PALS Flashcards
(95 cards)
1
Q
What are the first six interventions for respiratory emergencies?
A
Airway positioning Suctioning Oxygen Pulse oximetry ECG BLS as indicated
2
Q
Four main types for airway emergencies
A
Upper airway emergencies
Lower airway emergencies
Lung tissue disease
Disordered control of breathing
3
Q
Three upper airway emergencies
A
Croup
Anaphylaxis
Aspiration of a foreign body
4
Q
Two types of lower airway emergency
A
Bronchiolitis
Asthma
5
Q
Two types of lung tissue disease
A
Pneumonia
Pulmonary edema
6
Q
Three types of disordered control of breathing
A
Increased ICP
Poisoning/Overdose
Neuromuscular disease
7
Q
Croup treatment
A
Epi neb
Corticosteroids
8
Q
Anaphylaxis respiratory treatment
A
IM epi
Salbutamol
Antihistamines
Corticosteroids
9
Q
Aspiration foreign body treatment
A
Position of comfort
Speciality consultation
10
Q
Bronchiolitis treatment
A
Nasal suctioning
Bronchodilator trial
11
Q
Asthma treatment
A
Salbutamol Corticosteroids SQ epi Magnesium sulphate Salbutamol IV
12
Q
Pneumonia treatment
A
Salbutamol
Antibiotics
Consider CPAP
13
Q
Pulmonary edema treatment
A
Consider NIV
Consider ventilatory support with PEEP
Consider vasoactive support
Consider diuretic
14
Q
Increased ICP treatment
A
Avoid hyoxemia
Avoid hypercarbia
Avoid hyperthermia
15
Q
Poisoning/overdose treatment
A
Antidote
Contact poison control
16
Q
Neuromuscular disease management
A
NIV or invasive ventilators support with PEEP
17
Q
Six initial actions in shock management
A
Oxygen Pulse oximetry ECG IV/IO access BLS BGL
18
Q
Four types of shock
A
Hypovolemic
Distributive
Cardiogenic
Obstructive
19
Q
Two types of hypovolemic shock
A
Nonhemorrhagic
Hemorrhagic
20
Q
Three types of distributive shock
A
Septic
Anaphylactic
Neurogenic
21
Q
Two types of cardiogenic shock
A
Bradyarrythmia/tachyarrhythmia
Other - CHD, Myocarditis, cardiomyopathy, poisoning
22
Q
Four types of obstructive shock
A
Ductal dependant
Tension pneumothorax
Cardiac tamponade
Pulmonary edema
23
Q
Nonhemorrhagic shock treatment
A
20 ml/kg NS/LR prn
Consider colloid
24
Q
Hemorrhagic shock treatment
A
Control external bleeding
20 ml/kg NS/LR repeat up to three times
Transfuse PRBCs
25
Septic shock treatment
Refer to septic shock management algorithm
26
Anaphylactic shock treatment
```
IM epi
Fluid bolus 20 ml/kg
Salbutamol
Antihistamines, corticosteroids
Epinephrine infusion
```
27
Neurogenic shock treatment
20 ml/kg NS/LR prn
| Vasopressors
28
Cardiogenic shock treatment
Management algorithms
| Brady/Tachy
29
Other cardiogenic shocks
5-10 ml/kg bolus prn
Vasoactive infusion
Expert consult
30
Ducal dependant shock treatment
Prostaglandin E
| Expert consult
31
Tension pneumothorax shock treatment
Decompression
| Tube thoracostomy
32
Cardiac tamponade shock treatment
Pericardiocentesis
| 20 ml/kg NS/LR
33
Pulmonary embolism shock treatment
20 ml/kg NS/LR prn
Consider thrombolitics, anticoagulants
Expert consult
34
Two initial actions in cardiac arrest
O2
| Attach monitor
35
Which rhythm is shockable
VF/pVT
36
Reassess how often in cardiac arrest
2 minutes
37
PEA/asystole actions?
IV/IO access
2 minute cycles of CPR
Epi every 3-5
consider advanced airway
38
VF/pVT actions
```
IV/IO
2 minute cycles of CPR
If shockable rhythm defibrillate
Epi every 3-5 min
Consider advanced airway
Consider amiodarone or lidocaine
Hs & Ts
```
39
Quality CPR criteria
```
1/3 of chest
100-120/min
Minimize interruptions
Avoid excess ventilation
Rotate compressors every 2 minutes
```
40
Defibrillation energy dose
First shock: 2 J/kg
Second shock: 4 J/kg
Increase voltage to gradually to max of 10 J/kg
41
Cardiac arrest Epi dose
0.01 mg/kg q 3-5 min
42
Cardiac arrest amiodarone dose
5 mg/kg bolus May repeat up to 2 times
43
Cardiac arrest lidocaine
1 mg/kg loading dose
44
Estimating uncuffed endotracheal tube formula
(Age/4)+4
45
Cuffed endotracheal tube formula
(Age/4)+3.5
46
Cardiac arrest signs of rosc
Pulse/BP
| Spontaneous arterial pressure wave on invasive monitoring
47
Cardiac arrest Hs
```
Hypovolema
Hypoxia
Hydrogen ion (acidosis)
Hypoglycaemia
Hypo/hyperkalemia
Hypothermia
```
48
Cardiac arrest Ts
```
Tension pneumo
Tamponade
Toxin
Thrombosis - cardiac
Thrombosis - pulmonary
```
49
Cardiac arrest breaths per minute
10/min
| 1 every 6 seconds
50
Four signs of upper airway obstruction
Increased RR and effort
Stridor
Change in voice
Drooling, snoring or gurgling sounds
51
Five signs of lower airway obstruction
```
Increased RR and effort
Decreased air movement on auscultation
Prolonged exploratory phase
Wheeze
Cough
```
52
Six signs of lung tissue disease
```
Increased RR and effort
Grunting
Crackles
Diminished breath sounds
Tachycardia
Hypoxemia despite O2 admin
```
53
Three signs of disordered control of breathing
Irregular rate and pattern of breathing
Shallow or inadequate effort
Apnea
54
Bradycardia 5 initial actions
```
Maintain patent airway
Oxygen
Monitor - rhythm, BP and Spo2
IV/IO
12-lead
```
55
Bradycardia with S/S if cardiopulmonary compromise treatment?
