Pediatric Resuscitation Lecture Powerpoint

Question 1

Cardiac arrest in children is usually not from a ____ cause, rather result of ____ or ____*****

Answer 1

cardiac, respiratory failure, shock

Question 2

Why do children in presence of apnea see more tissue hypoxia than adults?

Answer 2

Because they have a higher metabolic rate

Question 3

Respiratory distress definition

Answer 3

Clinical state characterized by increased respiratory rate and effort often observed as nasal flares and tachycardia and tachypnea and retractions, adequate ventilation and gas exchange is still maintained, can range from mild to severe, once fail to compensate then progresses to respiratory failure

Question 4

Respiratory failure definition

Answer 4

Clincal state of inadequate oxygenation, ventilation, or both, often end stage of respiratory distress, requires intervention to prevent respiratory arrest-cardiac arrest, findings include bradypnea or apnea and bradycardia***

Question 5

Normal heart rate in newborns (0-3 months) vs children over 10 to adults

Answer 5

100-150bpm

60-100bpm

Question 6

Minimum blood pressure calculation for a child

Answer 6

70mmHg +(2xage)

Question 7

AED use for infants and children

Answer 7

• Infants manual defibrillator preferred to AED
• if not available, or if older, use AED with pediatric dose and pads
• if not available, use adult dose and pads

Question 8

Mild vs severe airway obstruction

Answer 8

Mild sees good air exchange, can cough forcefully, just monitor, vs severe no air exchange, no cough, high pitched noise while inhaling, must try to relieve

Question 9

PALS protocol

Answer 9

• General assessment
• Primary assessment ABCDE
• secondary assessment
• condition specific protocol between upper airway obstruction, lower, lung tissue disease, and disorderd control of breathing

Question 10

Upper airway obstruction definition

Answer 10

Foreign body aspiration, swelling of upper airway tissues, thick secretions in the mouth in obstructing airway are all causes of this, presents with tachypnea, increased inspiratory effort, stridor*** (exclusive to upper airways, high pitched upon inspiration), drooling, etc

Question 11

Lower airway obstruction definition

Answer 11

Obstruction in lower trachia, bronchi, or bronchioles often in asthma, RSV, bronchiolitis, signs include tachypnea, wheezing and rhonchi on expiration

Question 12

Lung tissue disease definition

Answer 12

Affects lung at level of alveolar capillary unit, can be caused by pneumonia, pulmonary edema, toxins, etc. signs include tahypnea, tachycardia, incread respiratory effort, grunting, crackles, diminished breath sounds

Question 13

Disordered control of breathing definition

Answer 13

Abnormal breathing pattern that produces inadequate respriatory rate, effort, or both, commonly neurological in origin such as seizures, CNS infections, hydrocephalus, sees signs such as variable or irregular respiratory rate, variable respiratory effort, shallow breathing

Question 14

OPA and NPA size selection

Answer 14

Measure from mouth or nose to angle of mandible

Question 15

Shock definition and what type is most common in children

Answer 15

Result of inadequate blood flow and oxygen delivery to meet tissue metabolic demands, most common is hypovolemic (inadequate blood volume or oxygen content of blood, often diarrhea)

Question 16

2 types of shock

Answer 16

Compensated - signs of poor perfusion but normal systolic blood pressure, compensatory mechanisms such as shunting (weak peripheral pulse and cool distal extremities), tachycardia, normal BP
Decompensated - when the compensatory mechanisms of compensatory shock fail resulting in depressed mental status, tachypnea, hypotension

Question 17

Distributive shock definition

Answer 17

Inapropriate distribution of blood volume with inadequate organ and tissue perfusion, includes sepsic shock, anyphylactic shock, and neurogenic shock (brain or spinal cord injury), can be warm or cold subtypes

Question 18

Most common distributive shock in children

Answer 18

Septic shock

Question 19

Findings consistent with cardiogenic shock (3)

Answer 19

• increased respiratory effort resulting from pulmonary edema
• signs of congesetive heart failure (JVD, hepatomegaly, pulmonary edema)
• cyanosis

Question 20

Obstructive shock definition

Answer 20

Impaired cardiac output caused by physical obstruction of blood flow such as cardiac tamponade, tension pneumothorax, PE

Question 21

Shock management (5)

Answer 21

• trendelenburg position
• o2 administration
• fluid resuscitation
• monitoring
• pharm support