Paediatric BLS Flashcards
What is the compression ratio for paeds
15:2
What is different from DRS ABC in paediatrics
5 rescue breaths [finish]
How do you perform a heimlich maneuvre on a baby?
Abdo thrust on child?
Heal of hand - 5 hard blows on back
two hands between xiphisternum and umbilicus
Breathing assessment: paediatrics
Effort: -RR -recession. accessory muscles, gasping, nasal flaring -insp or exp noises, grunting Efficacy -Chest expansion, Breath sounds, O2 sats Effects of failure -HR, Skin colour, GCS
BTS classification of asthma severity
Life-threatening 33-92-CHEST PEF <33% SpO2 <92% Cyanosis/Confusion, Hypotension, Exhaustion, Silent chest, Tachycardia Severe PEF 33-50% RR >25 SpO2 >92% HR >110 Cannot complete sentences Moderate PEF >50-75% SpO2 >92% No features of severe
Treatment of asthma (with doses)
O SHIT ME
O2 using a face mask, Venturi mask, or nasal cannulae. Adjust flow rates as necessary to maintain an oxygen saturation of 94–98%
Salbutamol NEB (5 mg to all people aged over 5 years, and 2.5 mg to children aged 2–5 years).*
IV hydrocortisone 100 mg in people aged over 5 years, and 50 mg in children aged 2–5 years. PO prednisolone (40–50 mg for adults, 30–40 mg for children over 5 years, 20 mg for children aged 2–5 years, and 10 mg for children aged under 2 years if pt can swallow.
Ipratropium bromide (500 micrograms for adults and 250 micrograms for children aged 2–12 years, do not repeat within 4 hours).*
Treat electrolyte imbalance ?Theophylline
Mag sulph IV 2g over 20m
Escalate care (i.e intubation?)
*For people with life-threatening or severe asthma, and those with a poor initial response to salbutamol, consider the addition of nebulized
** Ideally, nebulizers should be oxygen driven (flow rate of 6 L /min usually needed) to avoid worsening hypoxia. If an oxygen-driven nebulizer is unavailable, deliver by air-driven nebulizer, although be alert that oxygen desaturation may occur. When using intermittent nebulization, repeat salbutamol administration every 20–30 minutes. When using a continuous nebulizer, give the dose over 30–60 minutes.
If a nebulizer is not available, or if the attack is of moderate severity, use a pressurized metered-dose inhaler with a large-volume spacer. Children under the age of three years are likely to require a face mask connected to the mouthpiece of a spacer for successful drug delivery. A short pause between puffs may be necessary to avoid hyperventilation with puffs given one at a time and inhaled with five tidal breaths. For an adult, give 4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs. Repeat every 10-20 minutes if clinically necessary. For a child, give a puff every 30–60 seconds, up to 10 puffs. If the response is poor, give further doses while awaiting hospital admission, and switch to a nebulizer if available.
GCS less than 8?
Intubate
Should you perform LP on someone with a rash?
No -
First line abx for septic shock
IV Cefotaxime
How do you dx paediatric dka on a blood gas?
Glucose>11
pH <7.3, 7.1 (for severe)
Bicarb <15
