Questions And All Correct Answers.
Cause of cardiopulmonary arrest in children - Answer Most likely from respiratory failure
Pediatric chain of survival - Answer 1. prevention of cardiac arrest and injury (big distinction from adult
chain)
2. early CPR
3. early access to emergency response system
4. early advanced care (PALS)
5. integrated post-cardiac arrest care
Neuro exam in children - Answer Evaluate interest in environment and response to parent
- infant who does not have interest in the environment or seems unable to recognize their parent is
concerning
- infant who enjoys sucking a finger and making eye contact with the nurse during assessment is
reassuring
Pulses in children - Answer Carotid and femoral pulses are the easiest to asses
CPR for infant with one person - Answer 30 compressions to 2 breaths
Hand placement: two fingers placed one fingerbreadth below nipple line
CPR for infant with 2 people - Answer 15 compressions to 2 breaths
Hand placement: two thumbs encircling the chest at the nipple line
CPR for child with 1 person - Answer 30 compressions to 2 breaths
Hand placement: heel of the hand or two hands for older children, pressing on the sterum at nipple line
,CPR for child with 2 people - Answer 15 compressions to 2 breaths
Hand placement: heel of the hand or two hands for older children, pressing on the sterum at nipple line
When to do chest compressions on child? - Answer When there is no pulse OR
HR <60 (not really for adolescents)
What is circumoral pallor an indication of? - Answer Poor oxygenation
Shock - Answer Inability for blood flow and oxygen delivery to meet metabolic demands of tissue
- if left untreated cardiopulmonary arrest will result
Can be compensated or uncompensated
Compensated shock - Answer Poor perfusion exists without decrease in BP
Uncompensated shock - Answer Inadequate perfusion accompanied by drop in BP
- can lead to cardiac arrest and death
Cardiac complications in children - Answer Slow: bradyarrhythmia
Fast: tachyarrhythmias
Absent: pulseless, cardiovascular collapse
Bradyarrhythamis - Answer Life threatening when HR is <60 (not in adolescents)
- can result in hypoxia and shock
- sustained bradycardia is associated with arrest and should be taken seriously
Epinephrine can be used
Tachyarrhythmias - Answer Fever, fear, pain are common explanations
, - focus on underlying cause.
- inappropriate to treat sinus tachy with medications
SVT
SVT - Answer Common cause is re-entry problem in cardiac conduction system
- associated with caffeine
- infants >220
- children >180
- no variability!
- can be compensated or uncompensated
Compensated SVT - Answer Child is alert, breathing and well perfused
Treatment: vagal maneuvers
- ice on face
- blow through obstructed straw
- adenosine if vagal maneuver fails
Uncompensated SVT - Answer Change in consciousness, respiratory status, and perfusion
- emergent intervention needed
- adenosine
How to administer adenosine - Answer FAST IV push followed by rapid generous saline flush
- rapid onset and extremely short half-life
ventricular tachycardia - Answer Rare and associated with congenital or acquired cardiac abnormality
Submersion injury - Answer 2nd leading cause of preventable death in children and adolescents
- lapse of adult supervision is the single most contributing cause