Pediatric Resuscitation
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Questions and Answers

What are the 4 parameters needed in evaluating the breathing of a victim?

  • Air entry or breath sounds (correct)
  • Rate of breathing (correct)
  • Effort of breathing (correct)
  • Oxygen saturation (correct)
  • What are the 5 parameters needed in evaluating the victim's circulation?

  • Urine output (correct)
  • Central and Peripheral pulse (correct)
  • Heart rate (correct)
  • Blood pressure (correct)
  • Capillary refill time (correct)
  • In pediatrics, the most common cause of arrest is secondary to Pulmonary ________.

    disease

    High-quality CPR involves starting compressions within 10 seconds after recognizing cardiac arrest. True or False?

    <p>True</p> Signup and view all the answers

    What is the purpose of an AED (Automated External Defibrillator) during CPR?

    <p>An AED can identify abnormal heart rhythms and deliver a shock to restore normal heart rhythm through defibrillation.</p> Signup and view all the answers

    What is the recommended dose of autoinjector for a patient weighing 10 to 30 kg during chest compression interruption?

    <p>0.15 mg</p> Signup and view all the answers

    What is the maximum single dose of IM injection for a patient weighing 30 kg?

    <p>0.3 mg</p> Signup and view all the answers

    What is the recommended maximum single dose of IV/IO injection if a patient is hypotensive?

    <p>1 mg</p> Signup and view all the answers

    What is the dosage of racemic solution for croup treatment?

    <p>0.25 to 0.5 ml</p> Signup and view all the answers

    What is the recommended continuous infusion dosage of Vasopressin for catecholamine-resistant hypotension?

    <p>0.2 to 2 milliunits/kg per minute</p> Signup and view all the answers

    What is the loading dose of Milrinone for myocardial dysfunction and increased SVR/PVR?

    <p>50 mcg/kg</p> Signup and view all the answers

    What is the recommended dose of Sodium Bicarbonate for sodium channel blocker overdose?

    <p>1 to 2 mEq/kg</p> Signup and view all the answers

    Study Notes

    Pediatric Resuscitation

    Systematic Approach

    • Main goal: Prevent cardiopulmonary arrest
    • Most common cause of arrest in pediatrics: Secondary to pulmonary conditions
    • Continuously evaluate, assess, and manage the patient until stable enough for transport to the next level of care
    • If patient deteriorates, perform life-saving measures or interventions

    Initial Assessment

    • Visual and auditory tool to assess the patient's condition in the first few seconds of encounter
    • Evaluate:
      • Appearance or level of consciousness (AVPU)
      • Breathing pattern (rate, effort, and abnormal sounds)
      • Color (pink, pale, mottled, or cyanotic)
      • Physiologic condition (respiratory distress, respiratory failure, life-threatening condition with or without signs of life)

    Secondary Assessment

    • Focus on resuscitation-oriented history and pertinent physical examination of the patient using the mnemonic:
      • S - Signs and Symptoms
      • A - Allergies
      • M - Medications
      • P - Past Medical History
      • L - Last Meal
      • E - Events prior to critical condition

    Tertiary Assessment

    • Includes laboratory, radiologic, and other diagnostic tests
    • Makes a final diagnosis/impression and renders specific interventions to the patient

    Pulmonary Conditions

    • 4 types:
      • Upper airway obstruction
      • Lower airway obstruction
      • Lung parenchymal disease
      • Disorder of breathing control

    Breathing

    • 4 parameters to evaluate:
      • Rate of breathing
      • Effort of breathing
      • Air entry or breath sounds
      • Oxygen saturation

    Circulation

    • 5 parameters to evaluate:
      • Heart rate
      • Blood pressure
      • Central and peripheral pulse
      • Capillary refill time
      • Urine output
    • Presence of shock distinguished by severity:
      • Compensated shock
      • Hypotensive shock
    • Classify the type of shock the patient is suffering from (e.g., hypovolemic, distributive, obstructive, cardiogenic)

    Disability

    • Check for:
      • Level of consciousness (AVPU)
      • Neurologic status of the patient
      • Blood sugar

    Exposure

    • Check for:
      • Fever (temperature of 37.8°C)
      • Rashes
      • Bruises on the patient's body

    CPR

    • Components:
      • Chest compressions
      • Airway
      • Breathing
    • High-quality CPR:
      • Start compressions within 10 seconds of recognizing cardiac arrest
      • Push hard, push fast: Compress at a rate of 100-120/min with a depth of:
        • At least 5cm for adults, but no more than 6cm
        • At least one-third of the chest, approximately 5cm, for children
        • At least one-third of the chest, approximately 4cm, for infants
      • Allow complete chest recoil after each compression
      • Minimize interruptions to 30 seconds or less

    AED

    • Components:
      • Lightweight, portable, computerized device
      • Can identify an abnormal heart rhythm as shockable or non-shockable
      • Can deliver a shock to stop the abnormal rhythm and allow the heart's normal rhythm to return
    • How to use an AED:
      1. Open the carrying case (if applicable) and power on the AED if needed
      2. Attach the AED pads to the victim's bare chest, avoiding clothing, medication patches, or implanted devices
      3. "Clear" the victim and allow the AED to analyze the rhythm
      4. If the AED advises a shock, it will prompt you to clear the victim and then deliver a shock
      5. If the AED prompts that no shock is advised or after any shock is delivered, immediately resume CPR, starting with chest compressions

    Medications

    • Epinephrine:
      • Dose: 0.01mg/kg (0.01ml/kg of 1 mg/ml concentration) IM q 15 minutes PRN (max single dose 0.3 mg)
      • Indications: Asthma, croup, and anaphylaxis
    • Norepinephrine:
      • Dose: 0.05 to 0.5 mcg/kg per minute IV/IO infusion
      • Indication: Hypotensive (usually distributive) shock
    • Vasopressin:
      • Dose: 0.0002 to 0.002 unit/kg per minute (0.2 to 2 milliunits/kg per minute) continuous infusion
      • Indication: Catecholamine-resistant hypotension
    • Milrinone:
      • Dose: Loading dose: 50 mcg/kg IV/IO over 10 to 60 minutes followed by 0.25 to 0.75 mcg/kg per minute IV/IO infusion
      • Indication: Myocardial dysfunction and increased SVR/PVR
    • Sodium bicarbonate:
      • Dose: 1 mEq/kg IV/IO slow bolus
      • Indications: Metabolic acidosis, hyperkalemia, and sodium channel blocker overdose

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    Related Documents

    Pediatric Resuscitation PDF

    Description

    This quiz covers the principles and guidelines for pediatric resuscitation, including assessment and management of pediatric patients. It includes decision-making scenarios for medical professionals.

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