Pediatric Advanced Life Support | Mackenzie Thompson | Skillshare
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54 Lessons (1h 32m)
    • 1. Introduction to PALS

      0:57
    • 2. The Resuscitation Team

      1:45
    • 3. Basic Life Support

      1:08
    • 4. One Rescuer BLS in Children

      1:45
    • 5. Two Rescuer BLS in Children

      1:26
    • 6. One Rescuer BLS in Infants

      2:13
    • 7. Two Rescuer BLS in Infants

      1:40
    • 8. Normal Heart Anatomy

      1:58
    • 9. Normal Heart Physiology

      2:08
    • 10. A Systematic Approach

      1:59
    • 11. Initial Diagnosis and Treatment

      1:09
    • 12. Airway

      1:01
    • 13. Breathing

      1:06
    • 14. Circulation

      1:23
    • 15. Disability

      1:03
    • 16. Exposure

      1:08
    • 17. Secondary Diagnosis and Treatment

      1:15
    • 18. Life Threatening Issues

      1:03
    • 19. Resuscitation Tools

      0:57
    • 20. Bag Mask Ventilation

      1:52
    • 21. Endotracheal Intubation

      0:41
    • 22. Basic Airway Adjuncts

      2:20
    • 23. Basic Airway Techniques

      2:27
    • 24. Automated External Defibrillator

      2:23
    • 25. Pharmacological Tools

      1:06
    • 26. Recognizing Respiratory Distress

      1:58
    • 27. Causes of Respiratory Distress

      1:15
    • 28. Responding to Respiratory Distress

      1:39
    • 29. Recognizing Bradycardia

      1:55
    • 30. Responding to Bradycardia

      1:39
    • 31. Recognizing Tachycardia

      1:52
    • 32. Narrow QRS Complex

      1:24
    • 33. Wide QRS Complex

      1:28
    • 34. Responding to Tachycardia

      1:10
    • 35. Shock

      2:11
    • 36. Hypovolemic Shock

      1:23
    • 37. Distributive Shock

      3:03
    • 38. Cardiogenic Shock

      1:13
    • 39. Obstructive Shock

      1:41
    • 40. Responding to Shock

      0:59
    • 41. Responding to Hypovolemic Shock

      1:46
    • 42. Responding to Distributive Shock

      3:16
    • 43. Responding to Cardiogenic Shock

      1:14
    • 44. Responding to Obstructive Shock

      1:05
    • 45. Recognizing Cardiac Arrest

      2:06
    • 46. Pulseless Electrical Activity & Asystole

      1:52
    • 47. Ventricular Fibrillation

      1:05
    • 48. Responding to Cardiac Arrest

      2:30
    • 49. Post Resuscitation Care

      7:01
    • 50. Infant 1 Person BLS

      1:33
    • 51. Infant 2 Person BLS

      1:41
    • 52. Infant Airway

      0:21
    • 53. Airway Management

      2:52
    • 54. Who is NHCPS?

      1:08

About This Class

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Pediatric Advanced Life Support (PALS) will prepare you to respond to life-threatening emergencies in the pediatric population with advanced interventions. This PALS course is based on the latest guidelines which focus on doing several tasks simultaneously with a group process that enables efficiency and minimization of error.

This course will teach participants how to perform advanced emergency interventions as well as review foundation theories including Basic Life Support, Anatomy and Physiology of the Heart, the Resuscitation Team, a Systematic Approach, Life-Threatening Issues, Medical Devices, Bradycardia, Tachycardia, and much more.

The course package includes:

  • PALS Provider Handbook
  • PALS Self-Assessments and Review Questions
  • PALS Lectures and Video Presentations
  • Optional Certification Available: This course is for training in Pediatric Advanced Life Support (PALS). If you would like to be certified please visit https://nhcps.com/mooc-life-saving-course/ and complete your PALS certification test. Skillshare students receive a FREE certification.

If you want to stay up to date on my newest classes, be sure to click “Follow” below. I also share resources, and my followers are the first to hear about these opportunities!

