APLS

Infanct Up to One

Child 1 - puberty

• 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

• 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

• If ineffective cough
• Child back blows / abdominal thrusts
• Infant Back blows followed by chest thrusts

• Child - Sniffing morning air, yanauer sucker
• Infant - Neutral position - suction catheter & y - piece

• >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

15-30/minute

• 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

• Landmarks
• Tibial 2-3cm below tibial tuberosity
• Femoral anterolat surface 3 cm above lateral condyle

• Least satisfactory
• X10 dose adrenaline followed by 2mls normal saline via suction catheter via et / nt tube

• Paediatric paddles <1 else front(left chest) & back
• Left mid axillary line and infra clavicle left of sternum

• Shock & bradycardia(<60) - chest compressions * fluid bolus
• Shock & SVT vagal manouvres. iv adenosine
• Shock & VT - shock synchronous else asynchronous 1J/kg then 2J/kg

• Dont forget glucose
• 2mls/kg 10%glucose followed by effusion

Morphine 2mg bolus/5 mins then 0.5mg increments at 10 min interval

Standard dose 0.1-0.2 mg/kpovolaemia

• Surface - head to toe, front & back
• Orifaces
• Cavities
• Extremities

Base excess- Amount of base removed for normal pH

• <1yr = (.5Xwt) + 4
• 1-5yr = (2Xage) + 8
• 6-12yr = (3Xage) + 7

• <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

• <1 yr 110 - 160 bpm
• 1-2 yr 100 - 150
• 2 - 5 yr 95 - 140
• 5 - 12 80 - 120
• >12 60 - 100