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ACP 250 Special Pops > PALS > Flashcards

PALS Flashcards

1
Q

In hospital chain of survival

A

Early recognition/prevention
Activation of emergency response
High quality CPR
Advanced resuscitation
Post-arrest care
Recovery

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2
Q

Out of hospital chain of care

A

Prevention
Activation of emergency response
High quality CPR
Advanced resuscitation
Post arrest care
Recovery

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3
Q

When to start CPR

A

Pulseless
HR less than 60

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4
Q

CPR compression to ventilation ratio

A

30:2 (1 rescuer)
15:2 (2 rescuer)
Asynchronous (advanced airway)

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5
Q

Maximum amount of time between compressions

A

10 seconds

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6
Q

Chest compression fraction goal

A

80%

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7
Q

Team leader role

A

Organization
Monitor performance
Back up team members
Models team behaviour
Trains and coaches
Facilitates understanding
Focus on pt care
Designates a temp if required.

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8
Q

CPR coach roles

A

Coordinate start of CPR
Coach quality of compressions
State mid-range targets
Coach to mid-range targets
Help minimize compression pauses

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9
Q

Members of a 6 person high performance team

A

Compressor
CPR coach/defibrillator
Airway
Team lead
IV/IO medications
Timer/recorder

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10
Q

Pediatric Assessment Triangle

A

Appearance
Work of breathing
Circulation

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11
Q

Rescue breathing rates for infants and children

A

1 breath every 2-3 seconds (20-30/min)

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12
Q

TICLS mnemonic for pediatric appearance

A

Tone
Interactivity
Consolability
Look/gaze
Speech/cry

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13
Q

Primary assessment

A

Airway
Breathing
Circulation
Disability
Exposure

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14
Q

Normal RR by age

A

Infant: 30-53
Toddler: 22-37
Preschooler: 20-28
School age: 18-25
Adolescent: 12-20

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15
Q

Apnea classifications

A

20 seconds or longer
Central or obstructive

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16
Q

Location of retractions for mild to moderate respiratory distress

A

Subcostal
Substernal
Intercostal

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17
Q

Location of retractions for severe respiratory distress

A

Supraclavicular
Suprasternal
Sternal

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18
Q

Signs of inadequate respiratory effort

A

Apnea
Weak cry or cough
Bradypnea
Agonal gasps

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19
Q

Adequate SPO2 for children

A

94%

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20
Q

Signs of probable respiratory failure

A

Very rapid or inadequate RR
Absent resp effort
Absent distal air movement
Extreme tachycardia
Bradycardia
Low SPO2 despite high flow O2
DLOC
Cyanosis
Seesaw breathing
Head bobbing

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21
Q

Normal Urine output targets

A

Infant and young child: 1.5-2mL/kg/hr
Older children/adolescents: 1mL/kg/hr

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22
Q

Awake normal HR by age

A

Neonate: 100-205
Infant: 100-180
Toddler: 98-140
Preschool: 80-120
School age: 75-118
Adolescent: 60-100

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23
Q

Asleep normal HR by age

A

Neonate: 90-160
Infant: 90-160
Toddler: 80-120
Preschool: 65-100
School age: 58-90
Adolescent: 50-90

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24
Q

Hypotension SBP by age

A

Term neonate: <60
Infant (1-12mo): <70
Child (1-10yo): <70 + age x 2
Child >10yo: <90

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25
Q

Severity of head injury based on GCS

A

Mild: 13-15
Moderate: 9-12
Severe: 3-8

26
Q

H’s and T’s for reversible cause of cardiac arrest

A

Hypovolemia
Hypoxia
Hydrogen ions
Hypoglycemia
Hypo/hyper K
Hypothermia
Tension pneumo
Tamponade
Toxins
Thrombosis (PE or coronary)

27
Q

Chest compression depth for children (1 year to puberty)

A

1/3 AP diameter or 5cm (2 inch)

28
Q

Chest compression depth in infants (less than 1 year)

A

1/3 AP chest diameter approx 4cm (1 1/2 inch)

29
Q

Shock energy for defibrillation

A

First dose: 2J/kg
Second dose: 4J/kg
Subsequent: >4J/kg to max 10J/kg or adult dose

30
Q

Epinephrine dose (arrest)

A

Administer early.
0.01mg/kg IV/IO to max 1mg every 3-5mins
0.1mg/kg of 1mg/mL endotracheal

31
Q

Amiodarone dose for refractory VF/pVT

A

5mg/kg bolus repeated up to 3 times

32
Q

Lidocaine dose for refractory VF/pVT

A

1mg/kg loading dose

33
Q

Magnesium for torsades dose

A

25 to 50mg/kg to max 2g

34
Q

VF/pVT arrest sequence

A

CPR
Rhythm check
Shock
CPR
Rhythm check
Shock
CPR (give vasopressor)
Rhythm check
Shock
CPR (consider antiarrhythmic)

