconds
What is the desired compression depth of infants and children?
Infants: 1 1/2 inches
Children: 2 inches
How long should each ventilation last?
About 1 second
How is Tidal Volume calculated in the pediatric patient?
5-8 mL/kg of ideal body weight
What are some dangers of excessive ventilations?
Increased intrathoracic pressure (decreased venous return and cardiac output)
Gastric insufflation (regurgitation and aspiration)
How often should providers switch off giving compressions?
Every 2 minutes or sooner.
What is the chest compression fraction (CCF)?
% of time spent performing compressions.
What does capnography measure?
End tidal carbon dioxide level
What are normal end tidal carbon dioxide levels?
35-45 mmHg
Where should end tidal carbon dioxide levels be when high quality CPR is being administered?
15-20 mmHg
When should 2 initial ventilations be delivered prior to starting CPR?
When drowning is suspected.
When a primary respiratory etiology is suspected
What is the definition of a child?
1 year to onset of puberty (usually around 12 years)
Where should hands be placed to administer compressions?
Center of chest.
Lower half of sternum.
What is the compression/ventilation ratio for 1-person CPR?
30:2
What is the compression/ventilation ratio for 2-person CPR?
15:2
How long should CPR be continued?
Until you are relieved
ROSC
Presented with DNR
Too exhausted to continue
Situation becomes unsafe
What are the two methods to perform compressions on the infant?
Encircling thumbs technique (preferred for single provider)
Two-finger technique
Where are the thumbs placed on the encircling thumbs technique?
Side-by-side on the center of the chest just below the nipple line
Where are fingers placed when administering the two-finger technique?
Center of chest, just below nipple line on the sternum.
How should the airway be positioned on an infant?
A neutral position
How should the airway be positioned for a child?
Slightly past neutral position
When should pediatric/adult AED pads be used and how should they be placed?
Infants up to 1 year: pediatric, anterior/posterior
Children 8 or younger (55 lbs): pediatric, anterior/lateral
Children older than 8 (55 lbs): adult, anterior/lateral
What is the systematic approach used to assess a pediatric patient?
Assess, Recognize, Care
What are the components of the Rapid Assessment?
Perform visual survey (Pediatric Assessment Triangle)
Check for responsiveness
What are the components of the Pediatric Assessment Triangle?
Appearance
Work of Breathing
Circulation
How long do you assess breathing and what do you check simultaneously check?
10 seconds
Central Pulse (brachial in infants & carotid in children)
At what rate should ventilations be delivered?
Every 2-3 seconds
Supplemental oxygen should be provided to keep oxygen saturation at what percentage?
94-99%
What is the TICLS mnemonic?
Tone
Interactivity
Consolability
Look/gaze
Speech/cry
How is an OPA size determined?
Measure from the corner of the mouth to the angle of the jaw.
How is a NPA size determined?
From the nostril to the angle of the jaw.
When is an NPA contraindicated?
Maxillofacial trauma
Head trauma
How is advanced airway placement confirmed?
Bilateral chest rise
Auscultation
Capnography (3, 4-point square wave forms)
What is considered hypotension?
Neonate: SBP <60
Infant: SBP <70
Child: SBP <70 + (age in yrs x 2)
Adolescent: SBP <90
What are the oxygen concentrations for the following flow rates: 1-4 LPM NC, 6-15 LPM SFM, 10-15 LPM NRB?
1-4 LPM NC: 24%-44%
6-5 LPM SFM: 35%-55%
10-15 LPM NRB: >60%-90%
How is correct ETT placement confirmed?
Chest radiograph or ultrasound
What is an appropriate ETT cuff inflation pressure?
<20-25 cm H2O
Is cricoid pressure recommended during ETT intubation of pediatric patients?
No
What is normal urine output for infants and older children?
Infants & young children: 1.5-2 mL/kg/hr
Adolescents: 1 mL/kg/hr
What is the preferred IO site in infants and children?
Anterior proximal tibia
What rhythms warrant synchronized cardioversion in the unstable patient?
SVT
A-Fib
A-Flutter
V-Tach w/ a pulse
What is the proper electrical dose during synchronized cardioversion?
0.5-1 Jule/kg
What are shockable rhythms?
V-Fib
Pulseless V-Tach
What is the electrical dose for shockable rhythms?
2 J/kg
What does SAMPLE stand for?
Signs and Symptoms
Allergies
Medications
Past medical history
Last intake/output
Events
