PALS, ACLS medication dosage, etc

Question 1

cpr for pals, compression to breaths ratio, if advanced airway breath is
- how deep chest compressions on child

Answer 1

PALS - 30:2 (compressions to breaths) (for 2 rescuer is 15:2)
advanced airway breaths every 3 seconds. breslow tape for volume, until you see chest rise.
one third the depth of their chest - for depth of compression (per AHA cards)

Question 2

Shock for PALS, in Cardiac arrest

Answer 2

Cardiac arrest defibrillate 2,4,6,8,10 J/kg, 10 is max dose or adult dose

Question 3

Dose of epi in cardiac arrest and bradycardia algorithms pals,
and if can’t get IO or IV then can give?

Answer 3

PALS - IV or IO epi, 0.01 mg/kg
max dose 1 mg
give every 3 (to5) minutes
Endotracheal dose is 0.1 mg/kg (10x)

Question 4

dose of amiodarone pals and when to give
and adult dosages
and the class of antiarrythmic?

Answer 4

class 3 antiarythmic - K channel blocker (potassium)
PALS - 5 mg/kg amiodarone may repeat up to 3 times
cardiac arrest - VF/pulsless VT
there is not any antiarrythmic infusions for the PALS tachycardia algorithms
ADULT - Amiodarone - 300 mg then 150 mg in cardiac arrest
ADULT - can also give for asymptomatic wide complex tachycardia (this situation in children, may just be expert consultation)

Question 5

dose of lidocaine IV/IO PALS,
and what scenario
adult dose of lidocaine

Answer 5

cardiac arrest
PALS - 1mg/kg lidocaine
in cardiac arrest in VF/pulsless VT
Adult -ACLS - cardiac arrest
1 mg/kg (to 1.5) lidocaine (SAME!)

Question 6

H’s and T’s- reversible causes of Cardiac Arrest

Answer 6

Hypovolemia (dehydration, blood loss)
Hypoxia
hydrogen ion (acidosis) - don’t forget!
Hypoglycemia
hypokalemia
hyperkalemia
hypothermia
tension pneumothorax
tamponade, cardiac
toxins - don’t forget!
thrombosis, pulmonary, coronary
kids - hypoxia FIRST

Question 7

PALS - what can you give besides epi in bradycardia?
adult dose?

Answer 7

PALS - Atropine IV/IO - 0.02 mg/kg, may repeat once, max dose is 0.5mg
can do transcutaneous pacing- DONT FORGET
also - adult dose of this is 1 mg atropine every 3-5 minutes with a maximum dose of 3 mg.
also - adults you can also give dopamine and epi infusions as well

Question 8

Adenosine, when to give, dose, pals

Answer 8

give in tachycardia - specifically narrow complex tachycardia OR wide complex that is regular and monomorphic without symptoms

PALS - adenosine IV/IO dose:
1st - 0.1mg/kg adenosine rapid bolus max of 6 mg (like adults)
2nd - 0.2 mg/kg rapid bolus (max second dose of 12 mg)

Question 9

what can you do besides meds in pediatric tachycardia? PALS

Answer 9

PALS
Synchronized cardioversion
begin with 1J/kg
can increase to 2J/kg
so if they are symptomatic (AMS, signs of shock, hypotension) and tachycardic can do synchronized cardio version wether narrow or wide.

Question 10

what heart rates do you get worried about for tachycardia and bradycardia - PALS
what about ACLS algorithms.

Answer 10

PALS
180 for children in tachycardia
60 for children in bradycardia
Adults is 150 for tachy and 50 for brady

Question 11

always remember WHAT? for all (cardiac arrest, bradycardia and tachycardia algorithms?) in both PALS AND ACLS

Answer 11

You can use energy to help the heart.
PALS
Tachycardia - if they have a symptomatic wide complex tachycardia - SYNCHRONIZED CARDIOVERSION
tachycardia - if they have a narrow complex tachycardia - FIRST adenosine (0.1 mg/kg, then 0.2 mg/k) and if ineffective then synchronized cardioversion

bradycardia - pacing - not sure energy for this

Cardiac arrest 2,4,6,8,10 (10 is max) J/kg

ACLS - look up

Question 12

put energy dosage here for adult stuff

Question 13

nitroglycerin dose and route of administration

Answer 13

0.4 mg sublingually