PALS Flashcards
H’s & T’s
Hypovolemia Hypoxia Hydrogen Ion (acidosis) Hypoglycemia Hypo/hyper K Hypothermia
Tension Pneumo Tamponade, cardiac Toxins Thrombosis, pulmonary Thrombosis, coronary Trauma
Compressions
- rate
- depth
- ratio
100-120
1/3 depth of chest (infant 1.5 inches, child 2 inches)
30:2 1 person
15:2 2 person
Pediatric defib sequence
2 J/kg
4 J/kg
10 J/kg max
Cardiac arrest epi dose
1: 10000 concentration
0. 01mg/kg (0.1ml/kg)
Every 3-5 minutes
Epi ET route dose
0.1 mg/kg (1:1000 ratio)
Pediatric cardiac arrest amiodarone dose
5mg/kg - May repeat up to 2x
Pediatric cardiac arrest lidocaine dose
1mg/kg loading dose
Maintenance: 20-50mcg/kg/minute
ET tube sizing formula
Cuffed: age/4 + 3.5
Uncuffed: age/4 + 4
Ventilation rate during cardiac arrest if intubated
1 breath every 6 seconds (10/min)
With continuous compressions
Pediatric bradycardia atropine dose
0.02mg/kg
Minimum 0.1, maximum 0.5
May repeat once
What HR is considered bradycardia for ped’s?
There is no specific number - it is relative to the age and activity of the child
Normal QRS duration for pediatrics
Less than or equal to 0.09 sec (90ms)
Adults are 120ms
Stable but symptomatic SVT interventions (after 12-lead)
Unstable?
Vagal maneuvers (no delays)
Adenosine if IV access
Synchronized cardioversion
Wide complex tachycardia with a pulse interventions
Unstable? Synchronized cardioversion
Stable? Adenosine if regular and monomorphic. Consider amiodarone
Pediatric synchronized cardioversion dose
Start 0.5-1 J/kg
Increase to 2 J/kg
Pediatric adenosine dose
1st : 0.1mg/kg
2nd 0.2mg/kg
Pediatric wide complex tachycardia with a pulse. Amiodarone dose?
What is another drug alternative to amiodarone?
5mg/kg over 20-60 minutes
Procainamide: 15 mg/kg over 30-60 minutes
Fluid bolts for hypotension pediatrics
20ml/kg
10ml/kg if poor cardiac function suspected
10ml/kg for neonates
Bradycardia treatment order
- Epi
- Atropine
- TCP
TCP starting settings
60-70 Ppm
20-30 mA
Where should pulses be checked for
Infants?
Children?
Infants - brachial
Child - carotid
ROSC
Hypotensive shock epi dose
Normotensive?
Hypotensive 0.1-1 mcg/kg/min
Normotensive 0.1-0.3 mg/kg/min
ROSC
Hypotensive shock dopamine dose?
Normotensive shock dose?
Hypotensive: 10-20 mcg/kg/min
Normotensive: 2-20 mcg/kg/min
ROSC
Hypotensive shock norepinephrine dose
0.1-2 mcg/kg/min
Dopamine quick calculation method
Pounds divided by 10, minus 2
= drips/min with a 60 drip set
Pediatric hypoglycemia dose
D25 2-4ml/kg
0.5g/kg
Cardiac arrest torsades mag dosage?
25-50 mg/kg IVP
