PaedsResus(DeAlwis) Flashcards
What compression-ventilation ratio does the ILCOR Neonatal Task Force recommend for resuscitating newborns?
3:1
A pause for ventilation is advised whether or not the infant has an advanced airway.
What compression-ventilation ratio may be more effective for cardiac arrests in infants?
15:2 (two rescuers)
This is more effective than a 3:1 ratio if the arrest is cardiac in nature.
What compression-ventilation ratio should be used for asphyxial or respiratory arrest?
3:1
This provides more effective ventilation, albeit with interrupted CPR.
What is the level of evidence (LOE) for the recommended compression-ventilation ratios?
Poor at best (level 5)
This indicates a lack of strong evidence supporting the recommendations.
What is the recommended compression-ventilation ratio for infants without an advanced airway according to the Pediatric Task Force?
15:2
This includes a pause for ventilation.
What is the preferred technique for emergency ventilation during initial steps of paediatric resuscitation?
BVM (Bag-Valve-Mask)
It remains the preferred technique despite advancements in airway management.
What airway technique has become useful for airway rescue when intubation is difficult?
Laryngeal Mask Airway (LMA)
LMAs are particularly useful in children with airway abnormalities.
What is the risk associated with using LMAs in younger patients?
Increased complication rates
This is observed with decreasing patient age and size.
What is the recommended depth for chest compressions in children?
At least one-third of the anterior-posterior dimension of the chest or approximately 5 cm
This is based on Australian Resuscitation Council guidelines.
What compression technique is strongly preferred for healthcare rescuers?
Two-thumb technique
This is recommended over the two-finger technique.
What are the acceptable tracheal tube types for infants and children during emergency intubation?
Both cuffed and uncuffed tracheal tubes
Both types are acceptable according to ILCOR and ARC recommendations.
What is the Khine formula for estimating cuffed tracheal tube size?
ID (mm) = (age/4) + 3
* Term newborn of 2000–3000 g birth weight: size 3
This formula is used for young children from full-term newborns to 8 years
* Uncuffed tubes: * Term newborn of 2000–3000 g birth weight: size 3.0 mm * Term newborn of >3000 g: size 3.5 mm * Infants ≤6 months of age: 3.5–4 mm * Infants 7–12 months of age: 4 mm * Children over 1 year: size (mm) = age (years)/ 4+4 * Cuffed tubes: * Newborn ≥3 kg and ≤1 year of age: 3mm * Children 1–2 years of age: 3.5mm * Children >2 years of age: size (mm) = age (years)/4 + 3.5
What is the recommended initial dose for cardioversion or defibrillation in children?
2–4 J/kg
This reflects lower success rates with 2 J/kg in termination of VF.
What should be done if there’s doubt about the presence of a pulse during resuscitation?
Begin CPR promptly
This is recommended unless a pulse can definitely be palpated within 10 seconds.
What is the primary cause of cardiorespiratory arrest in children?
Hypoxaemia, hypotension, or both
Various conditions such as trauma and drowning contribute to this.
What should be the first action for a rescuer encountering an unwitnessed collapse of an infant?
Start CPR immediately
After starting CPR, the rescuer should then obtain assistance.
What is the recommended approach for managing children older than 9 years during resuscitation?
Manage according to adult resuscitation guidelines
Clinical judgement should consider the child’s weight, height, and developmental age.
What is the role of Intraosseous (IO) access in paediatric resuscitation?
Provides faster and more reliable access than peripheral routes
This is particularly true when practitioners are trained in their use.
What is the primary purpose of using a nasopharyngeal airway?
To maintain airway patency
It should be of appropriate length from the tip of the nose to the tragus of the ear.
What is the potential risk of intubation in critically unwell children?
It may precipitate critical hypotension with cardiac arrest.
Intubation and mechanical ventilation can decrease the work of breathing and lessen metabolic demand.
What is the IV or IO dose of atropine indicated for bradycardia caused by vagal stimulation?
20 mcg/kg (Class A; Expert Consensus Opinion)
The ETT dose is 30 mcg/kg.
How should bradycardia caused by hypoxaemia be treated?
With ventilation and oxygen, and if unresponsive, with adrenaline.
What is the complication rate of IO insertion?
<1%.
Is IO insertion safe for preterm babies?
Yes, it has been rigorously studied and shown to be effective and safe.
