PALS 2010

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Anonymous
ID:
230343
Filename:
PALS 2010
Updated:
2013-08-18 12:19:23
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PALS
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Info for tests
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  1. What is the normal Respiratory rate for an infant, toddler, pre-school & school-age?
    • Infant          30-60
    • Toddler        24-40
    • Pre-school    22-34
    • School age   18-30
  2. What are the Normal Heart Rate?
    • < 3 months              80-205
    • 3 months - 2 years   75-190
    • 2-10 years               60-140
    • 10 + years               50-100
  3. Hypotension by SBP
    • < 1 month              <60
    • 1 month - 1 year     <70
    • 1-10 years              <70
    • 10 + years              <90
  4. Hypotension + signs of poor perfusion is?
    Decompensated Shock
  5. What are the 6 "H's"?
    • Hypo  xia
    • Hypo volemia
    • Hypo thermia
    • Hypo glycemia
    • Hypo/hyper Kalemia
  6. What are the 5 "T's"?
    • Tamponade
    • Tension Pneumothorax
    • Toxins-poisons, drugs
    • Trauma
    • Thrombosis -Coronary (AMI), Pulmonary (PE)
  7. What is a rapid cardiopulmonary assesment?
    It's a systematic head to-toe approach used to identify infants and children in respiratory distress and failure, shock and pulseless arrest
  8. What does AVPU stand for?
    • A=awake
    • V=responds to verbal
    • P=responds to pain
    • U=unresponsive
  9. What are the ABC's?
    • Airway
    • Breathing 
    • Circulation
  10. Breathing what are you looking for
    • Breathing: present - absent     
    • Rate: normal - slow -fast     
    • Pattern: regular - irregular - gasping      
    • Depth:  normal shallow deep   
    • Sound: stridor grunting  wheezing   
    • Exertion:  nasal flaring sternal retractions                     accessory muscles
  11. Circulation what are you looking for?
    • Circulation:     central pulses: present absent     Rate: normal slow fast   
    • Rhythm:  regular irregular     
    • QRS:  narrow  wide
  12. The liver is palpated where?
    At the costal margin
  13. When the liver is palpated below the costal margin what does this mean?
    fluid overload
  14. What is the normal urine output for infants, children & adolescents?
    • infant & children=1-2 cc/kg/hr
    • adolesencents= 30 cc/hr
  15. What is the difference between stable vs unstable?
    • Stable: needs little support reassess frequently
    • Unstable: needs immediate support & intervention
  16. What is respiratory distress &respiratory  failure?
    • Respiratory distress:
    •     increased heart rate, effort and noise of
    •     breathing
    •     requires much energy
    • Respiratory failure:
    •     slow or absent rate, weak or no effort 
    •     very quiet
  17. Compensated shock
    • SBP acceptable for age
    • perfusion is poor
    • central vs peripheral pulses are unequal
    • peripheral color is poor
    • skin cool
    • capillary refill is > 2 sec
  18. Decompensated Shock
    • Systolic hypotension with poor or absent pulses
    • poor color
    • weak compensatory effort
  19. How do you determine the correct ET tube size?
    Cuffed vs uncuffed
    • Uncuffed:  (age in years/4)+4
    • Cuffed:     (age in yrs/4)+3
  20. What is DOPE?
    • D=Displaced
    • O=Obstruction
    • P=Pneumothorax
    • E=Equipment
  21. Epinephrine
    • -drug of choice for bradycardia after oxygen &
    •   ventilation
    • -increases heart rate, PVR & CO
    • -during CPR it increases the myocardial &
    •  cerebral blood flow
    • -used during cardiac arrest
    • DOSE:
    •    0.01mg/kg (0.1ml/kg) Q 3-5 min
  22. Amiodarone
    • antiarrthmic (atrial & ventricular antiarrhythmic)
    • -slows AV nodal & ventricular conduction
    • -increases the QT interval
    • -cause vasodilation

    • DOSE:
    • VF/VT: 5mg/kg bolus
    • Perfusing VT: 5mg/kg over 20-60 min
    • Perfusing SVT:  5mg/kg over 20-60min
    • MAX: 15mg/24 hrs
    • CAUTION:  hypotension Torsades  half life up to 40 days
  23. Lidocaine
    • Ventricular anti-arrythmic when amiodarone is unavaialble
    • decreases ventricular automaticity conduction & repolarization

    • VF/VT:  1mg/kg bolus Q 5-15min
    • Perfusing VT: 1mg/kg bolus Q 5-15min
    • Infusion:  20-50 mcg/kg/min
    • CAUTION: neuro toxicity leading to seizures
  24. Magnesium
    • -Ventricular anti-arrhythmic for Torsades &
    •   hypomagnesium
    • DOSE: 25-50 mg/kg over 10-20 min
    • MAX: 2 gm
    • CAUTION: hypotension
    •                 can cause AV Block

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