Pediatric Advanced Life Support
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| 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
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| ET tube size and depth | Size(mm)=(Age/4)+4, Depth(cm)=(Age/2)+12
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| Blood pressure norms? | Typical(1-10yo)=90+(age x 2)mmHg, Lower limit=70+(age x 2)mmHg
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| Compression/Ventilation Ratio | 30:2
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| Anaphylaxis Meds/Doses: | Epi (0.01mg/kg) & Benadryl (0.5-1.0mg/kg)
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| Hypoglycemia Meds/Doses: | 0.5-1.0g/kg IV/IO D25W(2-4mL/kg)
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| Hypotension Meds/Treatment: | Oxygen, Volume, Pressors (Dopamine, Dobutamine, Epinephrine)
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| Hypovolemia/Shock Treatment: | 20mL/kg x 2-3 of crystalloid (treat the cause...e.g sepsis, hypoxia, acidosis)
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| Bradydysrhytmia treatment: | HR <60 bpm w/ AV dissoc. -> Tx: Oxygen, Chest compressions, Epinephrine, Atropine PRN
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| Greater than normal HR for age but usually < 200 bpm. Normal rhythm, no tx needed | Sinus tachycardia
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| 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)
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| 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.
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| Treatment for SVT and VT: | Synchronized cardioversion (0.5-1 J/kg) Note:synchronization avoids inducing VF.
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| Rare in kids, no discernible P, QRS, T wave. No organized cardiac contractions | VF, treat with defibrillation (2-4 J/kg)
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| 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.
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| 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
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| Pediatric BLS: attached AED, rhythm not shockable, how often do you check rhythm? | each 5 cycles
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| Pediatric BLS: attached AED, rhythm shockable and shock given... now what? | resume CPR immediately x 5 cycles
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