Transcripts

1. Introduction to PALS: Chapter one introduction to P A l s Welcome to P A L L s pls is a series of protocols to help health care professionals and caregivers achieve the best possible outcome for infants and Children who experience life threatening events. Thes protocols are designed to be simple enough to commit to memory and recall under moments of emergencies and stress. Pls guidelines have been developed from thorough review of available protocols, patient case studies in clinical research and they reflect the consensus opinion of experts in the Field. Pls Handbook in the corresponding videos are based on the most since h a publication of P A . L s and periodically compared the previous and the new recommendations for a more comprehensive review. This concludes our introduction of P A l s Next we'll review the resuscitation team. 2. The Resuscitation Team: Chapter two resuscitation team. Welcome to the lesson on the resuscitation team in this video will review the components that make up the resuscitation team in their roles. The A J Guidelines for Pls highlights the importance of effective team dynamics during resuscitation in the community outside of healthcare facilities. The first rescuer on the scene may be performing CPR alone, however, in a hospital setting, a pediatric arrest event may bring dozens of people to the patient's room. The A J supports a team structure, with each provider assuming a specific role during resuscitation. This consists of a team leader and several team members, all who should have clear communication among them. The team leader is responsible for organizing the group monitoring performance, directing team members, providing feedback on group performance after the resuscitation effort. Additionally, team leaders should be capable of performing all pls skills. Team members are expected to understand their roles, be willing, able and skilled to perform there, understand pls sequences and be committed to the success of the team. Resuscitation demands, mutual respect, knowledge sharing and constructive criticism. After each resuscitation effort, providers should review the process and provide each other with helpful, constructive feedback. A respectful and supportive attitude is crucial and eight in processing the inevitable stress during pediatric resuscitation. This concludes our lesson on the resuscitation team. Next, we'll review basic life support. No. 3. Basic Life Support: Chapter three Basic Life Support. Welcome to the overview on basic Life. Support in this video will briefly discuss Basic Life Support, or BLS, and its importance during pls. BLS is the life support method used when there is limited access to advance interventions such as medications and monitoring devices. In general, BLS had performed until the Emergency medical services, or AMS, arrives to provide a higher level of care. Pls utilizes CPR and cardiac defibrillation when a defibrillator is available in every setting, high quality CPR gives a child or the infant the greatest chance of survival by providing circulation to the heart, brain and other organs until the return of spontaneous circulation. Pls Handbook and its corresponding videos only briefly describe BLS call pls providers are assumed to be able to perform BLS appropriately. This concludes the overview on basic life support. Next, we'll review one rescuer. BLS in Children 4. One Rescuer BLS in Children: Welcome to the lesson on one rescuer. BLS in Children. In this video, we'll discuss step by step procedure for providing BLS in Children with one rescuer. If you're alone with a child in a life threatening situation, first tap their shoulders and talk loudly to them to determine if they're responsive, then assess their breathing. If the child does not respond and is not breathing or is only gasping for air, then yell for help. If someone responds, send them to call 900 get in a e D. If you're not in a health care facility or activate emergency response system and get a defibrillator. If you are in health care facility, feel for the child's corroded pulse on the side of the neck or ephemeral pulse on the inner thigh in the crease between their leg and growing. Feel from no more than 10 seconds. If you cannot feel a pulse, or if you're unsure that you feel a pulse, begin CPR by doing 30 compressions, followed by two breaths. If you can't feel a pulse, but the pulse rate is less than 60 beats per minute. Begin CPR. This rate is too slow for a child after doing CPR for about two minutes, which is usually five cycles of 30 compressions and two breaths. And if help has not arrived, call E. M s while staying with the child, the H A emphasizes to use speaker equipped cell phones that are available everywhere. Now get an 80 where defibrillator, if you know where one is, use and follow the prompts on the E. D or defibrillator while continuing CPR until AMs arrives or until child's condition normalizes. This concludes our lesson on one rescuer. BLS in Children. Next, we'll review to rescue a BLS in Children. 5. Two Rescuer BLS in Children: welcome to the lesson on to rescue a VLS and Children. In this video, we'll discuss step by step procedure for providing BLS and Children with two rescuers. If you're not alone with a child, first tap their shoulders and talk loudly to them to determine if they're responsive, then assess their breathing. If the child does not respond and is not breathing or is only gasping for air, then send the second rescuer to call 911 and get an A D. If you're not in a health care facility or activate emergency response system and get a defibrillator. If you are in a health care facility, feel for the child's corroded pulse on the side of the neck. Ephemeral pulse on the inner thigh in the crease between their legs and their groin feel for no more than 10 seconds. If you cannot feel a pulse, or if you're unsure that you feel a pulse, begin CPR by doing 30 compressions, followed by two breaths. If you can feel a pulse, but the pulse rate is less than 60 beats per minute. Begin CPR. This rate is too slow for a child. When the second rescuer returns Begin CPR by performing 15 compressions yourself and two breaths by the second rescuer. Use and follow the prompts on the E. D or the defibrillator while continuing CPR until the M S arrives or until child's condition normalizes. This concludes our lesson on to rescue a BLS and Children. Next, we'll review one rescuer. BLS in infants. 