PALS 2021 Low flow O2 systems 2022 with complete
solution
A low flow delivery system does what?
Delivers air through a nasal cannula or a simple mask that does not fit tightly against the
childs face.
Low flow systems provide how much inspired O2 concentration?
Who uses them?
22- 60%
Used for stable children who require a low inspired O2 concentration, such a when a
child is not in severe respiratory distress or shock
Examples of low flow systems?
Nasal cannula and simple mask
O2 flow rate for nasal cannula
0.25 to 4 L/min
Simple mask flow rate?
6-10 L/min Inspired O2 concentration of 35- 60%
Why cant the simple mask deliver inspired O2 concentration greater than 60%?
Because room air enters between the mask and face during inspiration
high flow O2 delivery systems do what? Flow rate?
When should they be used?
Most common example of High flow O2 system?
Deliver O2 concentration 60% or greater (95%) . Flow rate is 10L.
Used in emergency situations whenever the child has respiratory distress or shock
Nonrebreathing mask
Nonrebreathing mask valves do what?
A valve in 1 or both exhalation ports to prevent room air from entering during inspiration
Valve between reservoir bag and mask to prevent flow of exhaled gas into reservoir
How do you prevent bag collapse in nonrebreather?
Adjust O2 flow rate into mask. Greater than 10L
During inspiration how much O2 is drawn by the child with a nonrebreather?
100% from the reservoir bag and O2 inflow
High Flow nasal cannula
O2 can be adjusted from 4 L in infants up to 40 L or more in adolescents. Deliver a
combo of room air and oxygen.
Gas flow for nebulizer? How long?
, 5-6L/min
8-10 min
Does skin pigment affect accuracy or function of the pulse oximeter?
False
What must you confirm with a pulse ox?
Confirm validity of oximeter data by evaluating Childs appearance. Also compare HR
displayed by pulse ox with HR displayed by the bedside monitor
respiratory arrest
The absence of respirations (apnea) with detectable cardiac activity. Must provide
rescue breathing to prevent cardiac arrest
When should endotracheal intubation be considered?
If the child is unstable to maintain effective airway, oxygenation, or ventilation despite
initial intervention.
DOPE
Displacement
Obstruction
Pneumothorax
Equipment failure
Could cause deterioration of the pt
If a pts condition deteriorates you first must do what?
Supply oxygenation and ventilation. Rapidly assess the child to figure out cause of
crashing. Hand ventilate with bag
What should you observe while pt is deteriorating on a vent? And what do you
check?
Observe chest rise and symmetry
Auscultate over both sides of anterior chest
Check monitors
Check HR
Suction ET tube
Use sedatives or analgesics
If you cannot verify that the ET tube is in the airway what do you do?
Direct visualization of the tube passing through the glottis is advised.
What happens if the childs condition is deteriorating and you suspect that the
tube is no longer in the trachea?
You may need to remove it and ventilate with a bag mask device
Common causes of upper airway obstruction
Foreign body aspiration
Airway swelling
Mass compromising airway lumen
Thick secretions
Congenital airway abnormality
Poor control of upper airway
solution
A low flow delivery system does what?
Delivers air through a nasal cannula or a simple mask that does not fit tightly against the
childs face.
Low flow systems provide how much inspired O2 concentration?
Who uses them?
22- 60%
Used for stable children who require a low inspired O2 concentration, such a when a
child is not in severe respiratory distress or shock
Examples of low flow systems?
Nasal cannula and simple mask
O2 flow rate for nasal cannula
0.25 to 4 L/min
Simple mask flow rate?
6-10 L/min Inspired O2 concentration of 35- 60%
Why cant the simple mask deliver inspired O2 concentration greater than 60%?
Because room air enters between the mask and face during inspiration
high flow O2 delivery systems do what? Flow rate?
When should they be used?
Most common example of High flow O2 system?
Deliver O2 concentration 60% or greater (95%) . Flow rate is 10L.
Used in emergency situations whenever the child has respiratory distress or shock
Nonrebreathing mask
Nonrebreathing mask valves do what?
A valve in 1 or both exhalation ports to prevent room air from entering during inspiration
Valve between reservoir bag and mask to prevent flow of exhaled gas into reservoir
How do you prevent bag collapse in nonrebreather?
Adjust O2 flow rate into mask. Greater than 10L
During inspiration how much O2 is drawn by the child with a nonrebreather?
100% from the reservoir bag and O2 inflow
High Flow nasal cannula
O2 can be adjusted from 4 L in infants up to 40 L or more in adolescents. Deliver a
combo of room air and oxygen.
Gas flow for nebulizer? How long?
, 5-6L/min
8-10 min
Does skin pigment affect accuracy or function of the pulse oximeter?
False
What must you confirm with a pulse ox?
Confirm validity of oximeter data by evaluating Childs appearance. Also compare HR
displayed by pulse ox with HR displayed by the bedside monitor
respiratory arrest
The absence of respirations (apnea) with detectable cardiac activity. Must provide
rescue breathing to prevent cardiac arrest
When should endotracheal intubation be considered?
If the child is unstable to maintain effective airway, oxygenation, or ventilation despite
initial intervention.
DOPE
Displacement
Obstruction
Pneumothorax
Equipment failure
Could cause deterioration of the pt
If a pts condition deteriorates you first must do what?
Supply oxygenation and ventilation. Rapidly assess the child to figure out cause of
crashing. Hand ventilate with bag
What should you observe while pt is deteriorating on a vent? And what do you
check?
Observe chest rise and symmetry
Auscultate over both sides of anterior chest
Check monitors
Check HR
Suction ET tube
Use sedatives or analgesics
If you cannot verify that the ET tube is in the airway what do you do?
Direct visualization of the tube passing through the glottis is advised.
What happens if the childs condition is deteriorating and you suspect that the
tube is no longer in the trachea?
You may need to remove it and ventilate with a bag mask device
Common causes of upper airway obstruction
Foreign body aspiration
Airway swelling
Mass compromising airway lumen
Thick secretions
Congenital airway abnormality
Poor control of upper airway
