Resucitation Flashcards
In Resus scenario:
1st dose amiodarone
2nd dose
when given
300
150
After 3rd shock, after 5th shock
Stridor indicates what?
Obstruction in the larynx or upper trachea
It is a harsh crowing inspiratory noise
Absolute contraindications to organ donation
CJD
HIV disease
Ebola virus disease
Active cancer with spread outside the affected organ
BRUE definition
Infant <12 months
Sudden onset episode
Lasting <1 min
Return to baseline
Not explained by identifiable medical condition(s)
Can be associated with central cyanosis / pallor / irregular breathing / Marked change in tone / Altered level of consciousness
What makes a BRUE high risk (3)
Infant <2 months old
Hx of prematurity (especially <32 weeks)
More than 1 event
CXR findings in thoracic aortic dissection
Widened mediastinum
Hazy left lung field
Obliteration of aortic knob
Fractures of 1st and 2nd ribs
Deviation of trachea to the right
Presence of a pleural cap
Elevation and a rightward shift of right mainstem bronchus
Depression of left mainstem bronchus
Obliteration of space between pulmonary artery and aorta
Deviation of the oesophagus (or NG tube) to the right
The most common arrest rhythm in children?
Asytole
Adrenaline dose in paediatric cardiac arrest
Dose given via an ETT
10 micrograms/kg
100 micrograms/kg
Shockable rhythm in a paediatric arrest, shock strength
4J/kg
Amiodarone dose in paediatric cardiac arrest
5mg/kg
Alternative to amiodarone in paediatric cardiac arrest
Lidocaine
Lidocaine dose in paediatric cardiac arrest
1mg/kg
Magnesium dose in paediatric cardiac arrest
25-50mg/kg (max 2g)
ETT size calculation in children (1yr+)
Uncuffed
Cuffed
(Age/4) + 4
(Age/4) + 3.5
ETT tube length calculation in children
Oral
Nasal
(Age/2)+12
(Age/2)+15
TTM in post arrest care
32-36 degrees for 24hrs
Prevent fever for 72hr
Cardiac arrest due to hyperkalaemia, calcium chloride dose
10%, 10ml IV
Cardiac arrest due to hyperkalaemia, insulin dex initial dose
10 units of short acting insulin + 25g glucose IV
Cardiac arrest due to hyperkalaemia, additional medication to give if in renal failure or severe acidosis
50 mmol IV, sodium bicarb
Position of traumatic aortic rupture in patients who survive
incomplete laceration near the ligamentum arteriosum of the aorta (proximal descending)
Findings on chest X-ray can be helpful in making the diagnosis of traumatic aortic rupture:
Fractures of 1st and 2nd ribs
Grossly widened mediastinum
Hazy left lung field
Obliteration of the aortic knob
Deviation of the trachea to the right
Presence of a pleural cap
Elevation and rightward shift of right mainstem bronchus
Depression of the left mainstem bronchus
Obliteration of the space between pulmonary artery and aorta
Deviation of the oesophagus (or NG tube) to the right
Amiodarone in cardiac arrest, dose diluted in?
300 mg as an IV bolus diluted in 5% dextrose to a volume of 20 mL
Amiodarone MOA in cardiac arrest
membrane-stabilising antiarrhythmic drug that increases the duration of the action potential and the refractory period in atrial and ventricular myocardium
Adult patient with burns, minimum ETT diameter
7.5mm
Low risk BRUE, what investigations should be considered prior to discharge (2)
ECG
Pertussis swab
Lung protective ventilation in burns patients
Lung protective ventilation should be used with low tidal volumes (4-8 mL/kg) and peak inspiratory pressures <30 cmH2O.
TXA loading dose
Then infusion
1g over 10 mins
1g over 8hrs
Perimortem Caesarean section should be performed within what time frame?
5 mins of cardiac arrest
Four regions are assessed during a standard FAST scan:
Subxiphoid transverse view
Longitudinal view of the right upper quadrant
Longitudinal view of the left upper quadrant
Transverse and longitudinal views of the suprapubic region
Massive transfusion defined as
> 10 units of blood in 24hrs
> 4 units of blood in 1hr
The American Burn Life Support (ABLS) indications for early intubation include:
Signs of airway obstruction (hoarseness, stridor, accessory respiratory muscle use, sternal retraction)
Extent of the burn (total body surface area burn >40%–50%)
Extensive and deep facial burns
Burns inside the mouth
Significant oedema or risk for oedema
Difficulty swallowing
Signs of respiratory compromise: inability to clear secretions, respiratory fatigue, poor oxygenation or ventilation
Decreased level of consciousness where airway protective reflexes are impaired
Anticipated patient transfer of large burn with airway issue without qualified personnel to intubate en route.
The life-threatening thoracic injuries that should be treated in the primary survey are:
Airway obstruction
Tracheobronchial tree injury
Tension pneumothorax
Open pneumothorax
Massive haemothorax
Cardiac tamponade
Within what time period should tranexamic acid be used in the trauma setting?
Within 3hrs
Contraindications to Needle cricothyroidotomy include the following (3)
Local infection
Non-identifiable anatomy
Previous failed attempts
Elevation of the baseline on capnography indicates?
Re-breathing
ET size
6 month old
6 month - 1yr old
size 4
size 4.5
IO access
In children <7 where is preferred
Proximal tibia
Distal femur
