PALS AHA QUESTIONS AND ANSWERS RATED A

PALS AHA QUESTIONS AND ANSWERS RATED A Croup treatment (upper airway) Nebulized epi Corticosteroids Anaphylaxis treatment (upper airway) IM epi (auto injector) Albuterol Antihistamines Corticosteroids Bronchiolitis treatment (lower airway) Nasal suctioning Bronchodilator trial Asthma treatment (lower airway) Albuterol +/- ipratropium Corticosteroids SC epi Mg Sulfate Terbutaline HR for SVT in: - Infant: 220 bpm+ - Kids: 180+ Situations that may cause pedi pts go into VTach? - Near drowning - TCA OD - Underlying heart disease - Prolonged QT Normal HR for newborn to 3 mo: 85-205 bpm Normal HR for 3 mo to 2 years: 100-190 bpm Normal HR for 2-10 yo: 60-140 bpm Normal HR for 10 yo: 60-100 bpm Signs of compensated shock a. Tachycardia b. Increased RR c. Altered mental status d. Change in pulses e. Prolonged capillary refill f. Skin color changes g. Skin temperature Hypovolemic/Distributive Shock-- Fluid Resuscitation 20 ml/kg bolus of NS over 5-20 min repeat boluses to restore BP/Tissue perfusion Cardiogenic shock or Poisioning -- Fluid Resuscitation 5-10 ml/kg bolus of NS over 10-20 min DKA w/ Compensated Shock -- Fluid Resuscitation 10-20 ml/kg over 1 hr Cardiogenic shock A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions. Defibrillation Use largest pads w/o touching - 1st shock = 2 J/kg - 2nd shock = 4 J/kg - 3rd+ shock ≥ 4 J/kg - Max = 10 J/kg or adult dose How do you find the right ET tube size? 16 + age / 4 Synchronized cardioversion Unstable SVT or VT w/Pulse Use largest pads w/o touching -1st Zap 0.5-1 J/kg -2nd Zap 2 J/kg Primary Assessment A- airway B- Breathing C- Circulation D- Disability (LOC,Seizures) E- Exposure (Hypothermia,Bleeding) AVPU A- alert V- voice P- pain U- unresponsive Infant 1yr -- Norm RR 30-60/min Toddler 1-3yr -- Norm RR 24-40/min Preschool 4-5yr -- Norm RR 22-34/min School Age 6-12yr -- Norm RR 18-30/min Adolescent 13-18 -- Norm RR 12-16/min Hypotension (SBP) Neonate 0-28day -- 60 Infant 1-12mn -- 70 Child 1-10yr -- 70+ Age in yr x2 Child 10yr -- 90 Hypoglycemia Neonates 45 mg/dl Infants & Adolescents 60 mg/dl Bradycardia -- HR 60/min -- Drugs Epi 0.01 mg/kg (0.1ml/kg) of 1:10000 q 3-5 min Atropine 0.02 mg/kg Repeat 1x (min-0.1mg max-0.5mg) Adenosine -- SVT 0.1 mg/kg MAX 6mg RAPID wait... didn't convert 0.2 mg/kg MAX 12mg RAPID Lidocaine -- Stable VT 1 mg/kg Bolus Mag Sulfate -- Torsafes or VT w/ Hypomag 25-50 mg/kg IV/IO MAX 2g over 10-20 min Faster push if in arrest Child/Infant CPR 10 sec pulse check Compression 100/min (1= 30:2) (2=15:2) Depth 1/3 AP Diameter 1.5-2in or 4-5cm Rotate q 2 min Head tilt Chin Lift Advance airway 1 breath q 6-8 sec Shock? -- Yes! Cont CPR Immediately Cardiac Arrest Drugs Epi-- 0.01 mg/kg q 3-5 min 1:10000 Amiodrone-- 5mg/kg Bolus Repeat 2x PRN Dopamine 10-20 mcg/kg per min Norepi 0.1-2 mpg/kg per min Maintence Fluids 10kg (22lbs) 4 ml/kg per hr 10-20kg (22-44lbs) 40ml/h+2ml/kg per hr 20kg (44+lbs) 60ml/h+1ml/kg per hr Albuterol Neb 20 kg (44lb) 2.5 mg q 20 min 20 kg (44lb) 5 mg q 20 min Dextrose D50 1-2ml/kg D25 2-4ml/kg D10 5-10ml/kg Diphenhydramine 1-2 mg/kg q 4-6hr MAX 50 mg Ipratropium 250-500 mpg q 20 min Narcan 0.1mg/kg q 2 min IV/IO/IM/SC AEIOU-TIPS A Alcohol E Epilepsy I Insulin O Overdose U Underdose T Trauma I Infection P Pyschosis S Stroke