6. One Rescuer BLS in Infants: Welcome to the lesson on one rescuer. BLS in infants. In this video, we'll discuss step by step procedure for providing BLS in infants with one rescuer. If you're alone with an infant, tap their shoulders and talk loudly to them to determine if they're responsive, then assess their breathing. If the infant does not respond and is not breathing or is only gasping for air, then yell for help. If someone responds, send them to call 911 and get an 80 if you're not in a health care facility, or activate emergency response system and get a defibrillator. If you are in a health care facility, feel for the infants. Break your pulse for no more than 10 seconds. If you cannot feel a pulse, or if you're unsure that you feel a pulse, begin CPR by doing 30 compressions, followed by two breaths. If you can feel a pulse, but the pulse rate is less than 60 beats per minute. Begin CPR. This rate is too slow for a child. If you cannot feel a pulse, or if you're unsure that you feel a pulse, begin CPR by doing 30 compressions, followed by two breaths. If you can feel a pulse, but the pulse rate is less than 60 beats per minute. Begin CPR. This rate is too slow for a child to perform CPR on an infant. Make sure the infant is face up on a hard surface using two fingers performed chest compressions in the center of the infants chest. Be sure not to press on the end of the sternum, as this can cause injury to the infant. Compression. Death should be 1.5 inches that it's four centimeters, and the compression rate should be at least 100 to 120 per minute after doing CPR for about two minutes, which is usually five cycles of 30 compressions and two breaths. If help has not arrived, activate emergency response system while staying with the Infante Ph. A. Emphasizes to use speaker equipped cell phones that are available everywhere. Now get an A D or defibrillator. If you know where one is used, the E D or the defibrillator are continuing CPR until more help arrives or until infants condition normalizes. This concludes our lesson on one rescuer. BLS in infants. Next, we'll review to restaurant BLS in evidence 7. Two Rescuer BLS in Infants: welcome to the lesson on to rescuer BLS and infants. In this video, we'll discuss step by step procedure for providing BLS and infants with two rescuers. If you're not alone with the infant, first tap their shoulders and talk loudly to them to determine if they're responsive, then assess their breathing. If the infant does not respond and is not breathing, where's only gasping for air? Then send the second rescuer to call 911 and get in a D if you're not in a health care facility or activate emergency response system and get a defibrillator. If you are in health care facility, feel for the infants. Break your pulse for no more than 10 seconds. If you cannot feel a pulse, or if you're unsure that you feel a pulse, begin CPR by doing 30 compressions, followed by two breaths. If you can feel a pulse, but the pulse rate is less than 60 beats per minute. Begin CPR. This rate is too slow for an infant. When the second rescuer returns, begin CPR by performing 15 compressions yourself and two breaths by the second rescuer. Give compressions using the two thumb in circling hands. Method be sure not to press on the end of the sternum as this can cause injury to the infant. Compression. Death should be 1.5 inches, that is four centimeters, and the compression rate should be at least 100 toe 120 per minute. Use E T or the defibrillator while continuing CPR until further help arrives or until infants condition normalizes. This concludes our lesson on to rescuer BLS in infants. Next, we'll review normal heart anatomy for pls. 8. Normal Heart Anatomy: Chapter four Pediatric Advanced Life Support's Welcome to the lesson on no normal heart Anatomy for pls. In this video, we'll discuss the normal cardiac anatomy, which will help understand physiology in the next video. Heart is a hopeful muscle, comprised of four chambers that are all surrounded by thick walls of tissue called septum. The two upper chambers are the atria and the two lower chambers. Other ventricles, the right and left halves of the heart, work together to pump blood throughout the body. Right atrium receives blood from the body and sent it to the right ventricle to be sent to the lungs for oxygenation. The left atrium received the newly oxygenated blood and sends it to the left ventricle to be sent throughout the rest of the body. Balance between each chamber prevent reverse blood for blood leaves the heart for a large vessel called the aorta. The two atria contract simultaneously, as do the ventricles, making the contractions of the heart go from the top to the bottom. Each beat begins in the right atrium. Left ventricle is the largest and has the thickest wall as it is responsible for pumping the newly oxygenated blood to the rest of the body. The electrical pathways of the heart begin in the Sino atrial, or s a note in the right atrium. Together, they create the electrical activity that acts as the heart's natural pacemaker. This electrical impulse then travels to the atrial ventricular or a V note, which lies between the atria and ventricles. After pausing briefly, the electrical impulse moves the his Perkin Gee system, which acts as wiring to conduct the electrical signal into the left and right ventricles. This electrical signal causes the heart muscle to contract and pump blood. This concludes the normal heart anatomy for pls next, we'll review the normal heart physiology for pls. 9. Normal Heart Physiology: welcome to the lesson on normal heart physiology for pals. In this video, we will discuss the normal electrical pathways of the heart. Understanding the normal electrical function of the heart helps understand the abnormal functions. When blood inter see Atria of the Heart an electrical impulse that is sent from the S, a node conducts through the atria, resulting in atrial contraction which registers as the P wave on the electrocardiogram or E c. G strip. This impulse then travels to the A V node, which in turn conducts the electrical impulse through the bundle of hiss bundle branches and the per Kinji fibers of the ventricles, causing ventricular contraction. The time between the start of the atrial contraction and the start of ventricular contraction registers as the P R. Interval on an E. C G strip, the ventricular contraction registers as the QRS complex. Following ventricular contraction, the ventricles rest and re polarize, which registers as the T wave. The atria also re polarized, but this coincides with the QRS complex. Therefore it cannot be observed on the E C G Strip P wave QRS complex and the T wave together at proper intervals are indicative of normal Sinus rhythm, or NSR, abnormalities. That air in the conduction system can cause delays in the transmission of the electrical impulse and are detected on the E C G. These deviations from normal conduction can result in dysrhythmia as such as heart box pauses, tacka card, AEA's and bradycardia as blocks and dropped beats. This concludes our lesson on normal heart physiology for pals. Next, we will review a systematic approach. 