Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
13 Cards in this Set
- Front
- Back
|
When to transport?
|
1) special services
-ped surgery -neurosurg -cardio -neonatology 2) special equipment -ped/newborn ventilators (set sec, not cc) -invasive monitoring 3) beyond skills of hospital staff |
|
|
Pick a transport site based on:
|
subspecialties, resources, beds, time, distance, transport method,
|
|
|
How to arrange transport
|
hotline (no hold, voicemail)
call specialist accepting pt call PICU -->avoid calling ER or flight service |
|
|
Crew
|
1 - senior peds resident or critical care fellow
2 - resp therapist 3 - critical care nurse 4 - nurse clinician |
|
|
Transport crew is on the road in -- min and in air in -- min
|
30
60 |
|
|
Stabilization Protocol
|
Oxygenation Once
ABGs A Boy Fluids Finds (electro)Lytes Liquor Nutrition No Temperature Tavern Infection Is Parents Passed |
|
|
Oxygenation
|
intubate, ventilate, IV access for meds to increase BP, fluid challenge, pressor agents, NG tube, sedation, seizure, control, ICP
|
|
|
ABG
|
Usually acidotic
-if high CO2 = ineffective ventilation = fix 1st -if low/WNL CO2 = metabolic acidosis = give bicarb if needed |
|
|
Fluids/(electro)lytes
|
Acidosis - check for K+ - don't correct before correcting pH b/c can overcorrect
Think about Hx ex: drowning -freshwater = low Na+ -salt water = high Na+ |
|
|
Termperature
|
Sick kids generally have low temperature
-if from exposure, ask for low limit thermometer -warming lamp, blankets, etc Only times need to be rapidly cooled = heat stroke and malignant hyperthermia -otherwise (like w/infection), don't need rapid control |
|
|
Nutrition
|
(i.e. glucose control)
-seizing }both use lots of glu -not breathing -stress }both decrease glu -too rapid infusion -do NOT give insulin --> slow down fluids or d/c dextrose part of IV |
|
|
Parents
|
Need permission
Let them see kid once stable -keep informed Defer Px guesses to 24h -"...and then we'll know more" -look to survival, no longterm Can't ride along -often tell parent to leave when transport gets there, transport has to prep, will get to new site at around same time -->don't drive crazy! |
|
|
Once contact new site
|
-Have someone stay by the phone
-Find out who is new doctor and how the can be reached DIRECTLY -->stay in contact w/new team -Tell hospital operator how to reach YOU |
