PALs

Question 1

what is the major cause of cardiac arrest in pediatrics

Answer 1

respiratory failure

Question 2

how old is a child

Answer 2

age 1 until puberty (armpit hair and boobs)

Question 3

what is the compression to breath ratio with one person vs 2 person

Answer 3

30: 2
15: 2

Question 4

what is the minimum depth of compression for pediatrics

Answer 4

2 inches

Question 5

what is the best practice rate for CPR

Answer 5

100-120

Question 6

how do you give breaths

Answer 6

watch for chest rise and dont give more then that because it can cause air to enter the stomach leading to vomiting

Question 7

what do you do if you witness a collapse

Answer 7

call for help right away

Question 8

what do you do if you walk into a room with a collapsed patient

Answer 8

preform 2 mins of CPR before calling for help

Question 9

special considerations for infant CPR

Answer 9

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.

Question 10

CPR initation infant vs child

Answer 10

check brachial pulse vs carotid for 5-10 seconds before starting compressions

Question 11

how do you fix choking infant

Answer 11

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.

Question 12

choking considerations

Answer 12

never do a blind finger sweep but if you see the object and think you can get it then go for it.

Question 13

anatomic difference between adults and children

Answer 13

children have shorter and narrower airways (this is why theyre at higher risk for airway infections) additionally the tongue is bigger

Question 14

Upper airway obstruction signs

Answer 14

1. stridors
2. croup
3. respiratory distress

Question 15

Lower airway obstruction

Answer 15

1. Grunting
2. Crackles
3. Wheezing (with a prolonged expiratory time)

Question 16

what are examples of low air flow systems

Answer 16

nasal cannula and simple face mask

Question 17

non re-breather considerations

Answer 17

airflow must be atleast 10L in order to make sure the bag does not collapse

Question 18

how high can a high flow nasal cannula go up to

Answer 18

40L

Question 19

what is a bag mask used for

Answer 19

provides positive pressure airflow similar to CPAP and is great for unconscious patients

Question 20

what can cause hypocapnia if the patient is intubated during a code

Answer 20

your CPR is shit and the lungs are not being perfused because you’re shitty CPR sucks

Question 21

Laryngeal mask airway

Answer 21

secondary option to regular intubation. It is easier because the glottis does not need to be visualized.

Question 22

what is the treatment for UAO

Answer 22

nebulized epi vollowed by dextamethasone

Question 23

what is the treatment for LAO

Answer 23

give albuterol then steroids

Question 24

Lung tissue disease

Answer 24

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

Question 25

Disordered control of breathing

Answer 25

1.Characterized by slow and shallow breaths

Question 26

Disordered control of breathing etiology

Answer 26

1. Drug overdose
2. seizures
3. Increased ICP

Question 27

how do you measure an oral airway

Answer 27

from the edge of the mouth to the edge of the mandible

Question 28

how do you measure an NG airway

Answer 28

from the earlob to the nose to the xiphoid process

Question 29

what are the different types of shock

Answer 29

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

Question 30

what do we mean when we say compensated shock

Answer 30

the BP is not low

Question 31

what are the fluid resisitation rates for the shocks

Answer 31

20ml/kg over 10 mins for all shocks expect cardiogenic which is 5-10ml given over 5-20 mins

Question 32

what should you do after giving fluid bolus

Answer 32

check glucose for hypoglycemia

Question 33

Distributive shock treament

Answer 33

1. fluids
2. vasopressors
3. antibiotics within 1 hr for septic shock
   - check for fever, WBCs, and lactic acid

Question 34

cardiogenic treament

Answer 34

1. monitor for s/s of HF

2. use CPAP

Question 35

is bicarb part of AHA guidelines

Answer 35

no b/c its overused but if you’re going to use it then use it at the very end

Question 36

what is the main cause of sinus bradycardia in pediatrics

Answer 36

1.hypoxia

Question 37

treatment for sinus bradycardia

Answer 37

1.epi or atropine

Question 38

AV block treatment

Answer 38

1.pacemaker

Question 39

identifying SVT and how to treat it

Answer 39

abrupt increase in HR that does not change with activity

1. vagal stimulation (slows AV conduction)
2. adenosine

Question 40

V tach with pulse

Answer 40

1.synchronized cardioverison and dfib if no pulse

Question 41

what are the defib rates

Answer 41

0.5-1J/kg is what you start with

Question 42

what are the advantages of defib

Answer 42

does not require synch and can give higher energy doses

Question 43

what is the main cause of asystole

Answer 43

1. Hypoxia
2. Start CPR right away for atleast 2 mins
3. Give epi 0.01 mg/kg repeat every 3-5 mins

Question 44

Pulseless electrical activity major causes

Answer 44

1. hypoglycemia

2. hypovolemia

Question 45

treatment PEA

Answer 45

1. Start CPR right away

2. give fluids