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Pals 2010

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Pals 2010

  1. 1. PEDIATRIC CARDIOPULMONARY RESUSCITATION From PALS Course 2010
  2. 2. GENERAL CONSIDERATION <ul><li>Neonatal :1 - 28 days </li></ul><ul><li>Infant : <1 yr </li></ul><ul><li>Child :1 yr - puberty(HCP) </li></ul><ul><li>:1 yr – 8 yr (Lay provider) </li></ul>
  3. 3. GENERAL CONSIDERATION <ul><li>Weight : < 1yr : (age + 9)/2 </li></ul><ul><li>1-6yr : (age x 2) + 8 </li></ul><ul><li>7-11yr : [yr x 7 – 5] / 2 </li></ul>
  4. 4. BASIC LIFE SUPPORT
  5. 5. CALL FOR HELP <ul><li>Phone first </li></ul><ul><li>CPR first </li></ul>
  6. 6. CHEST COMPRESSION <ul><li>Rate </li></ul><ul><ul><li>1 – 30:2 </li></ul></ul><ul><ul><li>2 – 15:2 </li></ul></ul><ul><li>Land mark </li></ul><ul><ul><li>Ped : Lower half sternum </li></ul></ul><ul><ul><li>Infant : Below inter mamillary line </li></ul></ul>
  7. 9. CHEST COMPRESSIONS “ Push hard” “ Push fast” fully recoil. Minimize interruptions
  8. 10. AED <ul><li>Recommended for >1 yr only </li></ul>
  9. 11. ADVANCE LIFE SUPPORT
  10. 12. AIRWAY : ENDOTRACHAEAL TUBE <ul><li>The internal diameter roughly equal the size of that child’s little finger </li></ul><ul><li>Uncuffed (mm ID) </li></ul><ul><li>= (age in years/4) + 4 </li></ul><ul><li>Cuffed (mm ID) </li></ul><ul><li>= (age in years/4) + 3.5 </li></ul>
  11. 13. AIRWAY : ENDOTRACHAEAL TUBE <ul><li>Depth </li></ul><ul><ul><ul><ul><ul><li>Age/2 + 12 </li></ul></ul></ul></ul></ul>
  12. 14. IF INTUBATED PATIENT’S CONDITION DETERIORATES ? <ul><li>DOPE </li></ul><ul><li>● D isplacement </li></ul><ul><li>● O bstruction </li></ul><ul><li>● P neumothorax </li></ul><ul><li>● E quipment failure </li></ul>
  13. 15. BREATHING : ON ETT <ul><li>With pulse : 12 -20 /min </li></ul><ul><li>No Pulse : 8-10/min </li></ul>
  14. 16. CIRCULATIONS <ul><li>Peripheral vascular </li></ul><ul><li>Intraosseous access </li></ul>
  15. 18. ENDOTRACHEAL DRUG ADMINISTRATION <ul><li>IO or IV, is prefer </li></ul><ul><li>can give only lipid-soluble drugs </li></ul><ul><li>“ LEAN” such as lidocaine, epinephrine, atropine, and naloxone </li></ul><ul><li>Flush with a minimum of 5 mL NSS </li></ul><ul><li> 5 assisted manual ventilations </li></ul><ul><li>If CPR stop chest compressions briefly </li></ul>
  16. 19. EMERGENCY FLUIDS AND MEDICATIONS <ul><li>Estimating Weight </li></ul><ul><li>Out-of-hospital setting a child’s weight is often unknown </li></ul><ul><li>Tapes with precalculated doses printed at various patient lengths are helpful and have been clinically validated </li></ul>
  17. 25. DEFIBILLATIONS <ul><li>2 J / kg  4J / kg  not exeed 10 J/kg </li></ul>
  18. 30. Thank you for your attention

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