Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/103

Click to flip

103 Cards in this Set

  • Front
  • Back
Ventricular tachycardia (monomorphic)
Sustained series of wide QRS complexes (ie ventricular depolarizations) at a rate of at least 120/min
Monomorphic
all complexes have the same apperance
Clinical clue

HR = 214/min
Wide complex tachycardia; presumed ventricular tachycardia
Clinical cue

HR = 44/min; no detectable pulses
Pulseless electrical activity (PEA)
PEA (pulseless electrical activity)
Cardiac arrest rhythms
Idioventricular escape rhythm; characterized by wide QRS complexes
Clinical cue
8 yo ; HR= 50/min
Sinus bradycardia
Sinus bradycardia characterized by:
sinus rhythm with a rate that is slower than normal for age. P waves and QRS complexes are usually normal...QRS is narrow
Clinical cue:
no detectable pulses
Asystole
Asystole is
absence of ventricular depolarization ; may be preceded by an agonal (usually wide complex)
Clinical cue:
no consistent heart rate; no detectable pulses
Ventricular fibrillation
Ventricular fibrillation characterized by:
rapid, irregular waveform. If no CPR and no shocks are given, this will progress to asystole
Clinical cue:
3 yo ; HR = 188/min
Sinus tachycardia
Sinus tachycardia is characterized by:
normal sequence of impulse formation and conduction with a rate faster than normal for age. P waves precede QRS complex; QRS is narrow
Clinical clue:
HR = 300/min
supraventricular tachycardia
supraventricular tachycardia is characterized by:
no beat to beat variability with activity or stimulation
HR more than 220/min in infants and more than 180/min in children
absent or abn. P waves; narrow QRS complexes
Clinical cue:
8 yo ; HR = 75/min
normal sinus rhythm
Clinical cue:
Initial rhythm associated with no detectable pulses
Ventricular fibrillation converted to organized rhythm after succussful shock therapy
Clinical cue;
9 months old; HR 38/min
sinus bradycardia with first-degree AV block
Sinus bradycardia with first degree AV block is characterized by:
Atrial depolarization (p wave) before each QRS complex, but the rate is less than 60/min
Clinical cue;
HR - 200/min; no detectable pulses
Torsades de pointes (polymorphic ventricular tachycardia)
Torsades de pointes is characterized by:
QRS complexes that change in amplitude and polarity in a cyclic pattern . Ventricular rate range from 150 to 250/ min
clinical cue:

