Peds - emergency

Question 1

SVT recognition

Answer 1

SVT - narrow QRS, no known cause, abrupt onset, > 220 in infants, > 180 in children, no or abnormal P waves

Question 2

ST recognition

Answer 2

ST - narrow QRS, pwaves, can be irregular RR, regular PR, infants < 220, children < 180, known cause, nonabrupt onset

Question 3

Treat SVT

Answer 3

assess if stable
@ IV - vagal, and if IV then adenosine 0.1 mg/kg, no more than 6 mg. try again at 0.2 mg/kg.
@ no IV or ineffective > sync cardiovert at 1 J/kg then 2 J/kg

Question 4

Treat wide QRS tachycardia

Answer 4

possible VTACH
assess if stable
if stable: consider adenosine 0.1 mg/kg (max 6mg) then repeat dose at 0.2 mg/kg
if ineffective: expert consultation + amiodarone 5 mg/kg or procainamide

Question 5

length of CPR PALS

Answer 5

2 mins

Question 6

PALS: asystole

Answer 6

no pulse > ASYSTOLE and PEA route
start CPR 120 with 1/2 chest depth and appropriate recoil with breaths 15:2 if no airway, q6 sec if airway
get IV access
epi 0.01-0.03 mg/kg IV or epi 0.1 mg/kg ETT
CPR 2 mins

Question 7

PALS: VF/VT

Answer 7

start CPR
monitor, defib pads
shock as soon as possible 2 J/kg
CPR 2 mins + get access
shock 2 4 Jkg
CPR 2 mins + consider airway
shock >4 J/kg
epi 0.01-0.03 mg/kg IV q3-5 minus, 0.1 ETT
CPR 2 mins + r/o cause
shock > 4 J/kg
amiodarone 5 mg/kg or lidocaine 1 mg/kg