-
5th percentile for SBP formula
- 70 + (2*age) mm Hg
- (Goal for SBP post ROSC)
-
-
1-rescuer peds CPR compression :ventilation ratio
30:2
-
2-rescuer peds CPR compression :ventilation ratio
15:2
-
Peds rescue breathing rate:
12-20/minute (every 3-5 seconds)
-
Peds compression rate:
100-120/minute
-
Peds compression depth:
- 1/3 AP diameter:
- 1.5” in infant,
- 2” child,
- 2-2.4” adolescent/adult
-
Pediatric assessment triangle (PAT)
- ABC
- Appearance
- work of Breathing
- Circulation
-
TICLS is to assess appearance
- Tone
- Interactiveness
- Consolability
- Look/gaze/stare
- Speech/cry
-
Foreign body obstruction technique:
- <1 yo = 5 back slaps and 5 chest thrusts
- >1 yo = abdominal thrusts/Heimlich
- If unresponsive:
- Begin CPR
- Look into mouth and remove object if seen
-
E-C clamp technique for infant mask seal
- Lift jaw with 3-5 fingers
- use thumb and index finger to hold mask to face
-
Defibrillator PADDLE sizes:
- infant = <10 kg (1 year)
- adult = >10 kg (>1 year)
-
Measures to relieve airway obstruction:
- Position of comfort
- Minimize agitation
- Manual maneuvers - jaw thrust/head tilt-chin lift
- Suctioning - nose or mouth
- Foreign body removal
- Medications - to reduce airway swelling
- Airway adjuncts
- Advanced Airway
- Surgical Airway
-
Causes of upper airway obstruction:
- Foreign body
- Plugging - Secretions, Bronchiolitis
- Swelling - anaphylaxis, tonsillar hypertrophy, croup, epiglottitis
- Mass lesions - abscess or tumor
- Narrowing - Congenital or acquired (subglottic stenosis secondary to intubation)
-
Croup Severity:
- Mild - occasional barking cough, little or no stridor, absent or mild retractions
- Moderate - frequent barking cough, stridor at rest, retractions at rest, little or no agitation, good air entry by auscultation
- Severe - frequent barking cough, prominent inspiratory and expiratory stridor, marked retractions, significant agitation, decreased air entry by auscultation
-
Croup treatment by severity:
- Mild - PO dexamethasone
- Moderate - + O2, racemic epic, 2 hour observation,
- Severe - + heliox, IV dexamethasone, high flow O2, secure airway
-
Causes of lower airway obstruction:
-
Bronchiolitis Management:
- Suctioning - Oral or nasal as needed
- Oxygen if SaO2 <94%
- Trial of albuterol or epinephrine
- HFNC
-
-
Asthma Management
- Mild - Albuterol via MDI or nebulizer, consider oral steroids, monitor peak flow
- Moderate - + ipratropium, oral or IV steroids, O2 to keep SaO2 ≥94%, consider CXR
- Severe - + IV steroid, magnesium, ABG, terbutaline subq or IV, NIPPV with BIPAP or nasal cannula for infant, consider ETT
-
Causes of lung tissue disease:
- Pneumonia
- Pneumonitis
- Pulmonary edema
- Pulmonary contusion
- ARDS
-
Causes of disordered breathing control
- Increased ICP - infection, hemorrhage/TBI, Tumor, hydrocephalus, hypoxic/ischemic insult
- Neuromuscular disease - congenital, botulism, guillane-barre
- Poisoning or drug OD
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