10. A Systematic Approach: welcome to a systematic approach. In this lesson, we'll discuss the comprehensive approach to take in the event of finding an unresponsive child or infant. When you find an unresponsive child or infant, it's often possible to immediately deduced. The ideology should act quickly, decisively and apply interventions that fit the needs of the individual at that moment, while there are various ways for a child or an infant to become unresponsive, central issues that need to be addressed include keeping blood pumping through the vasculature or profusion in supplying oxygen to the lungs or oxygenation when the child or infant is experienced, poor perfusion and oxygenation CPR manually takes over for the heart and lungs if they're still adequately maintaining profusion and oxygenation. But unresponsive and rapid diagnosis and treatment may be possible. Without CPR, it's important to differentiate normal breathing from gasping or agonal breathing. Gasping is considered ineffective breathing. Similarly, not all pulses are adequate. Rule of thumb is that at least 60 beats per minute is required to maintain adequate profusion in a child infant. The assessment must be carried out quickly. There is a low threshold for administering ventilation and or compressions. If there's evidence that the child or the infant can not do either effectively on their own . If the problem is respiratory in nature, that initiation of rescue breathing is warranted. If breathing is ineffective and pulses are inadequate, begin high quality CPR immediately. It's important to understand that any case can change at any time, so you must reevaluate periodically and adjust the approach to treatment according you CPR to support breathing and circulation until the cause has been identified and effectively treated. This concludes our lesson on a systematic approach. Next will review initial diagnosis and treatment. 11. Initial Diagnosis and Treatment: welcome to the lesson on initial diagnosis and treatment. In this video, we'll consider this scenario of when the child or infant is not in immediate danger and briefly discussed the A B C D E method. If you've reached the initial diagnosis and treatment phase of care, the child or infant is not in immediate danger of death. Well, this means that you have a brief moment to find the cause of the problem and intervene with appropriate treatment. It does not mean that a life threatening event is impossible in this case. Always be vigilant for any indication to initiate high quality CPR and look for life threatening events such as respiratory distress. A change in consciousness or cyanosis. The H recommends following the A B C D E method. When reaching initial diagnosis and treatment. Face the A B C D E method consists of checking for airway breathing, circulation, disability and exposure is concludes. Our lesson on initial diagnosis and treatment X will go in depth to review each of the A, B, C D E method components 12. Airway: Welcome to the lesson on airway. In this video, we will discuss how to assess the child or the infants airway. When assessing airway, you should determine one of the three possibilities. One. If the airway is open and unobstructed, then move on to breathing. Two. If the airway cannot be kept open manually, then use the head tilt chin lift, maneuver, the jaw thrust maneuver or the basic airway at junks like nasal fair in jail or or affair in jail. Three. If an advanced airway is required, then used endotracheal intubation or cry Koth. Iroda Me once an airway has been established and maintained, then move on to breathing. This concludes our lesson on airway. Next, we will review breathing. 13. Breathing: Welcome to the lesson on breathing. In this video, we'll discuss how to assess the child or the infants breathing. If the child or infant is not breathing effectively, it's a life threatening event, and you should treat it as a respiratory arrest. However, if it's abnormal yet marginally effective breathing, it can be assessed and managed by determining the breathing Being too fast or too slow to keep. Nia is abnormally fast breathing and has an extensive differential diagnosis. Well, Brad Dip Nia were abnormally slow breathing could be a sign of impending respiratory arrest to assess effective breathing. You should also for increased respiratory effort. Signs of increased respiratory effort include nasal flaring, rapid breathing, chest retractions, abdominal breathing, strider, grunting, wheezing and crackles. This concludes our lesson on breathing. Next, we'll review circulation. 14. Circulation: Welcome to the lesson on circulation. In this video, we'll discuss. How do you assess the child or the infants? Circulation Assessment of circulation in pediatrics involves more than checking the pulse and blood pressure, Color and temperature of the skin and mucous membranes can help to assess effective circulation. Paler blue skin indicates poor tissue. Proficient cap Hillary Refill time is also a useful assessment in pediatrics. Adequately refused skin rapidly, really filled with blood after it's squeezed, for example, by bending the tip of the finger at the nail bed. Inadequately, profuse tissues will take longer than two seconds to respond. Abnormally cool skin can also suggest poor circulation. The normal heart rate and blood pressure and pediatrics are quite different than in adults and change with age. Likewise, heart rates are slower when Children and infants are asleep. Most centers will have acceptable ranges that they use for normal and abnormal heart rates . Forgiven age. While you should follow your local guidelines, approximate ranges are listed in Table five in your corresponding pls manual. This concludes our lesson on circulation. Next, we'll review disability 15. Disability: Welcome to the lesson on disability. In this video, we'll discuss how to assess that is the child or the infants of disability NPLs. Disability prefers to performing a rapid neurological assessment. A great deal of information can be gained from determining the level of consciousness on a four level scale. Pupil Larry Response to Light is also a fast and useful way to assess neurological function . Urologic assessments include a VP you that is alert, voice pain, unresponsive response scale and the Glasgow Coma scale. GCS, especially modified GCS, is used for Children and infants and takes developmental differences into account. Refer to table six and seven in your corresponding pls manual for a VP you response scale and GCS respectively. This concludes our lesson on disability. Next, more review exposure. 