Resuscitation Children Flashcards
common causes of arrest among children and infants than adults
Respiratory failure and shock
subsequently lead to bradycardia, hypotension, and secondary cardiac arrest in children
hypoxemia, h nia, and acidosis
The American Heart Association specifically d courages two common maneuvers used with adult patients
(1) do not use the “Heimlich maneuver” for patients <1 year old, because of the potential for injury to abdominal organs; and
(2) do not use blind finger sweeps, because of the possibility of pushing the foreign body farther into the airway
No normal breathing, has pulse
Provide rescue breathing:
1 breath every 3-5 seconds, or about 12-20 breaths/min.
Add compressions if pulse remains ≤60/min with signs of poor perfusion.
- Activate emergency response system (if not already done) after 2 minutes.
- Continue rescue breathing: check pulse about every 2 minutes. If no pulse, begin CPR (go to “CPR” box).
Ventilation bags used for infants and children
minimum volume of 450 mL,
those used for older children and adolescents
minimum volume of 1000 mL
Adenosine
IV/IO: 0.1 milligram/kg, followed by 2–5 mL NS flush
Double dose and repeat once, if needed
Maximum single dose: 6 milligrams first dose, 12 milligrams second dose
Amiodarone
IV/IO: 5 milligrams/kg over 20–60 min; then 5–15 micrograms/kg/min infusion
Maximum bolus repetition to 15 milligrams/kg/d. Use lowest effective dose. Bolus may be given more rapidly in shock states
Atropine
IV/IO: 0.02 milligram/kg, repeat in 5 min (minimum single dose is 0.1 milligram)
Endotracheal: 0.04–0.06 milligram/kg diluted with NS to 3–5 mL
Maximum single dose: 0.5 milligram (child) and 1.0 milligram (adolescent). Maximum cumulative dose: 1.0 milligram (child) and 2.0 milligrams (adolescent).
Not routinely recommended. Use for bradycardia in the setting of suspected increased vagal tone or primary heart block
Calcium chloride (10%)
IV/IO: 20 milligrams/kg (maximum dose 2 grams)
Not routinely recommended. Use in documented hypocalcemia, calcium channel–blocker overdose, hypermagnesemia, or hyperkalemia. Administer slowly.
Epinephrine
Bradycardia:
IV/IO: 0.01 milligram/kg (0.1 mL/kg of 1:10,000) Endotracheal: 0.1 milligram/kg (0.1 mL/kg of 1:1000) Pulseless arrest:
IV/IO: 0.01 milligram/kg (0.1 mL/kg of 1:10,000) Endotracheal: 0.1 milligram/kg (0.1 mL/kg of 1:1000)
Maximum dose: 1 milligram IV/IO; 2.5 milligrams ETT.
Unlike other agents, epinephrine per endotracheal tube is 10× the IV dose. Follow endotracheal dose with several positive-pressure ventilations.
No evidence for high-dose parenteral epinephrine (may worsen outcomes).
Glucose
IV/IO:
Newborn: 5 mL/kg D10 W Infants and children: 2 mL/kg D25 Adolescents: 1 mL/kg D50 W
D10 W preferred (5 mL/kg) through small guage IV as higher dextrose concentrations may be sclerotic to peripheral IVs. Higher dextrose concentrations may be given through IO if needed.
Lidocaine
IV/IO: 1.0 milligram/kg bolus Endotracheal: double IV dose and dilute with NS to 3–5 mL
Naloxone
IV/IO: If <5 y or ≤20 kg: 0.1 milligram/kg If >5 y and >20 kg: 2.0 milligrams
Titrate to desired effect.
Sodium bicarbonate
IV/IO: 1 mEq/kg (1 mEq/mL)
Not routinely recommended. Infuse slowly and use only if ventilation is adequate for tricyclic antidepressant overdose and hyperkalemia
