New Pediatric Protocols - 1-1-17 Flashcards
Any patient under what age is considered a “pediatric patient?”
15 years
Explain the three parts of the Pediatric Assessment Triangle (PAT).
Appearance:
- TICLES mnemonic
Work of breathing -
Circulation -
Explain the “TICLES” mnemonic
This is the appearance portion of the PAT. They might be “alert,” by AVPU, but still ill.
T - Muscle tone
I - Interactiveness with others
C - Consolability - Can they be consoled by caregiver?
L - Look/gaze - “glazed over?”
E - “empty”
S - Speech/cry - Is it a strong cry? Confused/garbled?
Explain the “Work of breathing” portion of the PAT
Abnormal airway sounds?
Abnormal position?
Retractions?
Flaring of nostrils?
Explain the “Circulation” portion of the PAT
Pallor - white/pale skin
Mottling - Patchy skin 2/2 to vasoconstriction OR vasodilation
Cyanosis - bluish discoloration of skin/mucous membranes
Why is monitoring for shock important in children?
Children have excellent compensatory mechanisms. They will maintain normal vital signs for quite some time, until they are unable to maintain perfusion.
The “first line” drug for control of pediatric pain is ____.
a. Aspirin
b. Ketoralac
c. Morphine
d. Fentanyl
c. morphine
Current AHA guidelines for pediatric arrest includes what ventilation:compression ratio in two rescuer CPR?
15:2 w/o advanced airway.
Under what heart rate do you begin pediatric CPR?
A. 30 BPM
B. 40 BPM
C. 50 BPM
D. 60 BPM
D. 60 BPM
If pediatric defibrillation pads are unavailable, how should adult pads be placed on the pediatric patient?
Anterior-posterior placement
- Anterior: center of chest
- Posterior: back between shoulder pads
Initial dose of V-fib/Pulseless V-tach for pediatric patients.
2 J/kg
What is the MINIMUM dose of pediatric 1:10,000 IV/IO epinephrine in cardiac arrest?
0.1 mg (0.1 mg/mL)
Formulation:
1 mg/10mL = 0.1mg/mL
For refractory V-fib/V-tach, what drug is administered in pediatric patients?
5 mg/kg IV/IO amiodarone
In the pediatric patient, what is the second dose of defibrillation?
4 J/kg
In the pediatric patient, what are the treatments of hypoglycemia?
0-1 month: dilute D25 1:1 with sterile water, 2 mL/kg IV/IO
1 month - 2 years: D25 2mL/kg IV/IO
Over 2 years: D50 2 ml/kg IV/IO
Which of the following accounts for the largest amount of pediatric seizures?
A. Fever
B. Hypoglycemia
C. Trauma
D. Overdose
A. Fever
What is the IN/IM dose of Midazolam for pediatric patients?
0.2 mg/kg IN/IM over 1 minute
What is the IO/IV dose of pediatric Midazolam for seizures?
0.1 mg/kg IO/IV
Epinephrine SQ for pediatric patients.
a. 0.01 mg/kg SQ 1:1000
b. 0.1 mg/kg SQ 1:1000
c. 0.001 mg/kg SQ 1:000
d. 1 mg/kg SQ 1:000
a. 0.01 mg/kg SQ 1:1000
Epinephrine IV for pediatric patients with allergic reaction/anaphylaxis
a. 0.01 mg/kg IV 1:10,000
b. 0.1 mg/kg IV 1:10,000
c. 0.001 mg/kg IV 1:100,00
d. 1 mg/kg IV 1:100,000
a. 0.01 mg/kg IV 1:10,000
IV fluid therapy for pediatric patients in anaphylaxis/allergic reaction with hypotension.
20 mL/kg
In the event of a pediatric patient is found to be contaminated, what must be done to remove up to 90% of the contaminant?
a. Remove the pt’s clothing
b. Irrigate the entire body with 1L NS
c. Irrigate the entire body with 1L sterile water
d. Brush off all visible contaminants from the pt’s clothing
a. Remove the pt’s clothing
With a medical control order, a pediatric patient may be given ____ in the event of a KNOWN ASA/TCA overdose.
a. 1 gm CaCl2 IV
b. 1 mEq/kg sodium bicarb IV
c. 2mL/kg D50 IV
b. 1 mEq/kg sodium bicarb IV
NaHCO3 acts to neutralize (HCO3-) the excess H+ produced through TCA/ASA ingestion.
In the event of nerve agent/organophosphate exposure in the pediatric patient, what should be given after establishing contact with medical control?
a. 1 gm CaCl2 IV
b. 1 mEq/kg sodium bicarb IV
c. 2mL/kg D50 IV
d. 0.02 mg/kg atropine IV
d. 0.02 mg/kg atropine IV
Overall care for the injured pediatric patient involves:
a. oxygenation
b. rapid transport
c. blood glucose monitoring
d. cardiac monitoring
b. rapid transport