HR = 150/min
wide complex tachycardia
clinical cue:
initial rhythm associated with HR = 300/min
Supraventicular tachycardia converting to sinus rhythm with adenosine administration
Treatment?
Infant with severe symptomatic bradycardia associated with resp. distress. Which is the first drug?
Epinephrine
What is epinephrine?
a catecholamine with direct effects at the beta adrenergic recepter
What does epi do?
improves HR in a hypoic-ishemic myocardium
When to use atropine?
if bradycardia is vagally induced or associated with heart block.
Epi improves
coronary artery perfusion pressure and myocardial oxygen
What delivers a high (90%) concentration of oxygen in a toddler or older child?
Nonbreathing face mask with 12L/min oxygen flow
High flow O2
more than 10 L / min. tight fitting - non breathing mask with reservoir
Low flow O2
Less than 10 L /min. patient inspiratory flow exceeds O2 flow
Max nasal cannula flow
4 L / min
OPA
only for unconscioius victim without gag reflex
NPA
for conscious or semi conscious victim
Measuring OPA
from corner of mouth to angle of mandible
Measuring NPA
Tip of nose to tragus of ear
Apply ECG correctly:
White lead to:
white lead to right shoulder
red lead
red lead to left ribs
Black, green or brown lead to
left shoulder
energy from pads (AED)
0,5 - 1 J/kg
Site for IO insertion
anterior tibia
distal femor
medial malleolus
anterior superior iliac spine
Contraindications for IO insertion
fracture in extremity
previous attempt in extremity that entered marrow space
infection overlying bone
PAT
pediatric assessment triangle
appearance, work of breathing, circulation
primary assessment
ABCDE ASSESSMENT
how to assess breathing
RR; Resp effort; tidal volume; airway and lung sounds; pulse ox
how to assess circulation
skin color and temp
HR and rhythm
pulses
capillary refill time
BP
how to assess disability
AVPU ped response scale
glascow coma scale (GSA)
pupolliary responses
how to assess exposure
remove clothing;
secondary assessments
SAMPLE
ACDA
Assess
Catagorize
Decide
Act
Pediatric Flowchart
General Assessment
Primary Assessment
Secondary Assessment
Tertiary Assessment
General Assessment
Appearnce
Work of Breathing
Circulation
Primary Assessment
ABCDE
Secondary Assessment
SAMPLE history, PE, bedside glucose
Catagorize illness by type and severity
Respiratory and Circulatory
Respiratory
Respiratory distress or failure
upper airway obst
lower airway obst
lung tissue disease
disordered control of breathing
Circulatory
compensated shock or hypotensive shock
If life threatening condition began life saving interventions such as;
Support ABC's
provide 100% O2
bag mask ; ET intubation
Clinical signs of cardiac arrest:
apnea or agonal gasps
no palpable pulses
unresponisiveness
Rhythms associated with pulseness arrest are:
pulseless ventricular tachycardia (VT)
ventricular fibrillation (VF)
asystole
If the arrest is unwittnessed then:( assumed to be asphyxial in origin) and out of hospital then:
Start CPR immediately
Perform cycles of chest comp. and ventilations for about 2 minutes
Apply AED and follow
If arrest is witnessed (sudden collapse more likely to be cardiac) and in hospital arrest then:
Send someone to activate ERS and get AED while beginning CPR.
If alone activate ERS and then begin CPR
Apply AED
Drugs used for cardiac arrest
Epi
Amiodarone HCl
Lido
Magnesium sulfate
calcium chloride
atropine sulfate
sodium bicarbonate
Antiarrhythmic meds
amiodarone
or
lidocaine
HR - Newborn
Mean - 140
HR - 3 months - 2 years
Mean - 130
HR - 2 - 10 years
Mean - 80
HR more than 10 years
Mean - 75
Signs of bradyarrhythmias
shock with hypotension
poor end organ perfusion
altered level of consciousness
sudden collapse
Drugs used to treat bradyarrhythmias
atopine
epinephrine
Drugs used to treat tachyarrhythmias are
adenosine
amiodarone
lidocaine
procainamide
sodium bicarbonate
Tachycardia is an important early sign of
Shock
Following drugs are used in cardiac arrest
Epi
Amiodarone HCl
lido
magnesium sulfate
calcium chloride
atropine sulfate
sodium bicarb
Signs of bradyarrhythmias
shock with hypotension
poor end-organ perfusion
altered level of cons
sudden collapse
Signs of tachyarrhythmias
resp distress
shock with hypotension
poor-end organ perfusion
altered level of cons
sudden collapse
Classification of tachyarrhythmias
NARROW COMPLEX-
sinus tachy
atrial flutter
supravent. tachy ( SVT)
WIDE COMPLEX
supravent tachy
ventricular tachycardia
Upper airway obstruction
stridor ( inspiratory)
seal like cough
hoarseneess
lower airway obstruction
wheezing (expiratory)
prolonged expiratory phase
lung tissue disease
grunting
crackles
decreased breath sounds
Following drugs can be used for respiratory emergencies
albuterol
corticosteroids (dexamethasone)
diphenhydramine
epi
furosemide
ipratropium bromide
magnesium sulfate
oxygen
terbutaline
hypoglycemia
term neonates
less than 45 mg/dL
hypoglycemia
infants
children
adolescents
less than 60 mg/dL
adenosine
SVT
0.1 mg/kg rapid push (max 6mg) then
0.2 mg/kg rapid push (max 12mg)
albuterol
asthma
anaphylaxis (bronchospasom)
hyperkalemia
atropine sulfate
bradycardia (symptomatic)
Toxins Overdose
Calcium chloride 10%
hypocalcemia
hyperkalemia
hypermagnesemia
calcium channel blocker overdose
dexamethasone
Croup
0.6 mg/kg (max 16mg)
dextrose
hypoglycemia
0.5 to 1 g/kg
diphenhydramine
anaphylactic shock
1 to 2 mg/kg q 4-6 hrs (max 50mg)
dopamine
cardiogenic shock; distributive shock
2 - 20 microg/kg per minute
epi
pulse less arrest, bradycardia
hypotensive shock
anaphylaxis
asthma
croup; toxins/overdose
hydrocortisone
adrenal insufficiency
lidocaine
VF/ Pulseless Vt- wide complex tachycardia (with pulses)
Amiodarone 5mg/kg IO
treatment of life threatening ventricular arrhythmias in children. Used in txt of shock-refractory or recurrent VT
Estimate lower limit of systolic BP in children
70 mm + (2 X age)
Formula to estimate size of uncuffed endotracheal tube for children age 1 - 10 years
(Age in years + 16)/ 4
ABCDE
A - Airway
B - Breathing
C - Circulation
D - Disability
E - Exposure
Normal urine output infants and young children
1.5 - 2 mL/kg per hour
Normal urine output for older children and adolescents
1mL/kg per hour
Checking Disability
evaluation of 2 components of CNS
the cerebral cortex
the brainstem
Alert
Voice
Painful
Unresponsive
Checking disability
PERRL
Pupils Equal Round Reactive to Light
survival rates from ped cardiac arrest vary according to
location of arrest
the presenting of rhythm