FB Flashcards
(117 cards)
1
Q
Check first
A
Cogh
2
Q
If no cough and unconsciousness
A
Open airway
Rescue breath
3
Q
If no cough and conscious
A
Infant -5 back blow and chest trusts
Child -5 back blow and abdo thrusts
4
Q
Back blows position
A
Head down and prone
5
Q
Ratio of chest compression
A
15:20
6
Q
Rate chest compression
A
100-120
7
Q
Depth chest comp
A
4cm infants
5cm children
8
Q
Sites of Io
A
Proximal tibia
Distal Tibia
Distal femur
Prix humerus
9
Q
Fluid boils
A
10ml/kg
10
Q
Glucose solution
A
2ml/kg of 10%
2.5ml/kg in newborn
11
Q
When to consider blood replacement
A
2xgluid blouses
12
Q
Adrenaline indications
A
Arrest
Hr<60
Dose 10mcg/kg of 1:10000
Septic shock
Anaphylaxis
13
Q
Mechanism of adrenaline
A
Alfa and beta adrenergic
14
Q
Avoid adrenaline with
A
Sodium bicarbonate
15
Q
Half life of adrenaline
A
2m
16
Q
Indications amiodarone
A
VF or pVT
17
Q
Dose amiodaro e
A
5mg/kg
18
Q
Side effect amiodaro me
A
Hypotension
19
Q
Adenosine indication
A
SVT
20
Q
Dose adenosine
A
Neonates to 11 months -150mcg/kg max doe 300/500
1-11yrs- 100mcg/kg max 500
12-17yts- 3mg then 6 then 12
21
Q
Sodium bicarbonate indication
A
Acidaemia
Consider if prolonged arrests
22
Q
Sodium bicarbonate dose
A
1mg/kg
23
Q
Administration of calcium associated with
A
Increased mortality
24
Q
Dose for naloxone
A
Under 5 100mcg/kg
Over 5 2mg
Every 3m
25
Indication of mag
Low mag
Torsade de pointes
26
Mechanism of salbutamol
Beta 2 agosnit
27
Fise of IV salbutamol
1-23 month 5mcr/kg
2-17 yrs 15mcg/kg
28
Indication for atropine
Bradycardia
29
Bradycardia and tachycardia <1
80
180
30
Bradycardia and tachycardia <1
80
180
31
Bradycardia and tachycardia >1
60
160
32
First thing to do in Brady child
Airway opening
100% oxygen
33
Cardioversion energy level
1J/kg
2J/kg second shock
Increase to 4 under specialist advice and consider amiodarone if second shock fails
34
Adenosine side effects
Bronchospasm
35
Hr rate difference in Tachycardia and SVT
Infant tachycardia <220
Child tachycardia <180
SVT will be above these
36
Incidence of shockable rhythm in in hospital arrests
27%
37
Positions of pads
Bracket the heart
38
Position of pads in infant
Anterior posterior
Lower half of chest and between scapulae
39
Energy dose in defibrillation
4J/kg for all shocks
Consider escalation after 6th shock
Dose up to 8J/kg
40
Most common rhythms in children
Non shockable PEA, asystole, profound bradycardia
41
Most common rhythms in children
Non shockable PEA, asystole, profound bradycardia
42
Shockable rhythms common in children with
Underlying heart disease
43
Where to feel pulses
Infant brachial
Child carotid (>1yr)
Both femoral
44
Dose of adrenaline and amiodarone in arrest
10mcr/kg
5mg/kg
45
How often to give adrenaline
Ever 3/5m (every other cycle)
46
How often to give adrenaline
Ever 3/5m (every other cycle)
47
How often give amiodarone
3rd and 5th shocks
48
If using AES in child <8 give attenuated shock of
50-75J if possible
49
4H and T
Hypovolaemia
Hypoglycaemia
Hypothermia
Hypoxia
Toxins
Tension
Tamponade
Thrombus
50
Complication of BMV
Gastric distention
Manage with gastric tube
51
Causes of sudden deterioration in intubated patient
DOPES
Displacement of tube
Obstruction
Pneumothorax
Equipment failure
Stomach distention
52
Urine output target
>1ml/kg/h in child
>2ml/kg/h in infant
53
Hb target
>70
54
Clinical features of croup
Inspiratore stridor
Barking cough
Hoarseness
Resp distress
55
Common pathogen of croup
Parainfluenza
RSV
Adenovirus
56
Management of croup
Oral dexamethasone one to two doses
Neb adrenaline (3-5ml of 1:1000) if resp distress
Neb steroid as budesonide if unable to take oral
Intubation can be required if exhaustion
57
Causes of epiglottitis
Haemophilus influenzae B
58
CF of epiglottitis
Drooling lethargic
High fever and pale
59
When to consider bacterial tracheitis
Upper airway obstruction not responsive to croup management
60
Management of tracheitis
Abx for staph and strep
61
Cause of bronchiolitis
RSV 75%
Parainfluenza
Influenza
Adenoviruses
62
CF of bronchiolitis
1/3 days of cough
High RR
Wheeze
Crackles
63
When does bronchiolitis occur
Autumn and winter
64
Common age of bronchiolitis
1-9months 90%
Rare after 1 year
65
RF for severe bronchiolitis
Congenital heart disease
Premature
Less than 3m
Chronic lung disease
Immunodeficiency
66
Management bronchiolitis
Supportive
NIV required if resp failure
67
Indication of hospital admission
Poor oral fluid intake (50-75%)
Apnoea
Oxygen sta <92 ORA
Resp distress - gruntin, chest recession, RR >70
