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PALS > PALS > Flashcards

PALS Flashcards

1
Q

What are the first six interventions for respiratory emergencies?

A 
Airway positioning
Suctioning
Oxygen
Pulse oximetry
ECG 
BLS as indicated
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2
Q

Four main types for airway emergencies

A

Upper airway emergencies
Lower airway emergencies
Lung tissue disease
Disordered control of breathing

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3
Q

Three upper airway emergencies

A

Croup
Anaphylaxis
Aspiration of a foreign body

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4
Q

Two types of lower airway emergency

A

Bronchiolitis

Asthma

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5
Q

Two types of lung tissue disease

A

Pneumonia

Pulmonary edema

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6
Q

Three types of disordered control of breathing

A

Increased ICP
Poisoning/Overdose
Neuromuscular disease

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7
Q

Croup treatment

A

Epi neb

Corticosteroids

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8
Q

Anaphylaxis respiratory treatment

A

IM epi
Salbutamol
Antihistamines
Corticosteroids

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9
Q

Aspiration foreign body treatment

A

Position of comfort

Speciality consultation

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10
Q

Bronchiolitis treatment

A

Nasal suctioning

Bronchodilator trial

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11
Q

Asthma treatment

A 
Salbutamol
Corticosteroids
SQ epi
Magnesium sulphate 
Salbutamol IV
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12
Q

Pneumonia treatment

A

Salbutamol
Antibiotics
Consider CPAP

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13
Q

Pulmonary edema treatment

A

Consider NIV
Consider ventilatory support with PEEP
Consider vasoactive support
Consider diuretic

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14
Q

Increased ICP treatment

A

Avoid hyoxemia
Avoid hypercarbia
Avoid hyperthermia

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15
Q

Poisoning/overdose treatment

A

Antidote

Contact poison control

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16
Q

Neuromuscular disease management

A

NIV or invasive ventilators support with PEEP

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17
Q

Six initial actions in shock management

A 
Oxygen
Pulse oximetry
ECG 
IV/IO access
BLS
BGL
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18
Q

Four types of shock

A

Hypovolemic
Distributive
Cardiogenic
Obstructive

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19
Q

Two types of hypovolemic shock

A

Nonhemorrhagic

Hemorrhagic

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20
Q

Three types of distributive shock

A

Septic
Anaphylactic
Neurogenic

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21
Q

Two types of cardiogenic shock

A

Bradyarrythmia/tachyarrhythmia

Other - CHD, Myocarditis, cardiomyopathy, poisoning

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22
Q

Four types of obstructive shock

A

Ductal dependant
Tension pneumothorax
Cardiac tamponade
Pulmonary edema

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23
Q

Nonhemorrhagic shock treatment

A

20 ml/kg NS/LR prn

Consider colloid

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24
Q

Hemorrhagic shock treatment

A

Control external bleeding
20 ml/kg NS/LR repeat up to three times
Transfuse PRBCs

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25
Q

Septic shock treatment

A

Refer to septic shock management algorithm

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26
Q

Anaphylactic shock treatment

A 
IM epi
Fluid bolus 20 ml/kg
Salbutamol
Antihistamines, corticosteroids
Epinephrine infusion
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27
Q

Neurogenic shock treatment

A

20 ml/kg NS/LR prn

Vasopressors

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28
Q

Cardiogenic shock treatment

A

Management algorithms

Brady/Tachy

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29
Q

Other cardiogenic shocks

A

5-10 ml/kg bolus prn
Vasoactive infusion
Expert consult

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30
Q

Ducal dependant shock treatment

A

Prostaglandin E

Expert consult

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31
Q

Tension pneumothorax shock treatment

A

Decompression

Tube thoracostomy

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32
Q

Cardiac tamponade shock treatment

A

Pericardiocentesis

20 ml/kg NS/LR

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33
Q

Pulmonary embolism shock treatment

A

20 ml/kg NS/LR prn
Consider thrombolitics, anticoagulants
Expert consult

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34
Q

Two initial actions in cardiac arrest

A

O2

Attach monitor

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35
Q

Which rhythm is shockable

A

VF/pVT

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36
Q

Reassess how often in cardiac arrest

A

2 minutes

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37
Q

PEA/asystole actions?

