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Pediatric Advanced Life Support

Glasgow Coma Scale Modified GCS (<8 intubate) Eye 4-spontaneous 3-verbal 2-pain 1-no response Verbal 5-oriented 4-confused 3-inappropriate 2-nonspecific sounds 1-none Motor 6-obeys 5-localize pain 4-withdraw to pain 3-flex pain:decorticate 2-extend pain:decerebrate 1-non
ET tube size and depth Size(mm)=(Age/4)+4, Depth(cm)=(Age/2)+12
Blood pressure norms? Typical(1-10yo)=90+(age x 2)mmHg, Lower limit=70+(age x 2)mmHg
Compression/Ventilation Ratio 30:2
Anaphylaxis Meds/Doses: Epi (0.01mg/kg) & Benadryl (0.5-1.0mg/kg)
Hypoglycemia Meds/Doses: 0.5-1.0g/kg IV/IO D25W(2-4mL/kg)
Hypotension Meds/Treatment: Oxygen, Volume, Pressors (Dopamine, Dobutamine, Epinephrine)
Hypovolemia/Shock Treatment: 20mL/kg x 2-3 of crystalloid (treat the cause...e.g sepsis, hypoxia, acidosis)
Bradydysrhytmia treatment: HR <60 bpm w/ AV dissoc. -> Tx: Oxygen, Chest compressions, Epinephrine, Atropine PRN
Greater than normal HR for age but usually < 200 bpm. Normal rhythm, no tx needed Sinus tachycardia
HR usually >200 bpm, Usu. well tolerated but can lead to CHF. Abnl P axis. No beat-to-beat variability. Supraventricular Tachycardia (note: best drug- Adenosine)
Rare and SERIOUS. HR >120 bpm, no P wave, wide WRS (>0.08s), & usu w/ abnl anatomy, hypoxemia, long QT syn, etc. Vent. Tachycardia: If no pulse, tx like VF, Give lidocaine before defibrillation.
Treatment for SVT and VT: Synchronized cardioversion (0.5-1 J/kg) Note:synchronization avoids inducing VF.
Rare in kids, no discernible P, QRS, T wave. No organized cardiac contractions VF, treat with defibrillation (2-4 J/kg)
First responder to man down, what to do first? If witnessed sudden collapse, call 911 and then AED and ABCs, otherwise, do first round of ABCs first.
Persistent SYMPTOMATIC bradycardia despite adequate ventilation, O2, CPR... what next? Epi IV/IO (0.01mg/kg or 0.1mL/kg or 1:10k), per ETT same dose, but of 1:1k, repeat Q3-5min - for incr. vagal tone or primary AV block give 0.02mg/kg Atropine (max dose 1mg) & consider pacing
Pediatric BLS: attached AED, rhythm not shockable, how often do you check rhythm? each 5 cycles
Pediatric BLS: attached AED, rhythm shockable and shock given... now what? resume CPR immediately x 5 cycles
Created by: kidderjm