HR <60 despite O2 and ventilation then CPR
56
Bradycardia persists after 02, ventilation and CPR?
Epinephrine
Atropine
Consider TCP
Treat underpaying cause
57
Epi dose for Bradycardia
0.01 mg/kg q 3-5 min
58
Atropine dose for Bradycardia
0.02 mg/kg - 1 repeat
Min dose 0.1 mg
Max dose 0.5 mg
59
Three initial approach criteria
Appearance
Breathing
Circulation
60
Five initial actions in tachycardia
```
Maintain airway
Oxygen
Monitor
IV/IO
12-lead - without delaying therapy
```
61
Five sinus tachycardia criteria
```
Compatible history
P wave present/normal
Variable R-R constant PR
Infant rate <220
Child rate < 180
```
62
Five SVT criteria
```
Compatible history
Abnormal or absent P waves
HR not variable
Infants rate >220
Child rate > 180
```
63
Possible VT with cardiopulmonary compromise treatment?
Synchronized cardioversion
64
Possible VT without cardiopulmonary compromise treatment?
Consider adenosine - in regular and monomorphic
| Expert consult - amiodarone or procainamide
65
Probable sinus tachycardia treatment?
search for and treat cause
66
Probable SVT treatment?
Consider vagal maneuver
Consider adenosine
Consider cardioversion if adenosine unavailable or ineffective
67
Synchronized cardioversion dose?
Consider sedation
0.5-1 J/kg then increase to
2 J/kg
68
Adenosine SVT dose?
First dose: 0.1 mg/kg max of 6 mg
| Second dose: 0.2 mg/kg max of 12 mg
69
Amiodarone SVT dose?
5 mg/kg over 20-60 min
70
Procainamide SVT dose?
15 mg/kg over 30-60 min
71
Procainamide is incompatible to administer with which drug?
Amiodarone
72
Amiodarone is incompatible to administer with which drug?
Procainamide
73
Normal HR for neonate awake/asleep?
Awake 100-205
| Asleep 90-160
74
Normal HR for infant awake/asleep?
Awake 100-180
| Asleep 90-160
75
Normal HR for toddler awake/asleep?
Awake 98-140
| Asleep 80-120
76
Normal HR for preschooler awake/asleep?
Awake 80-120
| Asleep 65-100
77
Normal HR for school aged awake/asleep?
Awake 75-118
| Asleep 58-90
78
Normal RR for adolescent?
12-20
79
Normal RR for infant?
30-53
80
Normal RR for toddler?
22-37
81
Normal RR for preschooler?
20-28
82
Normal RR for school aged child?
18-25
83
Five sign of septic shock
```
Altered mental status
Altered heart rate
Altered temperature
Altered perfusion
Hypotension
```
84
Six actions of initial stabilization in sepsis
```
ABCs
Monitor
IV/IO
Antibiotics
Fluid bolus
Antipyretic
```
85
Septic signs of shock do not persist past initial stabilization?
Consider critical care consult
86
Septic signs of shock persist beyond initial stabilization?
Obtain expert consult
Warm shock: norepinephrine
Cold shock: epinephrine
Dopamine is backup if other pressures are unavailable
87
Four sepsis critical care goals of therapy?
Scvo2 >70%
Adequate BP
Normalized HR
Adequate CO and organ perfusion
88
Sepsis Scvo2 <70, poor perfusion with cold extremities treatments despite epinephrine ? (6)
Fluid boluses
Transfusion if Hgb <100
Epinephrine infusion
If BP low consider adding norepinephrine
If BP normal consider milrinone or vasodilator
Consider inotrope
89
Sepsis with Scvo2 >70, poor perfusion and warm extremities despite norepinephrine? (3)
Fluid boluses prn
Continue Norepinephrine
Consider pressors and inotropes as needed
90
Sepsis Scvo2 >70 signs of shock resolves after initial vasopressor?
Monitor in ICU
| Treat infection source
91
Management of shock after ROSC initial three actions?
Titrations FiO2 to SpO2 of 94-99%
Consider advanced airway
Target PCO2 appropriate for pt condition
92
Shock post ROSC three treatments for persistent shock?
Treat contributing factors (Hs, Ts)
Boluses 20 ml/kg
Consider inotropes or vasopressors
93
Three post ROSC hypotension shock medications?
Epinephrine
Dopamine
Norepinephrine
94
Four medications for post ROSC normotensive shock?
Dobutamine
Dopamine
Epinephrine
Milrinone
95
Post ROSC care after pressors and inotropic support? (6)
Treat agitation or seizures
Treat hypoglycaemia
Blood gas and electrolytes
If comatose targeted temperature management
Consider consult and transport to tertiary care