16. Exposure: welcome to the lesson on exposure. In this video, we'll discuss. How do we set That's the child or the infants? Exposure Exposure is classically most important when you're responding to a child or infant who may have experienced trauma. However, it has a place in pls evaluations. Exposure reminds the provider to look for signs of trauma, burns, fractures and any other obvious sign that might provide a clue as to the cause of the current problem. Skin temperature and color could provide information about the child or infants, cardiovascular system, tissue perfusion and mechanism of injury. If time allows. Pls provider can look for more subtle signs such as petechiae or bruising. Exposure also reminds the provider that Children and infants lose core body temperature faster than adults do. Therefore, while it's important to evaluate the entire body, make sure to cover and warm the individual after diagnostic survey. This concludes our lesson on exposure. Next will review the secondary diagnosis and treatment 17. Secondary Diagnosis and Treatment: welcome to the lesson on secondary diagnosis and treatment. In this video, we'll discuss a more thorough survey of the brief. A B C D secondary diagnosis includes focused history and physical examination involving the person, the person's family and any witnesses in terms of history. Follow the acronym span, which stands for signs and symptoms past medical history, allergies and medications. For details on what to check during spam evaluation preferred to table eight in the corresponding PLS manual. The focus examination is guided by the answers to the focused history. For example, a report of difficult breathing will prompt a thorough airway and long examination. It may also prompt a portable chest X ray study in a hospital setting. The key point is that it's best to work from head to toe to complete a comprehensive survey . Make use of diagnostic tools when possible to augment physical examination. This concludes our lesson on secondary diagnosis and treatment. Next will review life threatening issues 18. Life Threatening Issues: welcome to the lesson on life threatening issues. In this video, we'll discuss what to do during a life threatening emergency if it any time you determined that the child or infant is experiencing a life threatening emergency support breathing and cardiovascular function immediately, this usually means providing high quality CPR. While it's important to recognize and respond to the particular cause of the problem, the time required to determine the problem should not interfere with profusion and oxygenation for the child or the infant. As you maintain breathing and circulation for them, determine if they're primarily experiencing respiratory distress or arrest bradycardia, tachycardia, shock or cardiac arrest. Individual pls protocols for each of these clinical situations are provided throughout the videos and corresponding pls manual. This concludes our lesson on life threatening issues. Next, we'll review resuscitation tools. 19. Resuscitation Tools: Chapter five resuscitation tools. Welcome to the overview on resuscitation Tools in this video will briefly discuss the resuscitation tools and their importance in pls. Understanding that resuscitation tools are available is an essential component of P. A. L s. The's adjuncts are broken down into two sub categories, which are medical devices and pharmacological tools. A medical device is an instrument used to diagnose, treat or facilitate care pharmacological tools on the medications used to treat the common challenges experienced during a pediatric emergency. It's important that you thoroughly understand all resuscitation tools to optimally care for a child or an infant who needs assistance. This concludes our lesson on the resuscitation tools. Overview. Next Will review medical devices intro CS Access. 20. Bag Mask Ventilation: Welcome to the lesson on bag mask ventilation. In this video, we'll discuss us how to perform bag mask ventilation when performed appropriately. Bag mask Ventilation is an important intervention in pls. Proper use of this device requires proper fit that is, the child or the infants. Mouth and nose should be covered tightly, but not the eyes. When possible, use it clear mats, since it allows you to see the color of the person's lips and the presence of condensation in the mask, indicating X elation. The two most common types of masks are self inflating and flow inflate. While a self inflating bag mask should be the first choice in resuscitation, you should not use it in Children or infants were breathing spontaneously flow. Inflating back masks, however, require more training and experience to operate properly as you must simultaneously manage gas flow. Suitable mask, seal individuals, neck position. A proper title volume. The minimum size bag should be 450 milliliters. For infants and young and or small Children. Older Children require a 1000 milliliters volume egg. Proper ventilation is of the utmost importance as insufficient ventilation. It's respiratory acidosis. First step of bag mask ventilation is proper position. In the absence of neck injury, tilt the forehead back and lift the chin. Next, ensure a tight seal used the E C clamp, which is the letters he ends. T formed by the fingers and thumb over the mask. Then eventually, by squeezing the bag for over one second until the chest rises. Do not over ventilate. This concludes our lesson on bag mask ventilation. Next, we'll review endotracheal intubation. 21. Endotracheal Intubation: Welcome to the lesson on endotracheal intubation. In this video, we'll briefly to discuss when to use endotracheal or e t. Intubation. You should use each intubation when the airway cannot be maintained when bag mask ventilation is inadequate or ineffective, or when a definitive airway is necessary. E T intubation requires specialized training. A complete description of e T intubation is beyond the scope of this video. This concludes our lesson on endotracheal intubation. Next will review basic airway adjuncts. 