Pals 2010

Front 1

Normal (awake) Heart Rates (by age)

Back 1

Newborn to 3 Months = 85-205
3 Months to 2 years = 100-190
2 to 10 years = 60-140
> 10 years = 60-100

Front 2

Respiratory Rates
(by age)

Back 2

Infant = 30-60
toddler = 24-40
preschooler = 22-34
school-aged child = 18-30
adolescent = 12-16

Front 3

CPR compression rate (all ages)

Back 3

100/min

Front 4

Compression depth
(children, infants)

Back 4

Children = 1/3 AP diameter (2 inches)
Infants = 1/3 AP diameter (1.5 inches)

Front 5

Compression to Ventilation Ratio
(children, infants)

Back 5

Single Rescuer = 30:2
2 rescuer = 15:2
(until advanced airway placed)

Front 6

Ventilation rate with advanced airway
(all ages)

Back 6

1 breath every 6-8 seconds
(8-10 breaths/min)

Front 7

Adenosine

Back 7

FOR: SVT
1st Dose: 0.1mg/kg
2nd Dose: 0.2mg/kg
Max Dose: 12mg

Front 8

Albuterol

Back 8

FOR: bronchospasm
1st Dose: 2.5mg (<20mg), 5.0mg (>20mg)
2nd Dose: q 20min
Max Dose: N/A

Front 9

Atropine Sulfate

Back 9

FOR: Bradycardia, toxins, overdose
1st Dose: 0.02mg/kg
2nd Dose: repeat x1
Max Dose: 1mg- 3mg

Front 10

Dextrose

Back 10

FOR: Hypoglycemia
1st Dose: 1g/kg
D25W 2-4ML/KG, D10W 5-10ML/KG

Front 11

Diphenhydramine

Back 11

FOR: Anaphylactic shock
1st Dose: 2mg/kg
Max Dose: 50mg

Front 12

Dopamine

Back 12

FOR: Cardiogenic Shock
1st Dose: 2-20mcg/kg/min

Front 13

Epinephrine 1:10,000

Back 13

FOR: PEA, Bradycardia, Anaphylaxis
1st Dose: 0.01mg/kg q 3-5 min

Front 14

Epinephrine 1:1,000

Back 14

FOR: Asthma
1st Dose: 0.01mg/kg SQ q 15min
Max Dose: 0.3mg

Front 15

Lidocaine

Back 15

FOR: VF/pulseless VT, Wide complex Tach
1st Dose: 1mg/kg
Maintenance: 20-50mcg/kg/min
Max Dose:

Front 16

Magnesium Sulfate

Back 16

FOR: Asthma, Torsades
1st Dose: 50mg/kg over 20 min
Max Dose: 2g

Front 17

Naloxone

Back 17

FOR: Narcotic OD
1st Dose: 0.1mg/kg
Max Dose: 2mg

Front 18

Sodium Bicarbonate

Back 18

FOR: Acidosis, Tricyclic antidepressant OD
1st Dose: 1mEq/kg

Front 19

indications for Endotracheal Intubation

Back 19

unable to maintain adequate AIRWAY, OXYGENATION or VENTILATION despite initial intervention

Front 20

Airway Obstruction Management (core case)

Back 20

1) Basic Pt. Management
2) Distress vs failure
3) Assisted Ventilations or CPAP
4) IV / IO access
5) reassessment

Front 21

Steps to Basic Pt. Management (core case)

Back 21

1) Assessment (ABC, vital signs)
2) manual airway, oxygen
3) EKG, pulse OX
4) HX and physical Exam
5) establish IV / IO

Front 22

Non-Cardiogenic Shock Management (core case)

Back 22

1) Basic Pt. Managment
2) Recognize type of shock
3) recognize hypotension
4) Isotonic crystalloid 20ml/kg (over 15-20min)
5) reassess

Front 23

S/S of Respiratory Distress

Back 23

increased work of breathing, inadequate respiratory effort and irregular breathing

Front 24

S/S of Respiratory Failure

Back 24

marked tachynea, bradypnea, apnea, cyanosis,

Front 25

Cardiogenic Shock Management (core case)

Back 25

1) basic Pt. Management
2) recognize shock
3) compensated or hypotensive
4) NS 10ml/kg (10-20min)
5) vasoactive infusion

Front 26

Supraventricular Tachycardia (core case)

Back 26

1) basic Pt. Management
3) compensated or hypotensive
4) vagal maneuver
5) adenosine (0.1mg/kg, 0.2mg/kg) rapid IV
6) cardioversion 1J/kg, 2J/kg

Front 27

Bradycardia (core case)

Back 27

1) basic Pt. management
3) compensated or hypotension
4) need for chest compressions
5) epi (0.01mg/kg 1:10,000)
5) Atropine (0.02mg/kg x1)

Front 28

Asystole / PEA (core case)

Back 28

1) basic Pt. Management
2) CPR
3) EPI (0.01mg/kg 1:10,000) q 3-5 min
4) rhythm check every 2 min
5) H's & T's

Front 29

VF/pulseless VT (core case)

Back 29

1) basic Pt. Management
2) CPR
3) Defib 2j/kg q 2min @ 4J/kg
4) EPI (0,01mg/kg, 1:10,000) 3-5min
5) Amiodarone 5mg/kg repeat x2

Front 30

Wide complex Tachycardia (core case)

Back 30

1) basic Pt. Management
2) unstable -> cardiovert 1J/kg, 2J/kg
3) regular, monomorphic -> adenosine
4) see expert consultation

Front 31

Begin CPR in the pediatric patient with poor perfusion despite oxygenation and ventilation with a heart rate less then what?