68
How often is mechanical ventilation required in bronchiolitis
3%
69
Dose of neb salbutamol in asthma
2.5-5mg every 20m
70
Dose of ipratropium
250mcg
71
Oral steroid dose pred
20mg for 2-5
30/40mg for >5
72
What to consider in asthma if no response to bronchodilators and steroid
Magn and aminophylline
73
What steroid to give in asthma if vomiting and dose
Hydrocortisone 4mg/kg every 4hrs
74
Adrenaline IM anaphylaxis doses
<6m 100-150mcg 1:1000 (0.1-0.15ml of 1mg ml)
6m-6yr 150mcg (0.15ml of 1mg ml)
6-12yt 300mcg (0.3ml of 1mg ml)
>12 500mcg (0.5ml of 1mg ml)
75
How often given adrenaline
Every 5m if no resolution
76
How to keep open PDA
Prostaglandin infusion
77
Dose of antiepileptic
Lorazepam 0.1mg/kg IV/IO
Midazolam 0.15 mg/kgIV/IO
Midaz 0.3 mg/kg buccal or intranasal
78
Side effect of rapid phenytoin
Bradycardia or asystole
79
5% degree of dehydration
Ph 7.2-7.29 or bicarbonate <15 = mild DKA
Ph 7.1-7.19 or bicarbonate <10 = moderate DKA
80
10% degree of dehydration
Ph <7.1 or bicarbonate <5 = severe DKA
81
Calculate fluid deficient
Degree of dehydration x weight x 10
82
Fluid requirement over 48hr
Maintenance fluid for 48hr + (fluid deficit-initial fluid given)
83
Maintenance fluid calculation
4ml/kg/hr for first 10
2ml/kg/hr for second 20 (11-20)
1ml/kg/hr for each kg above 20 up to 75kg max
84
Main cause of hyponatraemia in children
SIADH
85
Dose of sodium for replacement
3ml/kg of 3% sodium chloride over 20m
Rate of change no more than 0.5mmol/l/h
86
Management of hyperkalaemia
Calcium gluconate or chloride IV
Insuline dextrose infusion and salbutamol never
Diuretics
Calcium resonium (slow)
87
Management high calcium
Fluids: twice calculate basic daily fluid requirement
88
Percentage of blunt trauma in UK
80%
2/3 of life threatening due to brain injury
89
Triad that increases mortality in trauma
Acidosis
Hyperthermia
Coagulopathy
90
What is SCIWORA
Spinal cord injury without radiological abnormalities
91
How to assess for internal bleeding
USS evidence of free fluid
Contrast Ct
92
Total circulating volume in child
70ml/kg
93
At what point does BP drop
>40% loss
Not useful to initiate or guide treatment
94
Tranexamic acids dose
15mg/kg loading
2mg/kg/h infusion
95
Unilateral dilated pupil
Intracranial bleeding or raised ICP
96
Percentage of brain injury responsible for death
70%
97
Signs of tension pneumothorax
Hypoxia
Absent or decreased breath sounds
Resonant to percussion
Neck vein distention
Tracheal deviation away from side
98
Management of tension
Needle thiracicentesis - cannula in 2nd intercostal space mid clavicular line
Chest drain
99
Traumatic diaphragmatic hernia most common which side
Left
100
Landmark for chest drain insertion
4/5th intercostal in mid axillary line
101
Imaging for spinal injury
MRI especially is SCIWORA suspected
102
Epidermal burn
Pain with erythema and no blister
Heal in 7 days
103
Superficial partial thickness
Epidermis and superficial dermis
Blister and pale pink
Very painful
Heal in 2/3 wks
104
Deep partial thickness
Epidermis and dermis
Dry/moist skin
Blothciness with blisters
Decreased CRT
May or not be painful
Heals >3wks
105
Full thickness burns
Epidermis dermis and subcutaneous tissues and structures
White in appearance with no CRT
Manage with surgical debridement and grafting
106
Calculate burn area
Child’s palm = 1%
107
Burns of 10% or more require fluid through Parkland formula
% burn x body weight x 4ml/day
Half in first 8hr
Half in next 16hrs
108
Drowning management
Open airway
Rescue breath
Chest compressions
109
Hypothermia
Temp <35
High risk due to high body surface to weight ratio
110
What to do with newborn baby
Delay clamping cord if possible
Keep WARM
Assess- color, tone, breathing, HR
111
How long should you wait to clamp cord
60s at least
112
Heart rate morning in newborn
<100 without effective breathing = immediate inertvention with assessment every 30s
113
Acceptable says in newborn
2m 65
5m 85
10m 90
114
Signs of significant hypoxia in newborn
Apnoea
Low or absent HR
Pallor
Floppy
115
Newborn baby should be put in which position for airway management
Neutral
Jaw thrust can be done
116
Ho to perform inflation breaths
5 slow breaths over 2/3 sec in air
Check HT after 5 breaths to see increase >100
117
What to do after first 5 inflation
If HR raising and breathing = continue at 30/m until regular breathing
If no HT raise = give other 5 and check after, if ongoing nil response give oxygen and chest compressions after 30s of ventilation breaths
