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PHM BSc - Resus Science > ERC - Paeds > Flashcards

ERC - Paeds Flashcards

1
Q

define neonate, infant, child and adolescent

A

neonate <4 weeks
infant 4 weeks - 1 year
child 1 year - puberty
adolescent - >puberty

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2
Q

Airway management in paeds

A

Bag mask ventilation is first choice

if intubating use an uncuffed tracheal tube especially in neonates

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3
Q

what could cause a sudden deterioration in an intubated child

A 
Displaced
Obstruction
Pulmonary disorder (pneumothorax, oedema, bronchospasm)
Equipment failure
Stomach (distention splinting diaphragm)
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4
Q

at what rate do you ventilate a child

a) during CPR
b) post ROSC

A

a) 10 breaths/min

b) at the age appropriate rate

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5
Q

volume of fluid bolus given in paeds

A

20ml/kg

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6
Q

how does procainamide work and when is it used

A

1a antiarrhythmic - slows intraatrial conduction
wide QRS
prolong QT
used as a last resort in SVT and VT

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7
Q

what often causes bradycardia in children and therefore how is it treated

A

hypoxia! acidosis, hypotension

oxygen and PPV

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8
Q

Management of broad complex tachycardia in paeds

A

(very rare in paeds)
synchronised electrical cardioversion
amiodarone

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9
Q

how is pulmonary hypertension managed in paeds

A

high inspired fiO2
hyperventilation (reduce pulmonary vascular resistance)
IV epoprostenol

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10
Q

post ROSC goals in paeds

A

normoxia
normocapnoea
normoglycaemia
temp between 32-37.5

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11
Q

you find an unresponsive child who is not breathing, now what

A

5 rescue breaths

compressions: ventilations 15:2

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12
Q

describe an effective cough and an innefective cough

A

effective: able to vocalise, breathe between coughs, crying
ineffective: silent, unable to breathe or vocalise, LOC, cyanosed

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13
Q

a child has an effective cough, what do you do

A

encourage them to continue coughing

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14
Q

a child has an ineffective cough but is still conscious, what do you do

A

5 back blows

5 abdominal thrusts

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15
Q

an infant has an ineffective cough but is still conscious, what do you do

A

5 back blows

5 chest thrusts

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16
Q

compare FBAO management in an infant vs a child

A

back blows are the same (in a child if you can’t lie them across your knee then encourage them to lean forward)
thrusts are done on the chest (same position as CPR) in infants rather than abdominally (between umbilicus and xiphisternum)

17
Q

rate of compressions in paeds

A

100-120

18
Q

which arrest rhythm is most common in paeds and why

A

non-shockable as commonest cause of arrest is hypoxia

19
Q

management of a paediatric non-shockable rhythm

A

Ventilate and oxygenate

adrenaline ASAP then every other cycle eg 1st, 3rd, 5th

20
Q

management of a paediatric shockable rhythm

A

Ventilate and oxygenate

adrenaline and amiodorone after 3rd and 5th shock then continue with adrenaline every other cycle

21
Q

describe how electrode pad placement differs in paeds

A

<10kg use smaller pads (4-5cm)
>10kg use pads 8-12cm
if they are too close together there is danger of arcing electricity to place in AP position instead of sterno-apical

22
Q

if you are a lone responder to a paediatric emergency, how long do you perform CPR for before calling help

A

1 minute

23
Q

what is the energy used for shocking a paediatric patient in arrest

A

4J/kg

24
Q

in which age group of paediatric patients do you not give oxygen

A

neonates

25
Q

how often are you giving adrenaline in a paediatric patient

A

every 3-5 minutes

26
Q

which drugs can effect capnograph value

A

adrenaline and other vasoconstrictors can lead to reduced ETCO2
sodium bicarb can lead to an increased ETCO2

27
Q

to what depth should compressions be done to in infants and children

A

infants: 4cm
children: 5cm

28
Q

What is the initial dose of energy to cardiovert a paediatric patient in SVT

A

1J/kg

29
Q

When checking for a pulse in paediatrics, where should you feel

A

infants: femoral or brachial
children: femoral or carotid

30
Q

tracheal tube size for neonates:

a) premature
b) full term

A

UNCUFFED
premature: gestational age in weeks/10
full term: 3.5

31
Q

uncuffed tracheal tube size for

a) infants
b) 1-2
c) >2

A

a) 3.5-4
b) 4-4.5
c) age/4 + 4

32
Q

cuffed tracheal tube size for

a) infants
b) 1-2
c) >2

A

a) 3-3.5
b) 3.5-4
c) age/4 + 3.5

33
Q

what pressure should the cuff be inflated to in paediatric patients

A

25cm H2O

34
Q

when is atropine given to paediatric patients

A

only when the bradycardia is due to increased vagal tone or cholinergic drug toxicity
Adrenaline is used for bradycardia normally

35
Q

A child is bradycardic, how should they initially be managed

A

100% O2 and PPV

if they don’t respond to this start compressions and give adrenaline

36
Q

How is a stable paediatric patient in SVT managed

A

vagal manoeuvres and adenosine

37
Q

How should decompensated paeds patients with SVT be managed

A

1) synchronised electrical carioversion 1J/kg
2) synchronised electrical cardioversion 2J/kg
3) amiodarone or procainamide
4) 3rd attempt at electrical cardioversion

PHM BSc - Resus Science (29 decks)

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