Back 31

< 60 BPM

Front 32

Hypoglycemia thresholds (neonates, other peds)

Back 32

Neonates < 45mg/dl
all others < 60mg/dl

Front 33

Weight and age recommendations for pediatric sized defibrillator paddles

Back 33

Small Infant paddles = <10kg (1yr)
Adult paddles = > 10kg (1yr)

Front 34

Postresucscitation Care

Back 34

1) Oxygenation
2) Consider H's & T's
3) NS 20ml/kg bolus
4) Dopamine (2-20mcg/kg/min)
5) hypothermia

Front 35

abnormal respiratory rates (any age)

Back 35

<10 or >60

Front 36

normal tidal volume

Back 36

5 - 7 mg/kg

Front 37

Room air oxygen saturation which indicates oxygenation is adequate

Back 37

>94%

Front 38

What equation is used to determine cardiac output

Back 38

Stroke Volume X Heart Rate = Cardiac Output

Front 39

In children 1-10yoa, Hypotension is present if the systolic BP reading is less then what?

Back 39

70mm/HG + (childs age in years x 2)

Front 40

What length QRS is the "line" between a wide complex and a Narrow complex?

Back 40

0.09 seconds

Front 41

SVT is usually has a rate greater then what in infants? What in children?

Back 41

Infants +> 220BPM
Children =>180BPM

Front 42

what is the proper way to perform a vagal maneuver in an infant?

Back 42

place ICE over the eyes and forehead for 15-20 seconds

Front 43

Reversible Causes (6 H's)

Back 43

Hypovolemia
hypoxia
Hydrogen ion
Hypoglycemia
hypokalemia
Hypothermia

Front 44

Reversible Causes (6 T's)

Back 44

Tension Pneumo
Tamponade
Toxins
Thrombosis - pulmonary, coranary
Trauma

Front 45

AED Dose attenuators (pediatric pads) should be used for patients of what age and weight?

Back 45

<=8 years, or <=25kg

Front 46

Mnemonic for sudden deterioration in an intubated patient

Back 46

Displacement
Obstruction
Pneumothorax
Equipment Failure

Front 47

Hand placement for infant CPR

Back 47

Two fingers just below the nipple line

Front 48

Hand placement for child CPR

Back 48

one or two hands on lower half of breast bone

Front 49

Correct OPA size and use

Back 49

measure from corner of mouth to angle of mandible, for unconscious victim without a gag reflex

Front 50

Drug for: SVT

Back 50

Adenosine

Front 51

Drug for: Shock, Trauma, Burns

Back 51

Albumin

Front 52

Drug for: asthma, anaphylaxis, hyperkalemia

Back 52

albuterol

Front 53

Drug for: Hypocalcemia, hyperkalemia, CA blocker OD

Back 53

Calcium Chloride

Front 54

Drug for: croup

Back 54

Dexamethasone

Front 55

Drug for: CHF, Cardiogenic shock

Back 55

dobutamine

Front 56

Drug for: RSI

Back 56

Etomidate

Front 57

Drug for: Adrenal insufficiency

Back 57

hydrocortisone

Front 58

Drug for: asthma

Back 58

ipratropium bromide

Front 59

Drug for: Asthma, torsades de pointes, hypomagnesemia

Back 59

magnesium sulfate

Front 60

Drug for: asthma, anaphylactic shock

Back 60

methyl-prednisolone

Front 61

Drug for: myocardial dysfunction and increased SVR/PVR

Back 61

Milrinone

Front 62

Drug for: congestive heart failure, cardiogenic shock

Back 62

Nitroglycerin

Front 63

Drug for: cardiogenic shock, severe hypertension

Back 63

nitroprusside

Front 64

Drug for: hypotensive shock

Back 64

norephinephrine

Front 65

Drug for: SVT, A-flutter, VT

Back 65

proncainamide

Front 66

Drug for: ductal-dependent congenital heart disease

Back 66

prostaglandin I, (PGE)

Front 67

Drug for: metabolic acidosis, sodium channel blocker OD

Back 67

sodium bicarbonate

Front 68

Drug for: asthma, hyperkalemia

Back 68

terbutaline

Front 69

Drug for: Cardiac arrest, catecholamine-resistant hypotension

Back 69

vasopressin