PALS Flashcards
Lidocaine Vs Ami
No proof to prove difference
Epi
Improves survival prehospital but no proof for hospital discharge
eCPR
Oxygenate blood and out it back invbody
Compression depth
Infant 1 1/2
Child 2
Adult 2-2.4
Post Arrest
Noroxemia above 94% oxygen
Aggressive oxygen and don’t let become hypercarbic (don’t Breathing too fast)
Witnessed arrest for ped
911 then CPR.
Unwitnessed arrest
CPR 2 minutes then 911
Airway
Look in airway and position
Breathing
Look retractions
Listen noises
Feel tidal volume
Positions
Circulation
Color
Pulse
Disability
Mental Status
Lethargic, tired, reactive,
Pupils!
Glucose!
Exposure
Temperature
Warm or cold
Hypotension in 1 year to 12
Less than 70mmHg (age x 2)
Neonate
<45bgl
Infants and children
<60bgl
Hypovolemia Shock
Loss of volume due to bleeding, diarrhea and vomiting
Tachycardia and poor perfusion
BP may start high but then fall due to release of catecholamines
Distributive Shock
Septic Shock Tachycardia Warm flushed skin with fast refill Vessels dialate Anaphylaxis as well
Cardiogenic Schock
Poor heart perfusion Arrhythmia, cardiomyopathy Tachycardia High BP PULMONARY congestion
Obstructive Shock
Blood clot, air Embolism, thension pneumo, tamponade
Compensated shock
Adequate or high systolic BP
Hypotensive Shock
Ominous and requires immediate intervention
Fluid Resucitation
Rapid fluid bonuses unless cardiogenic Shock which should be given less rapidly
Cardiogenic 10ml/kg over 10-20 minutes
Other Shock 20ml/kg over 5-10 minutes
Sinus brady
BVM
<60 with poor perfusion start cpr
SVT
Abrupt increase in HR
Stable: vagal maneuver (ice to the face or blowing through straw)
Adenosine:
Unstable: pharmacological and electricity
Synchronized cardio version:
.5-1j/kg
Increase to 2j/kg for other doses
V-Tach
May result from heart disease or from normal hearts
H’s and T’s
Hypoglycemia Tension Pneumo Hypovolemia Tamponade Hypoxia Toxins Hydrogen ion Thrombosis Hyperkalemia Hypokalemia Hypothermia
Manual Defib
2-4j/kg
4j/kg
6j/kg
8j/kg
Post Arrest
Oxygenation ventilation and perfusion
5-10ml/kg over 10-20minutes
Hypothermia 32-34degrees Celcius