A

IV/IO access
2 minute cycles of CPR
Epi every 3-5
consider advanced airway

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38
Q

VF/pVT actions

A 
IV/IO
2 minute cycles of CPR
If shockable rhythm defibrillate
Epi every 3-5 min
Consider advanced airway
Consider amiodarone or lidocaine
Hs & Ts
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39
Q

Quality CPR criteria

A 
1/3 of chest
100-120/min
Minimize interruptions
Avoid excess ventilation 
Rotate compressors every 2 minutes
40
Q

Defibrillation energy dose

A

First shock: 2 J/kg
Second shock: 4 J/kg
Increase voltage to gradually to max of 10 J/kg

41
Q

Cardiac arrest Epi dose

A

0.01 mg/kg q 3-5 min

42
Q

Cardiac arrest amiodarone dose

A

5 mg/kg bolus May repeat up to 2 times

43
Q

Cardiac arrest lidocaine

A

1 mg/kg loading dose

44
Q

Estimating uncuffed endotracheal tube formula

A

(Age/4)+4

45
Q

Cuffed endotracheal tube formula

A

(Age/4)+3.5

46
Q

Cardiac arrest signs of rosc

A

Pulse/BP

Spontaneous arterial pressure wave on invasive monitoring

47
Q

Cardiac arrest Hs

A 
Hypovolema
Hypoxia
Hydrogen ion (acidosis)
Hypoglycaemia
Hypo/hyperkalemia 
Hypothermia
48
Q

Cardiac arrest Ts

A 
Tension pneumo 
Tamponade
Toxin
Thrombosis - cardiac
Thrombosis - pulmonary
49
Q

Cardiac arrest breaths per minute

A

10/min

1 every 6 seconds

50
Q

Four signs of upper airway obstruction

A

Increased RR and effort
Stridor
Change in voice
Drooling, snoring or gurgling sounds

51
Q

Five signs of lower airway obstruction

A 
Increased RR and effort
Decreased air movement on auscultation 
Prolonged exploratory phase
Wheeze
Cough
52
Q

Six signs of lung tissue disease

A 
Increased RR and effort
Grunting
Crackles
Diminished breath sounds
Tachycardia
Hypoxemia despite O2 admin
53
Q

Three signs of disordered control of breathing

A

Irregular rate and pattern of breathing
Shallow or inadequate effort
Apnea

54
Q

Bradycardia 5 initial actions

A 
Maintain patent airway
Oxygen
Monitor - rhythm, BP and Spo2
IV/IO
12-lead
55
Q

Bradycardia with S/S if cardiopulmonary compromise treatment?

A

HR <60 despite O2 and ventilation then CPR

56
Q

Bradycardia persists after 02, ventilation and CPR?

A

Epinephrine
Atropine
Consider TCP
Treat underpaying cause

57
Q

Epi dose for Bradycardia

A

0.01 mg/kg q 3-5 min

58
Q

Atropine dose for Bradycardia

A

0.02 mg/kg - 1 repeat
Min dose 0.1 mg
Max dose 0.5 mg

59
Q

Three initial approach criteria

A

Appearance
Breathing
Circulation

60
Q

Five initial actions in tachycardia

A 
Maintain airway
Oxygen
Monitor
IV/IO
12-lead - without delaying therapy
61
Q

Five sinus tachycardia criteria

A 
Compatible history
P wave present/normal
Variable R-R constant PR
Infant rate <220
Child rate < 180
62
Q

Five SVT criteria

A 
Compatible history
Abnormal or absent P waves
HR not variable
Infants rate >220
Child rate > 180
63
Q

Possible VT with cardiopulmonary compromise treatment?

A

Synchronized cardioversion

64
Q

Possible VT without cardiopulmonary compromise treatment?