22. Basic Airway Adjuncts: Welcome to the lesson on basic airway adjuncts. In this video, we'll discuss when to use the three basic airway adjuncts Orel for NGO Airway, nasal for NGO Airway and suctioning. The aural friend Jill Airway or O. P. A. Is a J shaped device that fits over the tongue toe. Hold the soft, hypo fragile structures and the tongue away from the posterior wall of the fairies. O P. A. Is used in individuals who are at risk for developing airway obstruction from the tongue or from relaxed upper airway muscles. If efforts to open the airway failed to provide and maintain a clear, unobstructed airway and use the O. P. A. In unconscious individuals, you should not use in o p, a unconscious or semi conscious individuals because it can stimulate gagging and vomiting. Key assessment is to check whether the individual has an intact cough and gag reflex. If so, they do not use in O P. A. The nasal for NGO Airway or N P. A is a soft rubber or plastic uncuffed tube that provides a conduit for air flow between the Nerys and the Ferencz. The N P. A is used as an alternative to in O. P. A. In individuals who need a basic airway adjunct. Unlike the oral airway, NPS may be used in conscious or semi conscious individuals with intact coffin gag reflex. Use N p A. When insertion of an O. P. A. Is technically difficult or dangerous, use caution or avoid placing NPS and individuals with obvious facial fractures. Suctioning is an essential component of maintaining a patent. Airway providers had suction the airway immediately. If there are copious secretions, blood or vomit attempts at suctioning should not exceed 10 seconds. To avoid high poxy MIA, follow suctioning attempts with a short period of 100% oxygen administration monitor the individual's heart rate, pulse, oxygen saturation and clinical appearance during suctioning. If you see a change in monitoring parameters than interrupt, suctioning and administer oxygen until the heart rate returns to normal and until clinical condition improves, assist ventilation as warranted. This concludes our lesson on basic airway Agins. Next, we'll review basic airway techniques 23. Basic Airway Techniques: Welcome to the lesson on basic airway technique. In this video, we'll discuss how to use three Basic Airways Orel for NGO airway, nasal, pharyngeal, airway and sexually. When selecting an airway device, keep in mind that too large of an airway device can damage the throat and too small of an airway device. Compress the tongue into the airway to insert an aural Frenzel airway or O P. A. First, clear the mouth of blood and secretions with suction. If possible, place the device at the side of the individual's face. Make sure to choose a device that extends from the corner of the mouth to the ear lobe. Insert the device into the mouth so the point is toward the roof of the mouth or parallel to the teeth. Do not press the tongue back into the throat. Once the device is almost fully inserted, turn it until the tongue is cut by the interior curve of the device. To insert a nasal for angel airway or NP a place the device at the side of the individual's face. Make sure to choose a device that extends from the tip of the nose to the ear. Low use the largest diameter device that will fit. Lubricate the airway with a water soluble lubricant or anesthetic jelly. Insert the device slowly into a nostril, moving straight into the face, not toward the brain. It should feel snug. Do not force the device into the nostril. It feels stuck and remove it and try the other nostril. Here are some tips on suctioning When section in the aural fairies do not insert the catheter too deeply. Extend the catheter to the maximum safe, deaf and suction as you withdraw. When sectioning e T tube. Remember, the tube is within the trachea and you may be suctioning near the bronchi or lump. Therefore, sterile techniques should be used. Each section attempt should be for no longer than 10 seconds. Remember the individual, not get oxygen during suctioning. Monitor vital signs during suctioning and stop suctioning immediately. If the individual experiences high poxy mia, that is oxygen SATs. Less than 94% has a new arrhythmia or become cyanotic. This concludes our lesson on basic airway techniques. Next, we'll review automated external defibrillator 24. Automated External Defibrillator: Welcome to the lesson on automated external defibrillator or a D. In this video, we'll discuss the E D steps for Children and infants, and A D is both sophisticated and easy to use, providing life saving power in a user friendly device. This makes the device useful for people who have no experience operating in a D and allows successful use in stressful scenarios. However, proper use of an A D is very important. The purpose of defibrillation is to reset the electrical systems of the heart, allowing a normal rhythm a chance to return. Remember criteria for a E D use is no response. After shaking the individuals shoulders and shouting at them. No breathing or ineffective breathing and no corroded artery. Pulse Detective to use an A, E d and infants or Children first received the E. D. Open the case and turn on the TV. Exposed the infants or the child's chest. If the chest is wet, dry it. Remove medication patches. Open the pediatric E D pants. If pediatric pads are not available, then use the adult pass in short, that the pants do not touch. Peel off the backing. Check for pacemakers or defibrillators if either our present Do not apply pads over the device, Apply the pads on the upper right chest above the breast and lower left chest below the armpit. Ensure that the wires are attached to the E. D box. Move away from the individual. Stop CPR and instruct others not to touch the individual. The E. D analyzes the rhythm and prompt you. If the message reads, check electrodes to ensure the electrodes make good contact. If the message reads, shock then shocked the individual. Resume CPR for two minutes and then repeat the cycle. Remember that if the A e. D is not working properly, continue performing CPR. Do not waste excessive time. Troubleshooting The e D. CPR Always comes first and eighties are supplemental. Also, do not use a D in water. This concludes our lesson on 80 Next will review pharmacological tools 25. Pharmacological Tools: Welcome to the lesson on pharmacological tools in this video will briefly discuss pharmacological tools Table nine in the corresponding PLS manual Details. Medications. The use of any of these medications should be done within your scope of practice and after thorough study of actions and side effects. Table nine provides only a brief reminder for those who are already knowledgeable in the use of these medications. Further table nine Onley contains pediatric doses, indications and routes of administration, intravenous or intra CS for the most common pls drugs. Although cited for reference routine administration of drugs, B A and E T tube is discouraged rapid access and drug delivery through an intro. CS is preferred over ET administration as drug absorption from E T tube route is unpredictable. This concludes our lesson on pharmacological tools. Next, we'll review recognizing respiratory distress or failure. 