PALs Flashcards
what is the major cause of cardiac arrest in pediatrics
respiratory failure
how old is a child
age 1 until puberty (armpit hair and boobs)
what is the compression to breath ratio with one person vs 2 person
30: 2
15: 2
what is the minimum depth of compression for pediatrics
2 inches
what is the best practice rate for CPR
100-120
how do you give breaths
watch for chest rise and dont give more then that because it can cause air to enter the stomach leading to vomiting
what do you do if you witness a collapse
call for help right away
what do you do if you walk into a room with a collapsed patient
preform 2 mins of CPR before calling for help
special considerations for infant CPR
use only 2 fingers or two thumbs (if you have two ppl) and compress 1.5 inches instead of 2. compression to breath ratio is the same.
CPR initation infant vs child
check brachial pulse vs carotid for 5-10 seconds before starting compressions
how do you fix choking infant
have them lying prone on your forearm as you give back slaps. You should use the arm theyre laying on to straighten their neck and open their mouth.
choking considerations
never do a blind finger sweep but if you see the object and think you can get it then go for it.
anatomic difference between adults and children
children have shorter and narrower airways (this is why theyre at higher risk for airway infections) additionally the tongue is bigger
Upper airway obstruction signs
- stridors
- croup
- respiratory distress
Lower airway obstruction
- Grunting
- Crackles
- Wheezing (with a prolonged expiratory time)
what are examples of low air flow systems
nasal cannula and simple face mask
non re-breather considerations
airflow must be atleast 10L in order to make sure the bag does not collapse
how high can a high flow nasal cannula go up to
40L
what is a bag mask used for
provides positive pressure airflow similar to CPAP and is great for unconscious patients
what can cause hypocapnia if the patient is intubated during a code
your CPR is shit and the lungs are not being perfused because you’re shitty CPR sucks
Laryngeal mask airway
secondary option to regular intubation. It is easier because the glottis does not need to be visualized.
what is the treatment for UAO
nebulized epi vollowed by dextamethasone
what is the treatment for LAO
give albuterol then steroids
Lung tissue disease
1.similar symptoms to LAO but the treatment is just to give high O2 concentrations and if that doesnt help then give them bag mask ventilation and if that doesnt work prepare to intubate
Disordered control of breathing
1.Characterized by slow and shallow breaths
Disordered control of breathing etiology
- Drug overdose
- seizures
- Increased ICP
how do you measure an oral airway
from the edge of the mouth to the edge of the mandible
how do you measure an NG airway
from the earlob to the nose to the xiphoid process
what are the different types of shock
1.Hypovolemic
-most commonly caused by vomiting/diarrhea
2.Distributive
Examples include anaphylatic and septic shock. Not enough blood is flowing to some tissues and to much is flowing to others
3.Cardiogenic
-Poor myocardial function r/t decreased perfusion to the heart. You have tachycardia with severe vasoconstriction leading to a increase in cardiac workload
4.Obstructive
-you have something blocking bloodflow to the heart or lungs such as an emboli
what do we mean when we say compensated shock
the BP is not low
what are the fluid resisitation rates for the shocks
20ml/kg over 10 mins for all shocks expect cardiogenic which is 5-10ml given over 5-20 mins
what should you do after giving fluid bolus
check glucose for hypoglycemia
Distributive shock treament
- fluids
- vasopressors
- antibiotics within 1 hr for septic shock
- check for fever, WBCs, and lactic acid
cardiogenic treament
- monitor for s/s of HF
2. use CPAP
is bicarb part of AHA guidelines
no b/c its overused but if you’re going to use it then use it at the very end
what is the main cause of sinus bradycardia in pediatrics
1.hypoxia
treatment for sinus bradycardia
1.epi or atropine
AV block treatment
1.pacemaker
identifying SVT and how to treat it
abrupt increase in HR that does not change with activity
- vagal stimulation (slows AV conduction)
- adenosine
V tach with pulse
1.synchronized cardioverison and dfib if no pulse
what are the defib rates
0.5-1J/kg is what you start with
what are the advantages of defib
does not require synch and can give higher energy doses
what is the main cause of asystole
- Hypoxia
- Start CPR right away for atleast 2 mins
- Give epi 0.01 mg/kg repeat every 3-5 mins
Pulseless electrical activity major causes
- hypoglycemia
2. hypovolemia
treatment PEA
- Start CPR right away
2. give fluids
