PCH resus guidelines

Question 1

causes of respiratory failure

Answer 1

asthma
bronchiolitis
aspiration
pnuemonia
foreign body
croup
posioning

Question 2

causes of circulatory failure

Answer 2

anaphylaxis
septic shock
hypovolaemia
congenital heart disease
arrythmia
trauma

Question 3

central neurological failure

Answer 3

raised ICP
infections
trauma
seizures

Question 4

airway assessment

Answer 4

stridor, hoarse voice, neck swelling or brusiing, airway foreign body
resus using: suction, airway mnouvres, airway adjuncts (oropharyngeal or nasopharyngeal airways)
endotracheal intubation, surgical airway

Question 5

breathing assessment

Answer 5

effort: resp rate, nasal flaring, grunt, tracheal tug
efficacy: air entry, chest expansion, O2 sats
effects: heart rate, skin colour, mental status

Question 6

resus for breathing

Answer 6

hgh flow oxygen via non-rebreathing mask with reservoir bag
support ventilation: humidified high flow oxygen, positive end expiratory pressure, bag valve mask ventilation
consider intubation and positive pressure ventilation

Question 7

circulation aassessment

Answer 7

cardiovascular function, tissue perfusion, intravascular volume and control bleeding
- heart rate
- pulse volume
- capillary refill time
- blood pressure

Question 8

resus for circulation

Answer 8

high flow oxygen
IV or inraosseous access with blood collection investigations
bolus of sodium chloride and repeat as necessary
early consideration of inotropes
control external bleeding
treat arrythmias

Question 9

disability

Answer 9

conscious level
pupil size, symmetry and reactivity
posturing and tone
seizure activity
fontanelle
BGL

Question 10

what shouldnt you forget during disability assessment

Answer 10

BGL

Question 11

disability resus

Answer 11

consider inntubation
correct hypoglycaemia
treat status ellipticus

Question 12

exposure asessment

Answer 12

temperature, abdominal examination
non-blanching rashes or purpura
urticaria or angiodema

Question 13

exposure resus

Answer 13

aim for normothermia
antibiotics for suspected sepsis
treaat anaphylaxis
analgesia

Question 14

aim of the secondary assessment

Answer 14

establish underlying cause
focused history and pysical examination
lab investigations and imaging
working diagnossiss
early antibiotics for suspected epsis

Question 15

aim of ongoing assessment

Answer 15

reasses patient
ECG monitoring
pulse rate
resp rate
O2 saats
BP
temp

Question 16

other forms of monitoring that may be indicated

Answer 16

endotracheal tube cardon dioxide
venous blood ga
urine output
arterial line
central venous pressure monitoring
ICP monitoring

Question 17

4 Hs and Ts

Answer 17

hypoxia
hypovolaemia
hypo/hyperkalaemia
hypo/hyperthermia
tension pnuemothorax
tamponade
toxins
thrombosis

Question 18

how to approach CPR

Answer 18

continue chest compressions with minimal interuptions
attach defribullator/monitor
assess rhythm
follow prrotocol if shockable/non-shockable
assess if spontaneous circulation has returned
administer post resus care if spontaneous circulation has returned

Question 19

shockable rhythms

Answer 19

VF/pulseeless VT

Question 20

what to do if you have a sshockable rhythm

Answer 20

shock 4J/kg
recommence CPR
adrenaline 10mcg/kg after the 2nd shock and then every second loop
continue CPR for two minutes
check if spontaneous circulation has returned

Question 21

non-shockable rhythms

Answer 21

PEA/asystole

Question 22

if there is a non-shockable rhtyhm

Answer 22

recommence CPR with minimal interuptions
adrenaline 10mcg/kg immediately then every second loop
continue CPR for 2 minutes
check if spontaneous circulation has returned

Question 23

post resus care

Answer 23

re-evaluate ABCDE
12 lead ECG
treat precipiatating causes
re-evaluate oxygenation and ventilation
temperature control

Question 24

advances peads life support algorithym

Answer 24