26. Recognizing Respiratory Distress: Chapter six respiratory distress or failure. Welcome to the lesson on recognizing respiratory distress or failure. In this video, we'll discuss what respiratory distress or failure is and how to recognize him. Respiratory distress is a condition in which pulmonary activity is insufficient to bring oxygen and to remove carbon dioxide from the blood. Challenges arise with the recognition of respiratory distress. The individual appears to be breathing but is not actually breathing effectively. Proper rate and depth of breathing is important to assess when evaluating whether the person is effectively breathing the two main actions involved in breathing our ventilation and oxygenation signs and symptoms of which you can review in your corresponding pls manual in the table in Figure 11. If the individual is in respiratory distress, their airway will open without support. Other signs and symptoms include Tikopia increased respiratory effort, clear lung sounds, tacky cardio agitation and pale and variable. If the individual is in respiratory failure, the airway could be possibly obstructed. Other signs and symptoms include slow breathing or no breathing effort, abnormal lung sounds, bradycardia failure to respond and cyanotic and variable. In some instances, breath sounds can provide information about the source of the breathing problem. Abnormal breath sounds includes strider, grunting, wheezing, crackles and absent or decreased breath sounds. For information on the source of breathing problems associated with each breath sound, consult Table 11 in your corresponding pls manual. This concludes our lesson on recognizing respiratory distress or failure. Next will review causes of respiratory distress or failure. 27. Causes of Respiratory Distress: welcome to the lesson on causes of respiratory distress or failure. In this video, we'll discuss the causes of respiratory distress or failure. Respiratory distress or failure generally falls into one of the four broad categories, including upper airway, Lower Airway, lung tissue disease and Central Nervous System or CNS issues. In the upper airway, distress or failure can be caused by croup or swelling foreign body retro for NGO abscess and or anaphylaxis in the lower airway. Distress or failure can be caused by bronchial itis and or asthma. The lung tissue disease can be caused by pneumonia, Newman itis and or pulmonary oedema. CNS issues can be caused by overdosing and or head trauma. This list is not comprehensive, and specific conditions should be addressed with specific therapy. However, this list represents the most common causes of respiratory distress or failure in pediatrics. This concludes our lesson on causes of respiratory distress or failure. Next, we'll review responding to respiratory distress or failure 28. Responding to Respiratory Distress: welcome to the lesson on responding to respiratory distress or failure. In this video, we will discuss management of respiratory distress or failure regarding airway breathing and circulation. Initial management of respiratory distress or failure includes opening and supporting the airway sectioning and considering advanced airway management of breathing includes monitoring oxygen stats, getting supplemental oxygen and nebulizer. Management of circulation involves monitoring vital signs and establishing vascular access . Pals. Management of respiratory distress or failure is adjusted based on the severity of the current condition. For example, mild asthma is treated with bronchodilator inhalers, but severe asthma or status Asthmatic ASUs may require e. T. Intubation. As a provider, you must continually assess the individuals current needs and adjust care accordingly. For further information on responding to respiratory distress or failure, refer to Table 14 in your corresponding Pals manual that describes treatments for upper airway, lower airway, lung tissue disease and CNS issues. This concludes our lesson on responding to respiratory distress or failure. Next, we will review recognizing bradycardia 29. Recognizing Bradycardia: Chapter seven bradycardia. Welcome to the lesson on recognizing bradycardia. In this video, we'll discuss what Braddock rd a means and how to recognize it. Bradycardia is defined as a heart rate that's lower than what is considered normal for a child's age. Bradycardia and Children and infants should be evaluated, but not all Braddock RD. It needs to be medically managed. Intervention is required when bradycardia is symptomatic and compromises cardiovascular function. This commonly means that the heart is beating too slowly to maintain blood pressure, thereby causing shock. Poor tissue perfusion and or a chain and mental status. Symptomatic bradycardia can cause a number of signs and symptoms, including low blood pressure, pulmonary oedema or congestion. Abnormal rhythm, just discomfort, shortness of breath, lightheadedness, confusion and or sink API. Bradycardia most commonly become symptomatic when it is of new onset for the individual, which means acute slowing of the heart rate. The following are the kinds of bradycardia and what happens during specific credit. Cardiac events. Sinus bradycardia, normal rhythm with a slow rate first degree. A V block PR interval is longer than 0.20 seconds. Type one second degree A B block or more bits one he original increases in length until cure s complexes dropped. Type two, second degree A V block or moments too. The orange level is the same life with intermittently dropped QRS complex third degree A V block or complete P R. Interval and Cure s complex are not coordinated with each other. This concludes our lesson on recognizing granite cardia. Next, we'll review responding to bradycardia. 