PALS Flashcards
Characteristics of respiratory failure
Tachypnea Bradypnea Increased, or decreased respiratory effort Poor to absent distal air movement Tachycardia Bradycardia Cyanosis, stupor, coma
What produces prolonged expiratory and wheezes
Lower airway obstructions
Asthma
Bronchiolitis
Characteristics of respiratory failure
Can result from upper or lower respiratory obstruction, lung disease, and disordered control of breathing
What abnormality would lung tissue disease cause
Respiratory distress or failure
Pneumonia, pulmonary edema, pulmonary contusion, allergic reaction, toxins, vasculitis,
Tachypnea, increased respiratory efforts, grunting, crackles, diminished breath sounds, hypoxemia
Fluid bolus administration
10-20 mL/kg over isotonic crystalloid over 5-20 min
Or smaller bolus of 5-10 mL/kg 10-20 min
What to do for collapsed lung
Needle decompression
Tube thoracostomy
Signs of pneumothorax
Tracheal deviation
Hyperresonance
Diminished breath sounds on affected side
Target oxygen sat when obtaining ROSC
Equal or greater than 94%
What happens after suctioning airway
May increase agitation and respiratory distress
Pulse pulse may change after removing obstruction
Bronchiolitis
Ventilation/perfusion imbalance
Mismatch of ventilation and perfusion
Blood flow through areas inadequately ventilated results in incomplete oxygenation of blood returning to heart
Results in decrease in O2 sat and PcO2
Treat with suction or epi Albuterol treatment
Vagal maneuver for 6 month old
Apply ice to upper half of face for 15-20 seconds
Initial meds for anapalaxis
Chest compression
Large volume of isotonic crystalloid
Epi .01 mg/kg .1mL/kg 1:10,000
Treatment for narrow SVT unstable
12 lead
Vagal
Adenosine 0.1 mg/kg
Synchronized cardioversion 0.5-1 J/kg then 2J/kg
CPR 2 rescuer
15:2
CPR 1 rescuer
30:2
Epi dose
IV, IO 0.01 mg/kg or 0.1 mL/kg 1:10,000
ET 0.1 mg/kg 0.1 mL/kg of 1:1,000
What would be an abnormality after a seizure and irregular respirations
Disordered control breathing
Decreased LOC
Ways to gain vascular access while administering fluid bolus
IV, IO, ET
Treatment for croup, stridor, moderate retractions
Nebulized epi
Corticosteroids (Dexamethasone)
Humidified O2
Hypotensive shock
Develops when physiologic attempts to maintain systolic BP and perfusion are no longer effective
Key sign is deterioration of LOC
Cardiogenic shock
Marked tachycardia high SVR decreased cardiac output, end- diastolic volume within the left and right ventricles is increased resulting in congestion in pulmonary and systemic system
Leads to pulmonary edema, and increased work of breathing
Compensating acting shock
Systolic pressure normal but inadequate tissue perfusion
Body is able to maintain BP despite impaired delivery of O2 and nutrients to vital organs
SVT treatment
Narrow- vagal, adenosine, cardioversion
Wide- cardioversion for unstable
Stable- adenosine, Amiodarone, Procainamide
Sick kid in respiratory arrest poor SpO2
Give O2
Respiratory failure pulse low, no breaths on one side tubed patient
Check tube placement
Check possible pneumothorax
Respiratory distress
Clinical state characterized by abnormal respiratory rate or effort
Rate may increase
Respiratory failure
Clinical state of inadequate oxygenation, ventilation or both
End stage of distress
Little to no respiratory effort
Bradycardia
Disordered control breathing
Inadequate respiratory rat effort or both Causes neurological disorders Seizures CNS infection Brain tumor
Sick kid low BP rr 36 cap less than 2 high fever and lethargic
Sepsis
Septic shock
Hypotension treatment after ROSC
Consider 20 mL/kg isotonic crystalloid fluid bolus Consider vasopressor support Epi Dopamine Norepinephrine
