PALS - Written Test and Case Study Review Material CPR Sequence (Ans- C-A-B Circulation-Airway-Breathing
Algorithm: Pediatric Septic Shock
First hour...(Ans- Oxygen & support ventilation Establish IV, draw labs (glucose, blood cultures) Begin resuscitation
Push repeated 20 mL/kg isotonic crystalloid (3-4) unless rales, resp distress, hepatomegaly
Correct hypo-glycemia/calcemia Admin 1st dose antibiotics STAT STAT vasopressor drip/stress-dose hydrocortisone Establish 2nd IV
Algorithm: Pediatric Septic Shock
Fluid Responsive?(Ans- Yes - ICU No - Vasoactive drug & titrate for normotension
Normo: begin dopamine
Hypo/warm: norepi
Hypo/cold: epi
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Adenosine (slows HR) (Ans- SVT 0.1 mg/kg - dose 1 0.2 mg/kg - dose 2 max = 6 mg RAPID push
Amiodarone (antiarrythmic) (Ans- VF/VT (pulseless)
- mg/kg
Bolus max = 300 mg
SVT, VT (with pulses)
- mg/kg
over 20-60 mins max = 300 mg
Atropine (increases HR) (Ans- Bradycardia 0.02 mg/kg may repeat once
Epinepherine (increases HR) (Ans- Bradycardia/Pulseless Arrest
0.01 mg/kg (1:10,000) every 3-5 min
Hypotensive Shock 0.1-1 mcg/kg per min
Anaphylaxis 2 / 3
0.01 mg/kg every 3-5 min
Algorithm: Pediatric Cardiac Arrest
(Ans- Shout for help CPR Oxygen, AED If no shock - CPR for 2 min, IV, Epi q 3-5 min, reassess If shock - after...CPR for 2 min, IV, reassess If 2nd shock - CPR for 2 min, Epi q 3-5 min, reassess If 3rd shock - CPR for 2 min, Amiodarone, treat cause, reassess...Post Resuscitation Care
Shock Doses (Ans- 1st shock - 2 j/kg 2nd shock - 4 j/kg Max 10 j/kg
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
- H's
(G,K,T,V,X,DRO)
(Ans-
- Hypo-Glycemia
- Hypo/hyper-Kalemia
- Hypo-Thermia
- Hypo-Volemia
- Hypo-Xia
- HyDROgen ion (acidosis)
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
- T's
(A,E,HC,HP,O)
(Ans-
- Tamponade, cardiac
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