35
Q

Cardiac arrest sequence PEA or asystole

A

CPR
Rhythm check
CPR (give Epi, ID factors)
Rhythm check
CPR

36
Q

Early signs of tissue hypoxia

A

Tachypnea
Increased resp effort (nasal flaring, retractions)
Tachycardia
Pallor, mottling, cyanosis
Agitation, anxiety, irritability

37
Q

Late signs of tissue hypoxia

A

Bradypnea, apnea, inadequate effort
Increased resp effort (bobbing, seesaw, grunting)
Bradycardia
Pallor, mottling, cyanosis
DLOC

38
Q

Mechanisms of hypoxemia

A

Low atmospheric PO2
Alveolar hypoventilation
Diffusion defect
V/Q mismatch
R-to-L shunt

39
Q

Croup interventions

A

Mild: consider dex
Moderate to severe: Humidified O2, Epi Neb, dex
Resp failure: high flow O2, dex, PPV, ETT or surgical airway

40
Q

Mild asthma

A

Walking, can lie down
Talks in sentences
May be agitated
RR increased
Usually no accessory muscles
Often end expiratory wheeze
HR <100
Absent pulsus paradoxus
PaCO2 <45

41
Q

Moderate asthma

A

Talking in phrases, prefers to sit
Usually agitated
Increased RR
Usually accessory muscles use
Loud wheezes
HR100-120
Pulsus pararoxus may be present
PaCO2 >65 or <45

42
Q

Severe asthma

A

Breathless at rest, speaks in words
Usually agitated
RR often >30
Usually accessory muscle use
Usually loud wheeze
HR >120
Pulsus paradoxus often present
PaCO2 <60 or >45

43
Q

Asthma management

A

Salbutamol and atrovent
Corticosteroid
Mag sulfate
IM epi

44
Q

Clinical parameters of oxygenation and ventilation

A

Chest rise with each breath
SPO2
EtCO2
HR
BP
Distal air entry
Appearance, colour, agitation

45
Q

Target for BVM manometer during breaths

A

Less than 30cmH2O PiP

46
Q

Nasal cannula flow rates and O2 concentration

A

0.25 - 4LPM
22-60% FiO2

47
Q

Simple face mask flow rates and oxygen delivery

A

6-10 LPM
35-60% FiO2
Minimum of 6LPM required

48
Q

NRB flow rates and oxygen delivery

A

10-15LPM
95% FiO2

49
Q

Nebulizer flow rates

A

5-6LPM

50
Q

Equipment checklist for intubation

A

Universal precautions (PPE)
Monitor, SpO2, BP
EtCO2
IV/IO equipment
O2
Suction
OPA/NPA
ETT and stylets
Laryngoscope
3, 5, and 10mL syringe
Adhesive cloth/tape/tube holder
Towel or pad
Special equipment (e.g. SGA and cric)

51
Q

3 factors affecting stroke volume

A

Preload
Contractility
Afterload

52
Q

Lab values to evaluate shock and guide therapy

A

CBC
Glucose
Potassium
Calcium
Lactate
ABG
ScvO2

53
Q

Vasoactive therapy in treating shock

A

Inotropes
PDE inhibitors (inodilators)
Vasodilators
Vasopressors

54
Q

Guide for fluid delivery in shock

A

Hypovolemic/distributive: 20mL/kg over 5-20 mins (5-10min if severe)
Cardiogenic: 5-10mL/kg over 10-20min
Poisoning: 5-10mL/kg over 10-20min
Septic: 10-20mL/kg over 5-20min
DKA: 10-20mL/kg over 1-2hrs

55
Q

Complications of rapid blood administration

A

Hypothermia
Myocardial dysfunction
Ionized hypocalcemia

56
Q

Administration of blood products

A

10mL/kg PRBC (if refractory to 2-3x 20mL/kg bolus fluid)
Order of preference:
Cross matched
Type specific
Type O- (female) or O +- (male)

57
Q

Hypoglycemia by age

A

Neonate: 2.6
Infant/child/adolescent: 3.3

58
Q

Characteristics of SVT

A

Abrupt
S/S of CHF (infant) or palpitations (child)
HR>220 (infant) or >180 (child)
Minimal monitor variability
P waves absent/abnormal/inverted

59
Q

Atropine dose for bradycardia

A

0.02mg/kg min dose 0.1mg max dose 0.5mg. May repeat once

60
Q

Ice to face vagal manoeuvre for infants/children

A

Apply a small plastic bag with ice and water to the upper half of the child’s face for 15-20 seconds.

61
Q

Cardioversion for unstable SVT or VT with a pulse

A

First dose: 0.5J/kg
Second dose: 1J/kg
Subsequent: 2J/kg

62
Q

Estimating maintenance fluid requirements

A

<10kg: 4mL/kg/hr
10-20kg: 40mL/hr + 2mL/kg/hr for each kg between 10-20 kg.
>20kg: weight in kg + 40mL/hr

ACP 250 Special Pops (1 decks)

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