PALS - REVIEW WITH CASE STUDIES
QUESTIONS AND VERIFIED
ANSWERS|100% CORRECT|GRADE A+
CPR Sequence - ANSWER C-A-B
Circulation-Airway-Breathing
Algorithm: Pediatric Septic Shock
First hour... - ANSWER Oxygen & support ventilation
Establish IV, draw labs (glucose, blood cultures)
Begin resuscitation
Push repeated 20 mL/kg isotonic crystalloid (3-4) unless rales, resp distress, hepatomegaly
Correct hypo-glycemia/calcemia
Admin 1st dose antibiotics STAT
STAT vasopressor drip/stress-dose hydrocortisone
Establish 2nd IV
Algorithm: Pediatric Septic Shock
Fluid Responsive? - ANSWER Yes - ICU
No - Vasoactive drug & titrate for normotension
Normo: begin dopamine
Hypo/warm: norepi
Hypo/cold: epi
Adenosine (slows HR) - ANSWER SVT
0.1 mg/kg - dose 1
,0.2 mg/kg - dose 2
max = 6 mg
RAPID push
Amiodarone (antiarrythmic) - ANSWER VF/VT (pulseless)
5 mg/kg
Bolus
max = 300 mg
SVT, VT (with pulses)
5 mg/kg
over 20-60 mins
max = 300 mg
Atropine (increases HR) - ANSWER Bradycardia
0.02 mg/kg
may repeat once
Epinepherine (increases HR) - ANSWER Bradycardia/Pulseless Arrest
0.01 mg/kg (1:10,000) every 3-5 min
Hypotensive Shock
0.1-1 mcg/kg per min
Anaphylaxis
0.01 mg/kg every 3-5 min
Algorithm: Pediatric Cardiac Arrest - ANSWER Shout for help
CPR
, Oxygen, AED
If no shock - CPR for 2 min, IV, Epi q 3-5 min, reassess
If shock - after...CPR for 2 min, IV, reassess
If 2nd shock - CPR for 2 min, Epi q 3-5 min, reassess
If 3rd shock - CPR for 2 min, Amiodarone, treat cause, reassess...
Post Resuscitation Care
Shock Doses - ANSWER 1st shock - 2 j/kg
2nd shock - 4 j/kg
Max 10 j/kg
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
6 H's
(G,K,T,V,X,DRO) - ANSWER 1. Hypo-Glycemia
2. Hypo/hyper-Kalemia
3. Hypo-Thermia
4. Hypo-Volemia
5. Hypo-Xia
6. HyDROgen ion (acidosis)
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
5 T's
(A,E,HC,HP,O) - ANSWER 1. Tamponade, cardiac
2. Tension pneumothorax
3. Thrombosis, coronary
4. Thrombosis, pulmonary
5. Toxins
Rescue Breaths - ANSWER 1 every 6-8 secs
QUESTIONS AND VERIFIED
ANSWERS|100% CORRECT|GRADE A+
CPR Sequence - ANSWER C-A-B
Circulation-Airway-Breathing
Algorithm: Pediatric Septic Shock
First hour... - ANSWER Oxygen & support ventilation
Establish IV, draw labs (glucose, blood cultures)
Begin resuscitation
Push repeated 20 mL/kg isotonic crystalloid (3-4) unless rales, resp distress, hepatomegaly
Correct hypo-glycemia/calcemia
Admin 1st dose antibiotics STAT
STAT vasopressor drip/stress-dose hydrocortisone
Establish 2nd IV
Algorithm: Pediatric Septic Shock
Fluid Responsive? - ANSWER Yes - ICU
No - Vasoactive drug & titrate for normotension
Normo: begin dopamine
Hypo/warm: norepi
Hypo/cold: epi
Adenosine (slows HR) - ANSWER SVT
0.1 mg/kg - dose 1
,0.2 mg/kg - dose 2
max = 6 mg
RAPID push
Amiodarone (antiarrythmic) - ANSWER VF/VT (pulseless)
5 mg/kg
Bolus
max = 300 mg
SVT, VT (with pulses)
5 mg/kg
over 20-60 mins
max = 300 mg
Atropine (increases HR) - ANSWER Bradycardia
0.02 mg/kg
may repeat once
Epinepherine (increases HR) - ANSWER Bradycardia/Pulseless Arrest
0.01 mg/kg (1:10,000) every 3-5 min
Hypotensive Shock
0.1-1 mcg/kg per min
Anaphylaxis
0.01 mg/kg every 3-5 min
Algorithm: Pediatric Cardiac Arrest - ANSWER Shout for help
CPR
, Oxygen, AED
If no shock - CPR for 2 min, IV, Epi q 3-5 min, reassess
If shock - after...CPR for 2 min, IV, reassess
If 2nd shock - CPR for 2 min, Epi q 3-5 min, reassess
If 3rd shock - CPR for 2 min, Amiodarone, treat cause, reassess...
Post Resuscitation Care
Shock Doses - ANSWER 1st shock - 2 j/kg
2nd shock - 4 j/kg
Max 10 j/kg
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
6 H's
(G,K,T,V,X,DRO) - ANSWER 1. Hypo-Glycemia
2. Hypo/hyper-Kalemia
3. Hypo-Thermia
4. Hypo-Volemia
5. Hypo-Xia
6. HyDROgen ion (acidosis)
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
5 T's
(A,E,HC,HP,O) - ANSWER 1. Tamponade, cardiac
2. Tension pneumothorax
3. Thrombosis, coronary
4. Thrombosis, pulmonary
5. Toxins
Rescue Breaths - ANSWER 1 every 6-8 secs
