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;
16 Cards in this Set
- Front
- Back
|
Cardiopulmonary arrest (CPA) usually begins as an isolated ... arrest
|
respiratory
|
|
|
... - Inability to provide a sufficient perfusion of oxygenated blood to tissues to maintain organ function
|
shock
|
|
|
Changes in metabolic demand are managed primarily by changes in ...
-Infant = increased ... -Older child = increased stroke volume, decreased arterial resistance, increased contractility |
cardiac output
heart rate |
|
|
What is the number 1 (most common) cause of shock in children?
|
hypovolemic shock
|
|
|
Categorization of shock:
... shock -#1 cause of shock in children ... -Seen in sepsis ... -Congenital heart disease Others |
Hypovolemic
Distributive Cardiogenic |
|
|
Hypovolemic Shock:
History ... of heart failure ... of sepsis ... heart rate Vaso... Dehydration -Dry membranes |
Absence
Absence Increased constriction |
|
|
Distributive shock:
...cardia Alteration of perfusion ... pulses Extremeties ... in the early phases, then progress to ... No history of ... loss |
Tachy
Bounding warm cool fluid |
|
|
Cardiogenic shock:
Congestive heart failure -... respiratory effort -Edema ... HR – their compensatory mechanism Abnormal chest xray |
Increased
Increased |
|
|
Tx. of pediatric shock:
... is the key! Initial therapy is directed to the ..., not the ... |
early recognition
signs and symptoms underlying etiology |
|
|
For shock treatment, you want to give lots of ...
|
fluids
|
|
|
Shock Tx;
Fluid resuscitation -20 ml/kg over 15-30 minutes -Crystalloids *Normal ... *Ringer’s lactate -Albumin -Blood Reassess and repeat as needed |
saline
|
|
|
Cardiac support – can use inotropes to increase their contractility a bit:
... – 1st choice ... – 2nd choice ... – effective in short term. usually only used if child is near death |
dopamine
dobutamine epinephrine |
|
|
Respiratory support:
Supplemental ... Bag and mask Endotracheal intubation |
oxygen
|
|
|
Which end organ are you most worried about if you have a patient in shock?
|
kidneys
|
|
|
Renal Salvage:
Prerenal azotemia -BUN:CR 10:1 or less, urine sodium <20 -this suggests ..., kids will generally do ... ... – renal tubule will start to die -BUN:CR >10:1, -urine sodium >40 Urine Output should be ... ml/kg/hour -... ml/kg/hr absolute minimum ... is standard therapy to promote UOP |
no damage
ok Acute Tubular Necrosis 2 1 Furosamide |
|
|
Take home message about pediatric shock:
It’s not all about the heart 1. Restore the ... and 2. Restore the circulating ... the heart will take care of itself! |
airway
volume |
