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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
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
Hypotension by SBP
- < 1 month <60
- 1 month - 1 year <70
- 1-10 years <70
- 10 + years <90
Hypotension + signs of poor perfusion is?
What are the 6 "H's"?
- Hypo xia
- Hypo volemia
- Hypo thermia
- Hypo glycemia
- Hypo/hyper Kalemia
What are the 5 "T's"?
- Tension Pneumothorax
- Toxins-poisons, drugs
- Thrombosis -Coronary (AMI), Pulmonary (PE)
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
What does AVPU stand for?
- V=responds to verbal
- P=responds to pain
What are the ABC's?
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
Circulation what are you looking for?
- Circulation: central pulses: present absent Rate: normal slow fast
- Rhythm: regular irregular
- QRS: narrow wide
The liver is palpated where?
At the costal margin
When the liver is palpated below the costal margin what does this mean?
What is the normal urine output for infants, children & adolescents?
- infant & children=1-2 cc/kg/hr
- adolesencents= 30 cc/hr
What is the difference between stable vs unstable?
- Stable: needs little support reassess frequently
- Unstable: needs immediate support & intervention
What is respiratory distress &respiratory failure?
- Respiratory distress:
- increased heart rate, effort and noise of
- requires much energy
- Respiratory failure:
- slow or absent rate, weak or no effort
- very quiet
- SBP acceptable for age
- perfusion is poor
- central vs peripheral pulses are unequal
- peripheral color is poor
- skin cool
- capillary refill is > 2 sec
- Systolic hypotension with poor or absent pulses
- poor color
- weak compensatory effort
How do you determine the correct ET tube size?
Cuffed vs uncuffed
- Uncuffed: (age in years/4)+4
- Cuffed: (age in yrs/4)+3
What is DOPE?
- -drug of choice for bradycardia after oxygen &
- -increases heart rate, PVR & CO
- -during CPR it increases the myocardial &
- cerebral blood flow
- -used during cardiac arrest
- 0.01mg/kg (0.1ml/kg) Q 3-5 min
- antiarrthmic (atrial & ventricular antiarrhythmic)
- -slows AV nodal & ventricular conduction
- -increases the QT interval
- -cause vasodilation
- 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
- 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
- -Ventricular anti-arrhythmic for Torsades &
- DOSE: 25-50 mg/kg over 10-20 min
- MAX: 2 gm
- CAUTION: hypotension
- can cause AV Block