Difference between revisions of "PALS (Main)"

(PALS: Tachycardia)
(See Also)
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==See Also==
 
==See Also==
 +
*[[Pediatric Quick Drug Card]]
 +
*[[Antiarrhythmics]]
 +
*[[Arrhythmias (DDX)]]
 +
*[[Synchronized Cardioversion]]
 +
*[[Post Cardiac Arrest]]
 
*[[ACLS (Main)]]
 
*[[ACLS (Main)]]
 +
*[[ACLS (Treatable Conditions)]]
  
 
==Source==
 
==Source==

Revision as of 06:09, 12 January 2012

2010 AHA Recommendations

  • 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)

BLS

Advanced Airway

  • Cuffed and uncuffed ETT are acceptable
    • Uncuffed
      • <1yo - 3.5mm ETT
      • 1-2yo - 4mm ETT
      • >2yo - 4 + (age/4)
    • Cuffed
      • <1yo - 3mm ETT
      • 1-2yo - 3.5mm ETT
      • >2yo - 3.5 + (age/4)

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

PALS: Tachycardia

See Also

Source

AHA 2010 Guidelines for PALS