PALS 2025|UPDATED&VERIFIED|100% SOLVED|GUARANTEED SUCCESS

Which pulses should be assessed to monitor systemic perfusion in a child? peripheral and central What should the first rescuer arriving on the scene of an unresponsive infant or child do? (in order) 1. verify scene safety 2. check for responsiveness 3. shout for help 4. activate the emergency response system Why may excessive ventilation during CPR be harmful? - it increases intrathoracic pressure - it impedes venous return If you cannot achieve effective ventilation (ie, the chest does not rise), do the following: - reposition/reopen the airway (sniffing position) - verify mask size and ensure a tight face-mask seal - suction the airway if needed - check the O2 source - check the ventilation bag and mask - treat gastric inflation (NG/OG) - consider 2-person bag-mask ventilation and inserting an OPA Ventilation rate 1 breath every 2-3 seconds delivered over 1 second (20-30 breaths per minute) Early signs of tissue hypoxia - tachypnea - increased respiratory effort (nasal flaring, retractions) - tachycardia - pallor, mottling, cyanosis - agitation, anxiety, irritability Late signs of tissue hypoxia - bradypnea, inadequate respiratory effort, apnea - increased respiratory effort (head bobbing, seesaw respirations, grunting) - bradycardia - pallor, mottling, cyanosis - decreased level of consciousness What is the role of the diaphragm during normal breathing in infants? pulls the ribs slightly inward S/S mild respiratory distress - mild tachypnea - mild increase in respiratory effort (nasal flaring, retractions) - abnormal airway sounds (stridor, wheezing, grunting) S/S Severe respiratory distress - marked tachypnea - marked increase in respiratory effort - paradoxical throacoabdominal breathing (seesaw breathing) - accessory muscle use (head bobbing) - abnormal airway sounds (grunting) - decreased level of consciousness S/S Impending respiratory arrest - bradypnea, apnea, respiratory pauses - low oxygen saturation (hypoxemia) despite high-flow supplemental oxygen - inadequate respiratory effort (shallow respirations) - decreased level of consciousness (unresponsive) - bradycardia What steps should be taken as part of initial management of a child in respiratory distress? - monitor O2 sat by pulse ox - monitor HR, rhythm, and, BP - support an open airway Stridor high-pitched breathing during inspirations Crackles breath sounds heart during expirations How should 1-rescuer infant compressions be delivered? - two fingers or two thumbs - rate of 100-120 - single rescuer (30:2) - two rescuer (15:2) How should 1-rescurer child compressions be delivered? either one or two hands - compress at least 1/3 the chest diameter (approximately 2 inches) Guidelines for rescue breathing for infants and children - give 1 breath every 2-3 seconds (about 20-30/min) - given each breath in 1 second - visible chest rise - check pulse every 2 minutes - use oxygen as soon as it is available 2-person bag mask ventilation may be necessary when: - making a seal is difficult - the provider's hands are too small - significant airway resistance (asthma) or poor lung compliance) - restricting spinal motion is necessary Best position to maintain an open airway - infant: place padding underneath shoulders - child: place padding underneath occiput Evaluate-Identify-Intervene Sequence evaluate (primary assessment, secondary assessment, diagnostic assessment) Evaluate - Primary Assessment a rapid hands-on ABCDE approach to evaluate respiratory, cardiac, and neurologic function; includes assessment of vital signs and pulse ox Evaluate - Secondary Assessment a focused medical history and focused physical exam Evaluate - Diagnostic Assessment laboratory, radiographic, and other advanced tests that help to identify the child's physiologic condition and diagnosis