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Bea PPS > PALS > Flashcards

PALS Flashcards

1
Q

Goals of resuscitation

A

To improve the quality of care provided to seriously ill or injured children resulting in improved outcome

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2
Q

Basic Life Support

A
  • check scene safety
  • check responsiveness
  • activate emergency response, ask for an AED
  • check breathing and pulses simultaneously (5-10 secs)
  • start CPR
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3
Q

Where to check for pulses in infant and child?

A

Infant: brachial
Child: carotid

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4
Q

Characteristics of high quality CPR

A
  • push hard
  • push fast
  • allow complete chest recoil
  • minimize interruptions
  • avoid excessive ventilation
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5
Q

What is the chest compression depth in infants and children?

A

At least 1/3 AP diameter of chest in pediatric patients
Infants: 1.5 inches (4 cm)
Child: 2 inches (5 cm)

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6
Q

What is the chest compression depth in adolescents?

A

Follow adult recommendations

- at least 2 inches (5 cm) but no more than 2.4 inches (6 cm)

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7
Q

What is the chest compression rate?

A
  • 100 to 120 compressions per minute
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8
Q

How to Allow complete chest recoil?

A

Avoid leaning on the chest between compressions to allow full chest wall recoil

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9
Q

How much interruption is permitted?

A

Limit to less that 10 seconds

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10
Q

Is the amount of time spent doing high quality chest compressions during CPR

A

Chest compression fraction (CCF)

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11
Q

How many breaths given if 1 rescuer or 2 rescuer?

A

1 rescuer: 30 compressions followed by 2 breaths
2 rescuer: 15 compressions followed by 2 breaths

  • give each breath over 1 second
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12
Q

ECG rhythm interpretation

A
  • heart rate
  • rhythm interval: regular or irregular
  • presence of P wave
  • QRS complex: narrow or wide
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13
Q

Cable connections

A

White lead: right shoulder (RA)
Red lead: left lower ribs (LL)
Black lead: left shoulder (LA)

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14
Q

Sinus tachycardia

A

infants <200 bpm; children <180 bpm

Present P wave

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15
Q

Sinus bradycardia

A

<60 bpm
Regular rhythm
Present P wave
Narrow QRS

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16
Q

Supraventricular tachycardia

A

infants >200 bpm; children >80 bpm
ABSENT P wave

Drug of choice: Adenosine 0.1 m/kg

17
Q

Ventricular tachycardia

A

100-250 bpm
ABSENT P wave
WIDE QRS complex

18
Q

Ventricular Fibrillation

A

150-500 bpm
IRREGULAR CHAOTIC RATE
NO IDENTIFIABLE P WAVE
NO IDENTIFIABLE QRS COMPLEXES

can give Amiodarone

19
Q

NEW UPDATE ON AHA GUIDELINES

- rescue breathing

A

1 breath every 2-3 seconds (20 to 30 breaths per minute)

Before: 1 breath every 3-5 seconds (12 to 20 breaths per minute)

20
Q

NEW UPDATE ON AHA GUIDELINES

- ventilation rate during CPR with an advanced airway

A

1 breath every 2 to 3 seconds (20 to 30 breaths per minute)

Before: 1 breath every 6 seconds (10 breaths per minute)

21
Q

NEW UPDATE ON AHA GUIDELINES

- cuffed endotracheal tubes

A

CHOOSE CUFFED ETTS over uncuffed ETTs for intubating infants and children

  • pay attention to ETT size, position, and cuffe inflation pressure (usually <20 to 25 cm H20)
  • decreased need for reintubation
  • decrease risk for aspiration
  • subglottic stenosis is rare
22
Q

NEW UPDATE ON AHA GUIDELINES

- cricoid pressure during intubation

A

Insufficient evidence to recommend routine application to prevent aspiration during ET intubation in children

23
Q

NEW UPDATE ON AHA GUIDELINES

- emphasis on early epinephrine administration

A

Administer the initial dose of epinephrine WITHIN 5 MINUTES FROM THE START OF CHEST COMPRESSIONS

24
Q

NEW UPDATE ON AHA GUIDELINES

- invasive blood pressure monitoring to assess CPR quality

A
  • maybe recommended for rescuers to use blood pressure to guide CPR quality
  • favorable outcome: infants 25 mmHg, children 30 mmHg
25
Q

NEW UPDATE ON AHA GUIDELINES

- detecting and treating seizures after ROSC

A
  • continuous EEG monitoring in pts with persistent encephalopathy
  • treat clinical seizures
  • treat noncinvulsive status epilepticus following cardiac arrest
26
Q

NEW UPDATE ON AHA GUIDELINES

- evaluation and support for cardiac arrest survivors

A
  • Neurologic evaluation for at least 1 year after the arrest

- evaluated for rehabilitation services

27
Q

NEW UPDATE ON AHA GUIDELINES

- fluid boluses

A

10 ml/kg or 20 ml/kg aliquots with frequent reassessment

Old: 20 ml/kg initial bolus

28
Q

NEW UPDATE ON AHA GUIDELINES

- choice of vassopressor

A

Fluid refractory shock

  • epinephrine or norepinephrine
  • if not available may consider dopamine
29
Q

NEW UPDATE ON AHA GUIDELINES

- corticosteroid administration

A

Unresponsive to fluids and requiring vasoactive support

- consider stress-dose corticosteroids

30
Q

NEW UPDATE ON AHA GUIDELINES

- hemorrhagic shock

A

Hypotensive hemorrhagic shock following trauma

- administer BLOOD PRODUCTS if available

Bea PPS (4 decks)

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