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PALS 2020 > PALS feb 20 Part 1-3 > Flashcards

PALS feb 20 Part 1-3 Flashcards

1
Q

what is the push rate for CPR compressions in infants, children, and adolescents?

A

100 - 120

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2
Q

During compressions, depress the chest __ in or __cm in infants and __ in or __ cm in children.

A
  1. 5 in or 4 cm

2. 4 in or 6 cm

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3
Q

Try to limit interruption of compressions to __ seconds, ideally, only for _______.

A

10 seconds

ventilation

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4
Q

You should provide continuous compressions compressions without pausing for ventilation once ____ _____ is established.

A

Advanced airway.

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5
Q

Each rescue breath should be given over __ second.

A

1 second

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6
Q

What is the ratio for compressions to breaths for a single rescuer?

A

30:2

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7
Q

What is the ratio for compressions to breaths in a 2 or more rescuer scenario?

A

15:2

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8
Q

After an advanced airway is established, deliver __ breaths per minute or __ breath every __ seconds.

A

10
1
6

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9
Q

What is the formula used to identify the fifth percentile for systolic BP

A

70 mmHg + (age in years x 2)

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10
Q

An infant is described as what in years of age.

A child is described as what in years of age.

A

Less than 1 year in age.

from 1 year to puberty.

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11
Q

If you find an unresponsive pediatric pt with no normal breathing but has pulse, what do you ?
When do you initial compressions?
When do you activate the emergency response system?

A

Provide 1 rescue breath every 3-5 seconds or about 12-20 breaths per minute.
Initiate compressions if pulse remains less than 60 with signs of poor perfusion.
After 2 minutes of rescue breathing, activate the emergency response system and begin CPR.

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12
Q

To minimize delay in starting CPR, assess breathing and pulse at the same time, this should take no more than __ seconds.

A

10

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13
Q

Where should you palpate a for a pulse in an infant?

A

bronchial artery, upper arm

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14
Q

Where should you palpate for a pulse in a child?

A

carotid or femoral artery, in either the neck or the groin.

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15
Q

If the victim is not breathing normally and has no pulse, what are your priorities?
First 3 steps.

A

Leave the victim and activate the emergency response system or code team.
Go get or send someone for an AED.
Begin high quality CPR for 2 minutes.

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16
Q

What should you use to deliver compressions in an infant.

Child?

A

2 finger chest compressions.

One or two hands.

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17
Q

After initiating CPR, if you are still alone and have not activated the emergency response system, what do you do?

A

Leave the victim to activate the emergency response system and find an AED. Use the AED as soon as possible.

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18
Q

After using the AED, whether shock completed or no shock advised, you begin CPR starting with what?

A

compressions.

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19
Q

What are 4 signs of poor perfusion?

A

Cool extremities
altered mental status
pulslessness
skin color; paleness, mottled, patchy, and later cyanotic

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20
Q

True or False

The single rescuer compression to ventilation ratio is the same in adults, children, and infants.

A

True

The universal rate is 100 to 120 per minute with a ratio of 30:2

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21
Q

What is the compression to ventilation rate for 2 rescuer for a child or infant?

A

15:2

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22
Q

For infants, the single rescuer should use what technique for compressions.
Multiple rescuers should use what technique?

A

Two finger technique.

Multiple rescuers should use the 2 thumb encircling hands technique.

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23
Q

For an infant, what is the preferred method of delivering compressions?

A

the 2 thumb encircling hands technique.

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24
Q

After every __ compressions, pause and give __ rescue breaths lasting __ second each using the what technique?

A

15
2
1

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25
Q

Two rescuers should switch roles every __ cycles or __ minutes.

A

5

2

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26
Q

What are the three reasons you would stop performing CPR?

A

AED arrives
Advanced providers arrive
the child begins to breath, move, or otherwise respond.

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27
Q

What are the two methods of opening the airway?

A

head tilt, chin lift

jaw thrust.

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28
Q

For AED, use child pads, if available for infants and children under __ years of age. What do you do if you don’t have child pads?

A

8 years of age

If you don’t have child pads use adult pads, because a higher shock is better than no shock.

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29
Q

What type of AED is best for infants.

What is the next best thing.

A

A manual defibrillator, which can deliver a lower dose shock. It’s use is not covered in the PALS course.
The next best thing is an AED with a pediatric dose attenuator.

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30
Q

What are the three components of the pediatric assessment triangle?

A

Appearance
Work of breathing
Circulation

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31
Q

This three step ongoing process is a core component of systematic evaluation and care of the seriously ill or injured child.

A

Evaluate-identify-intervene

32
Q

The PAT uses an A-B-C evaluation status. What is PAT and what does the A, B, and C stand for?

A

Pediatric assessment triangle
Appearance
work of Breathing
Circulation

33
Q

When assessing the appearance of a child, what is the mnemonic that can be used as an adjunct?

A

TICLS

34
Q

What does TICLS stand for, and what part of the PAT is it used as an adjunct?

A 
Tone
Interactiveness 
Consolability
Look/gaze 
Speech/cry
35
Q

What are some abnormal findings when assessing a childs breathing?
Positioning 4
Sounds

A

tripod, nasal flaring, use of accessory muscles. Normal expirations should be passive.
Wheezing, grunting, stridor

36
Q

A flushed appearance may suggest a child with a fever, or what?

