SD2 Knowledge Questions Flashcards
List the 2 indications for OPA insertion.
- Unconscious pt where there is a need to maintain airway by anteriorly displacing tongue
- Bite block for ETT
List the 3 contraindications for the insertion of an OPA.
- Trismus
- Gag reflex
- Any suspected neurological injury
List the indication for the insertion of an NPA.
- Unconscious with trismus where an OPA can not be inserted.
List the 3 contraindications for an NPA.
- Middle third facial fractures (brain intrusion)
- Significant nasal trauma (gag
- TBI/Neuro event where airway is patent and VT adequate despite trismus (gag)
List the 3 precautions for an NPA.
- Basal skull fractures
- CSF from ears or nares
- Remove during intubation, may obscure view of glottis
How does the triple airway manoeuvre improve airway assessment?
Pulls tongue and soft tissues away from the back of the throat to open airway.
What is the difference between the sniffing position and the neutral position?
Neutral - 2 to 5 cm towel under occiput, designed to open airway.
Ext. aud. meatus in line with clavicle.
Sniffing - ++padding, designed to improve view of vocal cords, ext. aud. meatus in line with suprasternal notch.
Hyperextension of the head can cause…?
Trachea to flatten.
What padding is required to assess the airway of a medium and small child?
Medium child - no padding
Small child/infants - 2cm pad under shoulders, due to large occiputs (can occlude easily with flexion)
When is a pulse check required in arrest?
If QRS complexes present indicate a PPR at the end of a cycle.
List the 6 correctable causes of PEA.
HEATAU
- Hypoxia
- Exsanguination
- Asthma
- Tension pneumothorax
- Anaphylaxis
- Upper airway obstruction
When is an arrest managed as a “hypothermic” arrest, and what are the 4 management differences?
<30 degrees.
- Double adrenaline interval.
- Aim to prevent further heat loss.
- > 3 shocks unlikely to be successful, aim for mCPR/AAV - if no additional resources available continue DCCS as per normal
- If hypothermia suspected to be cause of arrest, consult for mCPR to hospital.
When should compressions commence for a paediatric?
- No palpable pulse
- HR <60bpm for infants
- HR <40 for children
If ROSC, what 3 actions need to occur?
- 12 Lead ECG - consider PHT.
- If VF/VT, suspected cardiac cause or post-PHT then transport to closest 24hr PCI - consider AAV for transport.
- If suspected non-cardiac cause, Tx to nearest appropriate hospital with notification.
What is the compression technique for:
a. Infant
b. Small child
c. Medium child
Infant - two finger/thumbs, hands encircle chest
Small child - one handed, similar to adult
Medium child - two handed, same as adult
What is the compression to ventilation ratio for infants (No ETT/SGA)?
2R = 15:2
1R = 30:2
Aim for 100 -120 compressions per minute
Pause for ventilations.
What are the compression to ventilation rations for children (ETT/SGA)?
Aim for 100 - 120 compressions per minute.
10 ventilations per minute.
No pause for ventilations.
What are the 5 elements of APGAR?
Appearance Pulse Grimace Activity Respiratory Effort
What are the compression to ventilation rations for a newborn?
3:1 90 compressions + 30 ventilations per min. 120 events per min, 2 per second. Pause for 0.5s for ventilations. No pause once intubated.
List the 5 step ECG findings for VF.
Ventricular rate: Nil discernible Ventricular rhythm: Bizarre, chaotic, >0.1mV P Waves: Nil discernible PR Interval: Nil discernible QRS Duration: Nil discernible
List the 9 most common causes of cardiac arrest in paediatric patients.
- Hypoxaemia
- Hypotension
- SIDS
- Septicaemia
- Drowning
- Asthma
- Trauma
- Upper airway obstruction
- Congenital heart abnormalities
List the 6 Determinants of Death.
+ 1 optional.
- No palpable carotid pulse
- No heart sounds for 2 mins
- No breath sounds for 2 mins
- Fixed and dilated pupils
- No response to central stimuli
- supraorbital, mandibular, sternal pressure - No motor response or grimace to painful stimuli
- pinch inner elbow, nail bed pressure - ECG strip showing 2mins asystole optional.
List the 7 side effects of Adrenaline.
- Sinus tachycardia
- Supraventricular arrhythmias
- Ventricular arrhythmias
- Hypertension
- Dilated pupils
- May increase size of AMI
- Feelings of anxiety.
List the 5 benefits of administering Adrenaline in cardiac arrest (4 A, 1 Beta1)
Peripheral vasoconstriction leading to (A):
- increased PVR (A)
- increased venous return, CO and CPP (A)
- Aids good CPR in perfusing myocardium to obtain a shockable rhythm (A)
Increases irritability of ventricles (B1)
