Pediatric Emergency Flashcards
What is the definition of shock
Inadequate tissue perfusion
What is the relationship between BP and CO, SVR, and HR
If one increase the other will be decreased to maintain BP
What is the stroke volume
Combination of preload, afterload and contractility
What is the cardiac output?
Amount of blood pumped each minute by the heart from the aorta
What is the normal cardiac output in pediatric
75-85 ml\kg
Why do pediatric population have fixed stroke volume?
Immaturity of sympathetic innervation to the ventricle
What maintains adequate cardiac output in pediatric?
Heart rate
What is the first sign of shock in pediatric
Only tachycardia
Hypotension comes in late and only
What is the most common type of shock?
Hypovoulemic
What is the abnormality in hypovoulemic shock
Decreased SV
What is the abnormality in disruptive shock
Decreased SVR
What is the abnormality in cardiogenic shock
Decreased contractility
What is the abnormality in obstructive shock
Decreased CO
What is most important treatment part of hypovolemic shock
Fluid recessitaiton
What is most important treatment part of disruptive shock
Vasopressin
What is most important treatment part of cardiogenic shock
Vasopressin preferred over fluid
What is most important treatment part of obstructive shock
Treat the cause
“Needle decompression or cardiac temponade”
What are the peripheral IV access sites in infant younger than 9 months?
Hand, foot, arm, leg, scalp
When to opt for intrassous infusion for resuscitation
After 2 failed attempts
What is intraosseous infusion
Infusing medications, fluids and blood products through the bone marrow
Name vasopressor medications
Dopamine, norepinephrine, epinephrine, dobutamine
What are the effects of dopamine?
- low dose
- medium
- large
- Dilation of splanchinc
- increased CO
- Vasoconstriction
What are the effects of neorepinephrine?
- theortical increase of cardiac output but can be cancelled by reflex bradycardia
What are the effects of dopamine?
- low dose
- large
- increased CO
- Vasoconstriction
