Week 7 Chapter 51 Flashcards
Risk Factors for Respiratory Arrest in Children vs Adults
Smaller Airways
Underdeveloped immune systems
Lack motor coordination
Susceptible to choking on food and small objects
Higher risk for SIDS
Children are at greater risk for near drowning, poisoning, and traumatic injury compared to adults
Most pediatric arrests from respiratory failure or shock
True
Children who have cardiopulmonary arrest requiring resuscitative measures rarely fare well explains differences in each chain
True
AHA Chain or Survival
Adult
- EMS activation
- CPR
- Early defib
- Early access to advanced care
- Integrated postcardiac arrest care
Child
- Prevention of cardiac arrest and injuries
- Early CPR
- Early access to emergency response system
- PALS
- Integrated postcardiac and arrest care
Common Medical Treatments
Suctioning
Oxygen
BVM ventilation
Intubation
Needle Thoracotomy
IV Fluid Therapy
Blood Product Transfusion
Cervical Stabilization
Defib- V Fib and pulseless v tach
- Synchronized Cardioversion- SVTs V Tach with a pulse
AED uses only age above 1 and ?
Witnessed collapse
Common Laboratory and Diagnostic Tests
Electrolyte and glucose levels
CBC and basic metabolic
Blood cultures
Urinalysis
ABGs
Toxicology panel if needed
ECG
Chest Radiograph
Medication SVT
Adenosine
V tach and V fib
Amiodarone
Sinus Brady, asystole, PEA
Atropine
Adrenergic agent
Dobutamine
Inotropic agent
Dopamine
Vasopressor, inotropic
Epinephrine
Antidysrhythmic
Lidocaine
Opioid Antagonist
Naloxone
Drugs Administered through ETT
LEAN
L- Lidocaine
E- epinephrine
A- Atropine
N- Naloxone
ABCs of Life Support
ABC
Secondary Survey
- Disability
- Exposure
Increased respiratory rate
Tachypnea
Decreased in depth and rate of respiration
Hypoventilation
Regular breathing with occasional short pulses
Periodic Breathing
Use of intercostal muscles or presence of retractions
Increased work of breathing
Airway Devices and Ventilations Methods
Anesthesia bag or flow ventilation system
BVM or manual resuscitator
Laryngeal Mask Airway
Tracheal Intubation
Verify tracheal tube placement with
ETCO2
- Yellow color
- Symmetric rise and fall of chest
- Exhaled CO2 monitors as an indication of appropriate ventilation
DOPE for Intubation Troubleshooting
D- displacement
O- Obstruction
P- Pneumothorax
E- Equipment failure
- Disconnected oxygen supply
- Leak in the ventilator circuit
- Loss of power
Laboratory and Diagnostic Tests when Assessing Respiratory Status
ABGs
Pulse Oximetry
Chest Radiograph
Metal Detector
Circulation
HR
Pulses
Perfusion
Blood Pressure
Cardiac Rhythm
LOC altered
Establish Vascular access
Forms of vascular access
Peripheral IV route
Central IV Route
Saphenous Vein Cutdown
Intraosseous Access
Neurologic Assessment of a Child with a Pediatric Emergency
Level of awareness
Evaluate interest in environment
Evaluate the child’s head
Assess the eyes
Evaluate the child’s face
Evaluate Spontaneous movement
May use Pediatric Glasgow Coma Scale
Common Types of Pediatric Emergencies
Respiratory Arrest
Shock
Cardiac Arrhythmias
Near Drowning
Poisoning
Traumatic Injury- Leading Cause of death ( unintentional injuries)
Normally healthy child suddenly deteriorates without a known cause
Toxic Ingestion
Questions for Poisoning
Inquire about approximate time and nature of toxin
How was it ingested?
Caregiver medication bottle?
Older children possible suicide?
Alterations Occurring with Toxic Ingestions
Hyper/ Hypo Tension
Hyper/ Hypo thermia
Resp. Depression or hyperventilation
Pupillary Contraction or dilation
Types of Shock
Hypovolemic
Septic
Cardiogenic
Distributive
S/S of shock
Pallor
Hypotension
Brady or Tachycardia
Resp. Distress
Delayed capillary refill
Weak Distal pulses
Result of dramatic respiratory or hemodynamic compromise
Can be compensated or decompensated
Caused by impaired cardiac output, SVR or both
Depends on their HR
Shock
Causes of Sudden Cardiac Arrest in Children
Electrolyte abnormalities
Toxic drug ingestion
History of serious primary congenital or acquired cardiac defect
Potentially lethal arrhythmias such as prolonged QT syndrome
Hyper or hypo cardiomyopathy
Traumatic Injury
Rare exception for children for cardiac arrest
Commotio Cordis
Nursing Management of a Child with a Pediatric Emergency
Maintain Airway
Provide oxygen
Assisting in ventilation
Monitoring changes in status
Offering support and education to child and family
