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Flashcards in The collapsed child Deck (11):
1

Common causes of cardiorespiratory arrest

Respiratory:
-Failure
-Obstruction
-Smoke inhalation

Cardiac:
-Arrythmia
-HF
-Myocarditis

Neurological:
-Cerebral edema
-Coning
-Head injury
-Birth asphyxia

Severe hypoxic-ischemia
-Drowning
-Suffocation

Drug ingestion

Trauma:
-MVA
-Intentional
-Falls
-Leading to airway trauma->pneumothorax, major vessel disruption, cardiac tamponade

2

Pediatric advanced life support

Call for help
Open airway
Check for respiration
High flow oxygen ventilation
Mouth to mouth
15:2 CPR

During CPR:
LMA/ETT, oxygen
IV/IO access
Plan actions before interrupting

Consider and correct:
Hypoxia
Hypovolemia
Hyper/hypokalemia, metabolic
Hypo/hyperthermia
Tension pneumothorax
Tamponade
Toxins
Thrombus

Defibrillator->assess rhythm
1. Shockable (VF, pulseless VT)
-Shock 4j/kg
-Adrenaline 10mcg/kg after second shock, then every second loop
-Amiodarone 5mg/kg after 3rd shock

2. Non-shockable (PEA, asystole)
-Adrenalin 10mcg/kg immediately, then every second loop

Return of spontaneous circulation->
Post resuscitation care

3

What is involved in post-resuscitation care

Re-evaluate ABCDE
12 lead ECG
Treat precipitating cause
Re-evaluate oxygen and ventilation
Temperature control->cool

4

How to establish an airway

Chin lift->sniffing in child, neutral in infant
Jaw thrust if suspect cervical spine injury
Clear airway
2 breaths

5

DRABCD

Danger
Response
Send for help
Open airway
Normal breathing? 2 breaths
Check pulse (10 seconds). Start CPR 15:2
Defibrillator, ensure help is coming

6

Should the heimlick be attempted in infants and why/why not

No->risk damage to liver/spleen

7

Choking child management

DRABC
Effective cough

1. Yes
-Encourage coughing
-Support and assess continuously

2. No
-->Conscious: 5 back blows then 5 chest thrusts with infant in head down position. Heimlick in older children >1 yo (chest)
-->Unconscious: open airway, 5 breaths, CPR

8

External cardiac massage

In infants: encircle hands across chest compressing lower third of sternum with thumbs

In young children->heel of one hand/two in older

9

Ratio of compressions to breaths in children vs infant

In children 15:2
In infants 3:1

10

Child is breathing, non-responsive

Turn in recovery, left lateral position

11

Focal points for assessment of collapsed child

Call for help
Rapid assess of responsiveness "are you all right"
If responsive + breathing, leave in position and await help
If no responding/not breathing- basic life support
Breathing but not responding->turn to recovery position
Continue basic life support until help, if CPR 1 minute, and no help, go get help

Apply pressure to any bleeding
Assess neurology->pupils, posture and LOC

Once help/in hospital
-continue BLS uninterrupted
-Commence ALS as indicated
-Commence monitoring
-ALWAYS check blood sugar levels
-Perform investigations and commence definitive treatment

Once stabilised, transfer to ICU

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