Pedia Emergencies and Resuscitation Flashcards Preview

Nelson - Emergencies > Pedia Emergencies and Resuscitation > Flashcards

Flashcards in Pedia Emergencies and Resuscitation Deck (67):
1

2nd leading cause of accidental death in children <5

Drowning

2

3rd major cause of death in adolescents

Drowning

3

Associated with survival rates as high as 70% with good neurologic outcome

Rapid, effective bystander CPR for children

4

Upon arrival at the scene of a compromised child, a caregiver's first task is

A quick survey of the scene itself

5

Any child with these conditions requires immediate CPR

1) Without a pulse 2) HR <60

6

Normal HR is roughly ___x normal RR for age

2-3x

7

Lower limit of SBP in neonates should be

<60

8

Lower limit of SBP in infants should be

<70

9

Lower limit of SBP in 1-10 yr olds should be

< Age x 2 + 70

10

Lower limit of SBP in any child older than 10 y/o should be

<90

11

MC precipitating event for cardiac instability in infants and children

Respiratory insufficiency

12

First priority in resuscitation of a child

Rapid assessment of respiratory failure and immediate restoration of adequate ventilation

13

Earliest and most reliable sign of shock

Tachycardia

14

In the setting of a pediatric emergency, ___ refers to a child's neurologic function in terms of the level of consciousness and cortical function

Disability

15

A GCS score of ___ requires aggressive management

≤8

16

Components of a secondary assessment in pediatric emergencies

Focused history and PE using SAMPLE

17

Children of this age group are particularly susceptible to foreign body aspiration and choking

<5

18

MCC of choking in infants

Liquids

19

MCC of choking in toddlers and older children

Small objects and food

20

Management of airway obstruction in an infant

5 back blows and 5 chest thrusts

21

Management of airway obstruction in a child >1 y/o

5 abdominal thrusts (Heimlich maneuver) with the child sitting or standing

22

Upper airway narrowing is most often caused by

Airway edema

23

Lower airway narrowing is most commonly caused by

Bronchiolitis and acute asthma exacerbations

24

As effective as ET intubation and safer when provider is inexperienced with intubation

Bag-valve-mask ventilation

25

A child requires intubation when at least 1 of these conditions exist

1) Unable to maintain airway patency or protect the airway against aspiration 2) Failing to maintain adequate oxygenation 3) Failing to control CO2 levels and maintain safe acid-base balance 4) Sedation and/or paralysis is required 5) Care providers anticipate a deteriorating course that will eventually lead to the first 4 conditions

26

Most important phase of intubation procedure

Preprocedure preparation

27

Goals of rapid sequence intubation (RSI)

1) Induce anesthesia and paralysis 2) Complete intubation quickly minimizing elevations of ICP and BP

28

T/F Chest radiography is necessary to confirm appropriate tube position

T

29

Shock occurs when

O2 and nutrient delivery to tissues is inadequate to meet metabolic demands

30

MC type of shock among children worldwide

Hypovolemic shock

31

MCC of distributive shock

Sepsis and burns

32

Type of shock associated with closure of ductus arteriosus in a child with ductus-dependent systemic blood flow

Obstructive shock

33

Type of shock associated with massive pulmonary embolism

Obstructive shock

34

Type of shock associated with tension pneumothorax

Obstructive shock

35

Type of shock associated with pericardial tamponade

Obstructive shock

36

MC pre-arrest rhythms in young children

Bradyarrhythmias

37

HR that is an indication to begin chest compression

<60bpm

38

Factors known to cause bradycardia

6 Hs and 4 Ts: Hypoxia, hypovolemia, hydrogen ions, hypo- or hyperkalemia, hypoglycemia, hypothermia, toxins, tamponade, tension pneumothorax, trauma

39

Narrow QRS complex is objectively how many sec

≤0.08 sec

40

Wide QRS complex is objectively how many sec

>0.08 sec

41

Narrow complex tachycardia may either be

Sinus tachycardia and SVT

42

Sinus tachycardia vs SVT: History and onset are consistent with a known cause of tachycardia

Sinus tachycardia

43

Sinus tachycardia vs SVT: Onset is often abrupt without a prodrome

SVT

44

Sinus tachycardia vs SVT: P waves are consistently present, of normal morphology, and occur at a rate that varies somewhat

Sinus tachycardia

45

Sinus tachycardia vs SVT: P waves are absent or polymorphic, and when present is often fairly steady at or above 220/min

SVT

46

Management for SVT

Adenosine rapid push and flush; if without line or adenosine failed, do synchronized cardioversion using 0.5-1 J/kg

47

Management for wide complex tachycardia

Immediate cardioversion: 1J/kg then 2J/kg if 1J/kg is ineffective

48

Most important treatment of cardiac arrest

Anticipation and prevention

49

Unwitnessed pediatric cardiac arrest in an outpatient setting should be treated as ___ in nature

Asphyxial

50

Witnessed pediatric cardiac arrest in an outpatient setting should be treated as

Primary arrythmia

51

Management for asphyxial cardiac arrest

Initiate CPR immediately

52

Management for cardiac arrest from an arrythmia

Activate EMS immediately and obtain AED

53

When a LONE rescuer provides CPR, the universal ratio of ___ is used

30 compressions: 2 ventilations

54

When a second care provider arrives at the scene, ratio of ___ is used in children ≤8 years old

15:2

55

Emergency defibrillation is indicated for

Vfib or pulses Vtach

56

Meds to maintain cardiac output and for post-resuscitation stabilization: Inamrinone

Inodilator

57

Meds to maintain cardiac output and for post-resuscitation stabilization: Dobu

Inodilator

58

Meds to maintain cardiac output and for post-resuscitation stabilization: Dopa

Inotrope, chronotrope, renal and splanchnic vasodilator

59

Meds to maintain cardiac output and for post-resuscitation stabilization: Epi

Intrope, chronotrope, vasodilator at low doses, vasopressor at high doses

60

Meds to maintain cardiac output and for post-resuscitation stabilization: Mil

Inodilator

61

Meds to maintain cardiac output and for post-resuscitation stabilization: Norepi

Inotrope, vasopressor

62

Meds to maintain cardiac output and for post-resuscitation stabilization: Na nitrprusside

Vasodilator

63

Often the largest and easiest vein to access for cannulation in the upper extremities

Median antecubital vein

64

T/F IO is recommended for patients for whom IV access proves difficult or unattainable, even in older children

T

65

If venous access is not attainable within ___ with CP arrest, an IO needle should be placed in the anterior tibia

1 min

66

T/F Any and all medications and fluids may be administered via IO

T

67

Most common cannulated artery

Radial artery