Peds Flashcards
What is MR SOPA?
If neonate HR < 100
Mask Reposition head/airway Suction Open mouth, jaw forward Pressure increase every few BVM until chest rise Artificial Airway (ETT, LMA)
How often reassess on neonate interventions (ex. Bagging, CPR)
Every minute.
When do you give meds to an infant/neonate arrest?
After about 3min of active interventions (3 cycles of 1min CPR)
Best IO sites for neonates
Above or below knee
Minimum glucose for <1yr old pt
45mg/dL
Preferred site for SPO2 on babies
R wrist or hand
Mom has gestational diabetes, what do you expect of the baby when it comes out
Larger than normal baby. Extreme hypoglycemia risk after cutting cords
What is the risk of giving narcan to a baby
Seizures
Best IV size for a neonate/infant
24g
Best IV sites for babies (preferred VS last resort)
Preferred: Foot, leg
Last resort: Scalp
Ped sepsis criteria
Suspected infection w/ 2+ of the following
- or high risk w/ 1 of following
- Tachy or weak thready pulse
- tachypnea or ETCO2 < or = 30
- hypotensive, cap refill <3s or mottled skin
- acuted decrease mental or altered from baseline
Peds sepsis Rx
IV or IO
- fluids
- Epi drip if SBP still low
How fluids and how to give to peds in sepsis
Use hand tevy
- re-assess after 10ml/kg and repeat x 1 if no improvement
When should you be careful when giving fluids to a sepsis ped. What should you do?
Cardiac hx. Consult med control for second bolus after initial 10ml/kg dose
How is ped asthma Rx different from adults? How many doses of epi
Everything same except use handtevy for doses. Give epi asap if pt looks like shit on contact (repeat x1 after 3-5min pRN)
How does a ped medical arrest differ from adult?
“Restart the Heart- ABCDE in 5 min”.
- infinite epi’s (not just 3)
What must you do onscene prior to transporting a ped arrest?
CPR, BVM, electrical & pharmacologic Rx
How does ped rosc differ from adult/?
- Epi instead of norepi pressor
- norepi = OLMC
When do you do APGAR on a neonate?
1min and 10min
When do you give epi to a neonate during ressucitation?
If HR stays <60 despite CPR
When do you follow bradycardia Rx vs CPR when a ped HR is <60
Peds <1yr = CPR
Peds 1+ = brady algorithym
Ped bradycardia Rx
MOVAB
- Reversible causes (hypoxia, OD, hypoglycemia)
- then, epi IO/IV repeat every 3-5min PRN
- atropine if AV block, vagal tone, cholinergic
- pace = 3rd degree
- NS repeat x1 PRN
When would you pace a ped
Brady due to 3rd degree block
When do you give atropine to a bradycardic ped
If Due to AV block , vagal tone, cholinergic drug
Rx for a tachycardic ped (SVT)
MOVAB
- determine if stable or unstable and follow algorithym
Rx for stable SVT (narrow or wide)
- NS
- vagal
- adenosine x2
- amio drip over 20min
What rate is SVT for infants or peds
Infant = or > 220
Ped = or >180
What Rx of unstable SVT
- Synchronized cardiovert PRN
- consider versed
- find underlying cause
Whats the epi drip dose for anaphylaxis in peds?
1-4mcg/min
How many times can you narcan a ped?
2 times
When can you tube a kid?
After all immediate reversible causes treated and BVM ineffective
What are the hypoglycemia values for peds?
Neonate <45
All peds <60
How often can you repeat med doses for hypoglycemic kids?
Can repeat x1 after 5-10 min
Pediatric drowning Rx
ABC & MOVAB
- CPAP for rales
- albuterol for wheeze
Can hot packs directly touch the skin?
No
How often can you give zofran to kids
Can repeat dose x1
Max single dose IV vs IN fentanyl in kids. Max total dose?
IV = 50mcg single dose. Max total 3mcg/kg
IN = 100mcg, repeat every 5min until max 3mcg/kg
Seizure Rx in peds
- Versed IN, repeat x1
- IN doesn’t work = IV (repeat x1)
Lowest age for a sager splint
> 4 Yrs
What are high risk conditions for sepsis
Catheters, immunosuppression/compromise
