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Fa: Methods 2 > PALS Scenarios > Flashcards

PALS Scenarios Flashcards

1
Q

the most common cause of bradycardia in kids

A

hypoxia

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2
Q

if there is bradycardia what is the priority over everything else?

A

effective ventilation

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3
Q

when are chest compressions indicated in children?

A

HR below 60

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4
Q

primary bradycardia

A

result of congenital or acquired heart conditions that slow depolarization in the electrical conducting system

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5
Q

secondary bradycardia

A 
any non cardiac condition that slows HR
hypoxia
acidosis
hypothermia
drugs
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6
Q

when is atropine prioritized before epi?

A

there is an increase in vagal tone or vagal response is suspected
cholinergic drug toxicity

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7
Q

should you use atropine as a premediation?

A

no evidence to support routine use of it as premed

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8
Q

PALS algorithm for bradycardia

A

monitors iv o2
open and assist airway
start CPR if HR <60
Other options: epo/atropine/transcut pacing/Hs&Ts

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9
Q

SVT rate infants

A

> 220

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10
Q

SVT rate children

A

> 180

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11
Q

algorithm for sinus tachy stable or unstable

A

monitors iv o2

search for cause and treat

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12
Q

algorithm for stable SVT

A 
monitors iv o2
vagal maneuvers
adenosine up to 2 doses
consult
consider amiodarone or procainamide
consider synch cardiovert
consider reverse causes
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13
Q

first dose adenosine

A

100mcg/kg max 6mg

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14
Q

second dose adenosine

A

200mcg/kg max 12mg

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15
Q

algorithm for unstable SVT

A

same but cardiovert is #1

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16
Q

algorithm for vtach with pulse adequate perfusion

A 
amiodarone or procainamide NOT BOTH
consider adenosine only if monomorphic 
consult
search and treat reversible cause
consider sync cardiovert
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17
Q

algorithm for vtach with pulse poor perfusion

A 
prompt sync cardiovert
amiodarone or procainamide
consider adenosine
consult
search and treat reversible cause
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18
Q

algorithm for vfib/pulseless vtach

A 
shock 2J/kg
CPR 2 min
reanalyze
shock 4J/kg
cpr 2 min 
consider epi 10mcg/kg after 2 shock
consider antiarrhythmic after 3 shock
19
Q

torsades special therapy

A

magnesium after 3 shock

20
Q

algorithm for asystole/PEA

A

CPR 2 min
epi
consider advanced airway/HsTs

21
Q

what are the 4 types of airway scenarios

A

lower airway obst
upper airway obst
lung tissue disease
disordered control breathing

22
Q

treatment for lower airway obstruction

A

supplemental o2
nebulized bronchodilator
airway suctioning
consider labs and diagnostics

23
Q

asthma mild to moderate treatment

A

nebulized bronchodilator
corticosteriods
consider humidified o2

24
Q

asthma moderate to severe treatment

A

subcut epi
subq terbutaline
consider magnesium, bipap, intubation

25
Q

croup treatment

A

steroids
nebulized epi
humidified o2 and heliox
consider intubation

26
Q

anaphylaxis treatment

A

same as asthma and add:
20mL/kg crystalloid
histamine blocker (benadryl or zantac)

27
Q

if a choking pt becomes unconscious what should you do?

A

immediately start CPR even if they have pulse

28
Q

treatment for infectious, chemical, and aspiration pneumonia

A 
diagnostic test
administer o2 and abx
obtain consult
support ventilation (PEEP,Cpap, intub?)
treat wheezing with nebulizer
reduce metabolic demand by normalizing temp
29
Q

cardiogenic pulmonary edema treatment

A

ventilatory support
consider diuretics/inotropes
consider abx if fever
reduce met demand by treating fever

30
Q

non cardiogenic pulmonary edema (ARDS)

A

bilateral infiltrates due to alveolar capillary membrane injury

31
Q

protocol for lung tissue disease

A 
o2
suctioning and breathing treatment
assist airway
abx for pneumonia
diuretics for pulm edema
32
Q

treatment for disordered control of breathing caused by poisoning or OD

A

o2, support and assist airway
give antidote or poison control
(not if was used to treat seizure)
IF bradycardia present that therapy is prioritized

33
Q

treatment for disordered control of breathing caused by increased ICP

A

avoid hypoxemia, hypercardia, hyperthermia
-mild hyperventilation
osmotic agents
neuro consult

34
Q

treatment for disordered control of breathing caused by neuromuscular disease

A

support and assist airway with bag mask or intubation

35
Q

therapeutic endpoints for shock management

A

normal vital signs
good signs of perfusion
normal labs

36
Q

treatment for hypovolemic shock

A

o2, fluid bolus, consider blood transfusion and control hemorrhage
start pressors and consider aline/central line

37
Q

treatment of obstructive shock intubated pt

A

DOPE pneumonic then other treatment

38
Q

treatment of obstructive shock tension pneumo

A

needle decomp.

chest tube placement

39
Q

treatment of obstructive shock cardiac tamponade

A

pericardiocentesis

fluid bolus

40
Q

treatment of obstructive shock pulmonary embolism

A

fluid bolus
consider thrombolytics and anticoags
expert consult

41
Q

treatment of obstructive shock ductal dependent lesion

A

prostaglandin E1

expert consult

42
Q

treatment of septic (distributive) shock

A

o2 monitors ive, labs and identify type of shock in 10-15min
fluid boluses/vasopressors/abx (in first hr)
correct hypoglycemia and hypocalcemia, start invasive lines, consider stress dose steriods and intubation

43
Q

cardiogenic shock treatment

A

o2 monitors
slower fluid bolus (5-10mL/kg)
consider inotropes/diuretic
expert consilt

Fa: Methods 2 (15 decks)

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