Pediatric Emergencies Flashcards
1
Q
risk factors for peds cardiac arrest in anesthesia
A
- cardiac surgery
- infants less than 1 month of age
- ASA >/= 3
- prematurity
- congenital heart disease
- emergency procedures
2
Q
halothane associated with what in peds?
A
bradycardia and myocardial depression
3
Q
med related causes of cardiac arrest
A
- anesthetic OD (like OD of inhalational agent)
- succ induced dysrhythmia
- neostigmine induced dysrhythmia
- medication swap
- drug reactions
- unintended IV injection of LA
- high spinal
- LAST
- inadequate reversal of paralytic
- opioid induced resp depression
4
Q
CV related causes of cardiac arrest
A
- hypovolemia
- hemorrhage
- inadequate volume administration
- hyperkalemia (succ, or blood transfusion)
- hypocalcemia
- hypoglycemia
- vagal episode
- dysrhtymia, hemorrhage, tamponade
- embolism
- MH
- hypothermia
- myocardial infarction
- sepsis
5
Q
respiratory causes of cardiac arrest
A
- inadequate oxygenation and ventilation
- inability to ventilate
- ETT misplacement
- difficult airway anatomy
- residual NMB
- aspiration
- pneumothorax
6
Q
other factors that can lead to cardiac arrest of peds in OR
A
- lack of vigilance
- ignorance
- failure to apply knowledge
- unknown etiology
- surgical technique
- patient factors
7
Q
ROSC
A
-the restoration of a perfusing rhythm and blood pressure that persists for a period of at least 20 minutes post arrest
8
Q
Asystole in OR
A
- more likely an initial rhythm in response to a vagal stimulation
- more likely to be reversed and associated with good prognosis in the OR
- examples - insufflation; glyco, atropine
9
Q
duration of arrest
A
- need for more than 15 min of CPR is predictor of mortality
- up to 3 hours of CPR has been reported in anesthesia related events with a good outcome
- 10 min after failed resuscitation of reversible conditions ECMO should be activated
10
Q
periop cardiopulmonary arrest causes
A
- arrest during inhalation induction
- arrest during craniofacial or spine surgery
- hyperkalemia
- VP shunt malfunction
- LAST
- anaphylaxis
11
Q
CPR STEPS
A
- recognize need for CPR
- know how to perform CPR
- vascular access
- meds for CPR
- teamwork
- documentation
- post-resuscitation care
- self care post critical incident
12
Q
where to check for pulse in newborn
A
umbilical or brachial
13
Q
where to check for pulse in infant
A
brachail
14
Q
where to check for pulse in child
A
carotid
15
Q
vascular access in CPR
A
- IV
- IO
- ETT
- CVC
- cut down of saphenous
16
Q
care after ROSC
A
- titration of FiO2 after ROSC aimed at 94-99% SpO2
- assess for rebound arrest
- assess for ETT and line displacements during arrest
- avoid hyperthermia, hyperglycemia, and seizures
- accurate reporting to surgery team, family, ICU team