A

distributive shock such as with sepsis, toxins, or anaphylaxis.

37
Q

You may see evidence of bleeding within the skin, called ____ or ____. This purplish discoloration of the skin is often a sign of what?

A

petechiae or purpura

May be a sign of a life threatening infection

38
Q

Use this sequence every time there is a change in the childs condition or intervention.
What is the sequence and give some examples of interventions.

A

Evaluate
identify
intervene
Interventions; fluid boluses, oxygen

39
Q

What is the difference between the use of the PAT and a primary assessment?

A

The pediatric assessment triangle is used for an across-the-room assessment.
The primary assessment uses an ABCDE approach

40
Q

In the primary assessment, what does ABCDE stand for?

A 
Airway
Breathing
Circulation
Disability
Exposure
41
Q

If a child is less than one year of age, is responsive, has a complete airway obstruction(unable to make sound), what should you do?

A

give 5 back slaps, 5 chest thrusts

42
Q

If a child is more than one year of age, is responsive, has a complete airway obstruction(unable to make sound), what should you do?

A

Give abdominal thrusts.

43
Q

What are 4 advanced airway interventions that may be used to maintain patency?

A

ET tube
CPAP
removal of the foreign body via laryngoscopy
cricothyrotomy (needle puncture or surgical opening through the skin and cricothyroid membrane and into the trachea below the vocal cords).

44
Q

Primary assessment
Breathing
what are 5 things to look for?

A 
respiratory rate
respiratory effort
chest expansion
lung and airway sounds 
O2 saturation
45
Q

what are the normal breaths per minute for an infant?

A

30-53

46
Q

what are the normal breaths per minute for a toddler?

A

22-37

47
Q

what are the normal breaths per minute for a preschooler?

A

20-28

48
Q

what are the normal breaths per minute for a school aged child?

A

18-25

49
Q

what are the normal breaths per minute for an adolescent?

A

12-20

50
Q

A consistent respiratory rate of less than __ or more than __ breaths per minute in a child of any age is often abnormal and warrants further assessment for the presence of a potentially serious condition.

A

10

60

51
Q

Be aware that sleeping infants may have irregular (periodic) breathing with pauses lasting up to __ or even __ seconds.

A

10

15

52
Q

Normal tidal volume is __ to __ ml/kg of body weight throughout life.

A

5 to 7

53
Q

What is the location for lung sounds that is best for evaluating air movement into the lower parts of the lungs?

A

under the armpits

54
Q

What is the name of a short, low pitched sound heard during expiration?
what may is indicate?

A

grunting

a progression from respiratory distress to respiratory failure.

55
Q

____ is a high pitched or low pitched whistling sound that is heard most often during expiration, and less frequently during inspiration.

A

wheezing

56
Q

A pulse oximeter will reflect a falsely ____ reading in the case of carbon monoxide poisoning. Why?

A

false high

the meter does not distinguish oxygen saturated hemoglobin from carboxyhemoglobin

57
Q

Primary assessment

What are 5 things to evaluate?

A 
Heart rate and rhythm
Pulses 
capillary refill time 
skin color and temperature 
blood pressure
58
Q

What is the normal heart rate for a neonate ?

sleeping / awake

A

100-205 / 90-160

59
Q

What is the normal heart rate for an infant?

sleeping / awake

A

100-180/ 90-160

60
Q

What is the normal heart rate for a toddler?

sleeping / awake

A

98-140 / 80-120

61
Q

What is the normal heart rate for a preschooler?

sleeping / awake

A

80-120 / 65-100

62
Q

What is the normal heart rate for a school-aged child?

sleeping / awake

A

75-118 / 58-90

63
Q

What is the normal heart rate for a adolescent?

sleeping / awake

A

60-100 /50- 90

64
Q

_____ can be considered normal, but when accompanied with signs of poor perfusion, warrants intervention.

A

Bradycardia

65
Q

What is the most common cause of bradycardia in pediatrics?

A

hypoxia

66
Q

_____ is a bluish discoloration of the hands and feet and of the skin around the mouth. It is a common normal finding during the newborn period.

A

Acrocyanosis

67
Q

_____ ____ is a bluish discoloration of the hands and feet beyond the newborn period that can be cause by diminished O2 delivery to the tissues.

A

Peripheral cyanosis

68
Q

_____ _____ is a blue color of the lips and other mucous membranes

A

central cyanosis

69
Q

Hypotension in a neonate (28 days or less) is defined as what?

A

SBP < 60

70
Q

Hypotension in a infant is defined as what?

A

SBP < 70

71
Q

Hypotension in a child 1 to 10 years old is defined as what?

A

SBP < 70 + (age in years x 2)

72
Q

Hypotension in a child 10 years or older is defined as what?

A

SBP < 90

73
Q

Primary assessment
Disability
What are 5 assessment measures to evaluate neurological function?

A 
AVPU
TICLS
GCS
Pupils 
blood glucose
74
Q

What does AVPU stand for?

A

Alert, responsive to Voice, responsive to Pain, Unresponsive

75
Q

hypoglycemia refers to blood glucose lower than __ in an infant and less than __ in a child.

A

45

60

PALS 2020 (3 decks)

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