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Paeds: Child Health > Paediatric BLS > Flashcards

Flashcards in Paediatric BLS Deck (10):
1

What is the compression ratio for paeds

15:2

2

What is different from DRS ABC in paediatrics

5 rescue breaths [finish]

3

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

4

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

5

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

6

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.

7

GCS less than 8?

Intubate

8

Should you perform LP on someone with a rash?

No -

9

First line abx for septic shock

IV Cefotaxime

10

How do you dx paediatric dka on a blood gas?

Glucose>11
pH <7.3, 7.1 (for severe)
Bicarb <15