Paediatric Life Support Flashcards
Cardioversion of a SVT - initial dose?
1 j/kg
Temperature post ROSC
Normothermia or mild hypothermia
Head position of infant?
Neutral
What choking technique should not be used in infants?
Abdominal thrusts - due to horizontal position of ribs.
Severe febrile illness without circulatory failure - fluid bolus?
No
What kind of fluid in paeds for any kind of shock?
Isotonic crystalloids
Contraindications to NP?
basal skull fracture
coagulopathy
Sizing of NP
Nostrils to angle of mandible
When SMA useful?
If supraglottic abnormalities causing A problem or BVM (1st line) difficult
What circumstances are cuffed tubes indicated in kids?
Facial burns, poor lung compliance, high airway resistance or large glottis air leak.
Traditionally what kind of tube up to 8 years old?
Uncuffed
Uncuffed tube size?
- Premature neonates
- Full term neonates
- Infants
- Child 1-2years
- Child >2 years
- Gestational age in weeks/10
- 3.5
- 3.5-4.0
- 4.0 - 4.5
- Age/4 +4
Cuffed tube size?
- Premature neonates
- Full term neonates
- Infants
- Child 1-2years
- Child >2 years
- Not used
- Not usually used
- 3.0-3.5
- 3.5-4.0
- Age/4 + 3.5
Cuff inflation pressure?
Less than 25cm H2O
Sudden deterioration in an intubated child?
DOPES - Displacement of tracheal tube Obstruction of tracheal tube etc Pneumothorax Pulmonary disorders - bronchospasm, oedema, hypertension etc Equipment failure
When use air for resus not 100% oxygen?
Neonates
Ventilation rate post ROSC?
12-24 breaths/minute usually
NB chronic conditions etc
Adrenaline dose paeds in CPR
10mcg/kg
Amiodarone dose paeds in VF/VT
5mg/kg bolus
Alternative to amiodarone?
Lidocaine (1mg/kg)
AED Pad size for <10kg and >10kg?
- 4.5cm diameter
2. 8-12 cm
Primary determinant of survival from VF/pVT?
Time to defib
Common causes of bradycardia in paeds
Hypoxia
Acidosis
Severe hypotension
Treatment of SVT paeds?
Adenosine (rapid, near heart, flush with saline) and vagal manoeuvres if stable
If unstable - Dc cardioversion 1J/kg, then 2J/kg - synchronise shock with R wave.
3rd line: amiodarone (NB: for junctional ectopics in postop kids -can worsen in other situations) or procainamide or verapamil (not in infants)
S/e of amiodarone?
Hypotension
Wide complex tachycardia in kids?
Rare.
Supraventricular = more common than ventricular.
Usually underlying heart disease.
Treat: synchronised cardioversion
How to treat pulmonary hypertension if it is cause of arrest?
Emphasis on high Fi O2, alkalosis/hyperventilation (maybe as effective as inhaled nitric oxide in reducing pulmonary vascular resistance).
IV epoprostenol or inhaled nitric oxide.