A

Consider adenosine - in regular and monomorphic

Expert consult - amiodarone or procainamide

65
Q

Probable sinus tachycardia treatment?

A

search for and treat cause

66
Q

Probable SVT treatment?

A

Consider vagal maneuver
Consider adenosine
Consider cardioversion if adenosine unavailable or ineffective

67
Q

Synchronized cardioversion dose?

A

Consider sedation
0.5-1 J/kg then increase to
2 J/kg

68
Q

Adenosine SVT dose?

A

First dose: 0.1 mg/kg max of 6 mg

Second dose: 0.2 mg/kg max of 12 mg

69
Q

Amiodarone SVT dose?

A

5 mg/kg over 20-60 min

70
Q

Procainamide SVT dose?

A

15 mg/kg over 30-60 min

71
Q

Procainamide is incompatible to administer with which drug?

A

Amiodarone

72
Q

Amiodarone is incompatible to administer with which drug?

A

Procainamide

73
Q

Normal HR for neonate awake/asleep?

A

Awake 100-205

Asleep 90-160

74
Q

Normal HR for infant awake/asleep?

A

Awake 100-180

Asleep 90-160

75
Q

Normal HR for toddler awake/asleep?

A

Awake 98-140

Asleep 80-120

76
Q

Normal HR for preschooler awake/asleep?

A

Awake 80-120

Asleep 65-100

77
Q

Normal HR for school aged awake/asleep?

A

Awake 75-118

Asleep 58-90

78
Q

Normal RR for adolescent?

A

12-20

79
Q

Normal RR for infant?

A

30-53

80
Q

Normal RR for toddler?

A

22-37

81
Q

Normal RR for preschooler?

A

20-28

82
Q

Normal RR for school aged child?

A

18-25

83
Q

Five sign of septic shock

A 
Altered mental status
Altered heart rate
Altered temperature
Altered perfusion
Hypotension
84
Q

Six actions of initial stabilization in sepsis

A 
ABCs
Monitor
IV/IO
Antibiotics
Fluid bolus
Antipyretic
85
Q

Septic signs of shock do not persist past initial stabilization?

A

Consider critical care consult

86
Q

Septic signs of shock persist beyond initial stabilization?

A

Obtain expert consult
Warm shock: norepinephrine
Cold shock: epinephrine
Dopamine is backup if other pressures are unavailable

87
Q

Four sepsis critical care goals of therapy?

A

Scvo2 >70%
Adequate BP
Normalized HR
Adequate CO and organ perfusion

88
Q

Sepsis Scvo2 <70, poor perfusion with cold extremities treatments despite epinephrine ? (6)

A

Fluid boluses
Transfusion if Hgb <100
Epinephrine infusion
If BP low consider adding norepinephrine
If BP normal consider milrinone or vasodilator
Consider inotrope

89
Q

Sepsis with Scvo2 >70, poor perfusion and warm extremities despite norepinephrine? (3)

A

Fluid boluses prn
Continue Norepinephrine
Consider pressors and inotropes as needed

90
Q

Sepsis Scvo2 >70 signs of shock resolves after initial vasopressor?

A

Monitor in ICU

Treat infection source

91
Q

Management of shock after ROSC initial three actions?

A

Titrations FiO2 to SpO2 of 94-99%
Consider advanced airway
Target PCO2 appropriate for pt condition

92
Q

Shock post ROSC three treatments for persistent shock?

A

Treat contributing factors (Hs, Ts)
Boluses 20 ml/kg
Consider inotropes or vasopressors

93
Q

Three post ROSC hypotension shock medications?

A

Epinephrine
Dopamine
Norepinephrine

94
Q

Four medications for post ROSC normotensive shock?

A

Dobutamine
Dopamine
Epinephrine
Milrinone

95
Q

Post ROSC care after pressors and inotropic support? (6)

A

Treat agitation or seizures
Treat hypoglycaemia
Blood gas and electrolytes
If comatose targeted temperature management
Consider consult and transport to tertiary care

PALS (1 decks)

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