APLS

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Author:
esmond
ID:
229698
Filename:
APLS
Updated:
2015-06-29 11:27:26
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APLS
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APLS
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  1. Infant/child definitions
    Infanct Up to One

    Child 1 - puberty
  2. BPLS Infant
    • SSS Safety, stimulate, shout
    • Air way manouvres - hand forhead with gentle tilting, fingers other hand gently lifting chin +/- thumb to part lips, head neutral position
    • Look listen feel 10 seconds
    • 5 rescue breaths nose and mouth else nose with mouth closure
    • Check signs of life 10 secs incl pulse2 breaths 15 compressions lower sternum with 2 fingers of 2 thumbs with fingers on back 100bpm
    • Contact emergency services after 1 min
  3. BPLS Child
    • SSS Safety, stimulate shout
    • Air way manouvres - chin lift/ja thrust, sniffing morning air position
    • Look listen feel 10 seconds
    • 5 recuse breaths
    • Check signs of life 10 secs incl pulse
    • 2 breaths 15 compressions heal of hand over lower sternum 100bpm
    • Contact emergency services after 1 min
  4. Choking
    • If ineffective cough
    • Child back blows / abdominal thrusts
    • Infant Back blows followed by chest thrusts
  5. Airway
    • Child - Sniffing morning air, yanauer sucker
    • Infant - Neutral position - suction catheter & y - piece
  6. Intubation
    • >1 yr cuffless
    • Internal diameter (mm) = (age/4)+4
    • length(cm)= (age/2) + 12(oral tube)
    • length(cm)=(age/2)+15(nasal tube)
    •  
    • >2 yr cuffed
    • (Age/4) + 3.5
    • Infants 3-3.5
  7. Ventilation
    15-30/minute
  8. Cardiac arrythmia
  9. Reversable cardiac arrest 4 H 4T
    • H
    • Hypoxia
    • Hypovolaemia
    • Hyper/hypokalaemia
    • Hypothermia

    • T
    • Tension pneumothorax
    • Cardiac tamponade
    • Toxic substances
    • Thromboembolism

    • PEA tamponade,tension,hypovolaemia
    • Asystole hypoxia,hypovolaemia
    • VF/pulseless VT Hypothermia,hperkalaemia,toxic substance
  10. Non shockable rhythm
  11. Interosseous access
    • Landmarks
    • Tibial 2-3cm below tibial tuberosity
    • Femoral anterolat surface 3 cm above lateral condyle
  12. Tracheal route
    • Least satisfactory
    • X10 dose adrenaline followed by 2mls normal saline via suction catheter via et / nt tube
  13. Shockable rhythm
  14. Defibrillation
    • Paediatric paddles <1 else front(left chest) & back
    • Left mid axillary line and infra clavicle left of sternum
  15. Shock
  16. Shock & arrythmia
    • Shock & bradycardia(<60) - chest compressions * fluid bolus
    • Shock & SVT vagal manouvres. iv adenosine
    • Shock & VT - shock synchronous else asynchronous 1J/kg then 2J/kg
  17. Convulsions
    • Dont forget glucose
    • 2mls/kg 10%glucose followed by effusion
  18. Convulsions
  19. Fluid requirements
  20. Pain
    Morphine 2mg bolus/5 mins then 0.5mg increments at 10 min interval

    Standard dose 0.1-0.2 mg/kpovolaemia
  21. Burns fluid replacement
  22. Secondary survey
    • Surface - head to toe, front & back
    • Orifaces
    • Cavities
    • Extremities
  23. Acid - Base Balance
    Base excess- Amount of base removed for normal pH
  24. Weight
    • <1yr = (.5Xwt) + 4
    • 1-5yr = (2Xage) + 8
    • 6-12yr = (3Xage) + 7
  25. Resp rate
    • <1 yr 30 -40/min
    • 1-2 yr 25-35/min
    • 2 - 5 yrs 25 - 30
    • 5 - 12 yrs 20 - 25
    • >12 yrs 15 - 20
  26. Heart rate
    • <1 yr 110 - 160 bpm
    • 1-2 yr 100 - 150
    • 2 - 5 yr 95 - 140
    • 5 - 12 80 - 120
    • >12 60 - 100

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