PALS (Main): Difference between revisions

Revision as of 06:10, 12 January 2012

Use Heimlich for >1yr; back/chest thrusts for <1yr
Treat shock w/ initial 20cc/kg bolus
- Repeat boluses up to total of 60 mL/kg; thereafter pressors should be started
Do not routinely hyperventilate even in cases of head injury
Provide family w/ option of being present during resuscitation
IO is useful as initial vascular access
Self-Adhering Electrodes
- Use largest size that will fit on child’s chest w/o touching
- When possible leave 3cm between electrodes
- Adult size for >10kg; infant size for <10kg
Hypotension is defined as sys BP:
- <60 (0 to 28 days)
- <70 (1mo - 12mo)
- <70 + (2 X age in yr) (1-10yr)
- <90 (≥10yr)

AHA 2010 Guidelines for PALS

Authors:

@@ Line 29: / Line 29: @@
 ***>2yo - 3.5 + (age/4)
-==Pulseless Arrest==
+==Pediatric Pulseless Arrest==
-===Asystole and PEA===
-*Give Epi 0.01 mg/kg (0.1 mL/kg 1:10,000) (max 1mg) q3-5min
-*Rhythm check q2min
-*Consider H's and T's
-**Hypovolemia
-**Hypoxia
-**Hydrogen ion
-**Hypo/hyperkalemia
-**Hypothermia
-**Tension pneumo
-**Tamponade
-**Toxins
-**Thrombosis, pulmonary
-**Thrombosis, coronary
-===VF/Pulseless VT===
-*Shock as quickly as possible and resume CPR immediately
-**First shock 2 J/kg
-**Second shock 4 J/kg
-**Subsequent shocks ≥ 4 J/kg (max 10 J/kg)
-*Give Epi if (shock + 2min CPR) fails to convert rhythm
-*Perform pulse check/shock if appropriate q2min
-*Give antiarrhythmic if (2nd shock +2min CPR) again fails
-**1st line: Amiodarone
-***5 mg/kg (max 300mg)
-***May repeat twice up to 15mg/kg
-**2nd line: Lidocaine
-***1 mg/kg
-**Magnesium
-***25-50mg/kg (max 2g) IV
-***Only for polymorphic V-tach
 ==[[PALS: Bradycardia]]==