Resuscitation

Question 1

List the elements of a rapid clinical assessment

Answer 1

Airway
Breathing 
Circulation
Disability
Exposure

Question 2

How do we assess the airway and breathing?

Answer 2

Look, listen and feel for:

1. Airway obstruction or respiratory distress
2. Work of breathing
3. RR
4. Stridor, wheeze
5. Auscultation for air entry
6. Cyanosis
7. O2 sats

Question 3

How do we assess circulation?

Answer 3

Feel and assess:

1. HR
2. Pulse volume
3. Capillary refill time
4. BP

Question 4

How do we assess disability?

Answer 4

Observe and note:

1. Level of consciousness
2. Posture
3. Pupil size and reactivity

Question 5

Define exposure

Answer 5

To expose the patient adequately so as a full body assessment can be carried out

Question 6

How is level of consciousness assessed in a child?

Answer 6

AVPU
ALERT
Responds to VOICE
Responds to PAIN
UNRESPONSIVE

Question 7

List the elements of the secondary assessment

Answer 7

1. History
2. Examination:
   - Evidence of trauma
   - Rash
   - Smell
   - Scars
   - MedicAlert bracelet
3. Investigations

Question 8

What is the SAFE approach?

Answer 8

Shout for help
Approach with care
Free from danger
Evaluate (ABC)

Question 9

List the steps in paediatric BLS

Answer 9

1. SAFE
2. Open airway
3. Check breathing for max 10s
4. Breathe - 5 initial rescue breaths
5. Assess signs of life:
   - Movements
   - Coughing
   - Normal breathing
6. Check pulse
7. Chest compressions

Question 10

List the steps in paediatric ALS

Answer 10

1. Assess responsiveness and breathing
2. Breathing - initial 5 rescue breaths
3. Bag mask ventilate or advanced airway if skilled operators present
4. Give high concentration O2
5. 15 chest compressions:2 breaths
6. Continuous compressions if intubated
7. Establish IV access (Intraosseous if delay in IV)
8. Attach defibrillator/monitor
9. Assess rhythm
10. Shock if indicated

Question 11

What are the shockable rhythms?

Answer 11

1. Ventricular fibrillation

2. Pulseless ventricular tachycardia

Question 12

What are the non-shockable rhythms?

Answer 12

1. Pulseless electrical activity

2. Asystole

Question 13

What are the elements of post-cardiac arrest treatment?

Answer 13

1. Use ABCDE approach
2. Oxygenation and ventilation
3. Investigations
4. Treat precipitating cause
5. Temperature control

Question 14

What should be done during CPR?

Answer 14

1. Ensure high quality CPR
2. Plan actions before interrupting CPR
3. Give O2
4. Vascular access
5. Give adrenaline every 3-5mins
6. Consider advanced airway
7. Continuous chest compressions when advanced airway in place
8. Correct reversible causes
9. Consider amiodarone (5mg/kg) after 3 and 5 shocks

Question 15

List the reversible causes of cardiac arrest

Answer 15

1. Hypoxia
2. Hypovolaemia
3. Hypo/hyperkalemia
4. Hypothermia
5. Tension pneumothorax
6. Thrombosis
7. Cardiac tamponade
8. Toxic/therapeutic disturbances