30. Responding to Bradycardia: Welcome to the lesson on responding to bradycardia. In this video, we'll discuss how to respond to Brad A cardiac events to respond to symptomatic bradycardia , checked the heart rate to confirm abnormally low heart rate or significant drop from previous normal. Complete the ABC survey by checking airway breathing and circulation. Check for signs and symptoms of shock and acute change in mental status. Perform necessary CPR and administer epinephrine and atropine as indicated. Evaluate success of drugs and consider trance, Jurassic or trans Venus pacing, especially if bradycardia is the result of a complete heart block or an abnormal Sinus known function. See consultation from an expert if needed. Remember that the primary goal of symptomatic bradycardia treatment is to make sure the heart is adequately refusing. Treatment is not necessarily aimed at increasing the heart rate. Treatment should continue until symptoms and signs resolved. If the individual stops having a pulse moved to the cardiac arrest protocol. Always consider the reversible causes of Braddock, Cardia and Pediatrics and treat if possible. For further details on responding to Braddock RD and Pediatrics, please refer to Table 15 in the pediatric Braddock Cardio with pulse or poor perfusion, all algorithm that is figure 13 in your corresponding pls manual. This concludes our lesson on responding to bradycardia. Next, we'll review recognizing tachycardia. 31. Recognizing Tachycardia: Chapter eight Talking Hardy. Welcome to the lesson on recognizing tacking cardio. In this video, we'll discuss what tactic RD. It means how to recognize it and kinds of Jackie Hardy. Thank you. Cardio is defined as a heart rate greater than what is considered normal for a child's age . Like bradycardia, tachycardia could be life threatening if it compromises the heart's ability to profuse effectively when the heart beats too quickly. There is a shortened relax ation face, which causes two main problems. The ventricles are unable to feel completely so cardiac output is lowered and the coronary arteries received less blood. So supply to the heart is decreased. Signs and symptoms of attacking cardio, respiratory distress or failure. Poor tissue perfusion, for example. Low urine output, altered mental state pulmonary oedema or congestion. And weak rapid pulse. There are several kinds of tacking cardio. They could be difficult to differentiate in Children on E. C. G due to their elevated heart rate. The following is a list of the kinds of tacky cardio in what happens during the specific tacky Kartik event. Sinus tachycardia. Normal rhythm with fast rate is likely non dangerous and commonly occurs during stress or fever. Super ventricular tachycardia. Rhythm starts above the ventricles. Atrial fib. Relation causes irregularly irregular heart rhythm. Atrial flutter causes a saw tooth pattern on E C G ventricular tachycardia. Rhythm starts in the ventricles. This concludes our lesson on recognizing taking cardio. Next, we'll review narrow cure s complex. 32. Narrow QRS Complex: Welcome to the lesson on narrow, curious, complex pediatric techie arrhythmias are first divided into narrow, complex or wide complex tachycardia. In this video, we'll discuss the narrow, curious, complex tachycardia. Narrow, curious, complex ducky. Cardio is include atrial flutter, Sinus tachycardia and super ventricular tachycardia, or SBT. Atrial flutter is an uncommon rhythm. Distinguished on an E. C. G has a saw tooth pattern. It is caused by an abnormal re entrant pathway that causes the atria to beat very quickly and effectively. Atrial contractions may exceed 300 beats per minute, but not all of these will reach the A V node and cause a ventricular contraction, most often as a p A. L s provider, you'll have to distinguish between two similar narrow, curious, complex talking arrhythmias, Sinus tachycardia and super ventricular techie Hardy A or SPT SBT is more commonly caused by accessory pathway reentry, a V node reentry, an ectopic atrial. Focus for details and differences between Sinus Decade Cardio and SBT. Please refer to Table 17 in your correspondent pls manual. This concludes our lesson on narrow cure s complex. Next, we'll review wide curious complex 33. Wide QRS Complex: welcome to the lesson on wide curious complex. In this video, we'll discuss the wide Curis complex Techie Guardia's Why'd curious complex tachycardia is include ventricular tachycardia. An unusual SPT ventricular tachycardia or VT is uncommon and Children and could be rapidly fatal unless the individual has a documented, wide, complex, tacky arrhythmia. An E C G with a cure s complex. Greater than 0.9 seconds is VT. Until proven otherwise, polymorphic VT said that plan, an unusual SPT SPT With one complexes due to aberrant conduction may be reversible. For example, magnesium for just out. But do not delay treatment for BT, any of these rhythms could evolve into ventricular defibrillation or VF. V T may not be particularly rapid, simply greater than 1 20 ppm, but is regular. Generally, P waves were lost during the tea or become dissociated from the cure is complex. Fusion beats are a sign of VT and are produced when both a super ventricular and ventricular impulse combined to produce a hybrid appearing cure s or fusion beef. This concludes our lesson on wide curious complex. Next, we'll review responding Zaki cardio 34. Responding to Tachycardia: Welcome to the lesson on responding to tackle Cardia. In this video, we will discuss how to respond to Tak a Kartik events. The initial management of tacky arrhythmia is to assess pulse and profusion. First, identify and treat the underlying cause to do so. Maintained patent airway and assist breathing if necessary. If the individual is high poxy Mick, administer oxygen, cardiac monitor, identify rhythm, monitor blood pressure and pulse ox symmetry. Administer intravenous and intra Rossi s access. Assess 12 lead E. C. G For details on drug dosages and the pediatric Taqa cardia algorithm that is figure 15. Please refer to your corresponding pals manual. This concludes our lesson on responding to tackle Cardia. Next, we will review shock. 35. Shock: Chapter nine Shock. Welcome to the overview on shock. In this video, we will discuss what shock is and the types of shock there are. Shock is defined as a condition in which peripheral tissues and end organs do not receive adequate oxygen and nutrients. While it is sometimes used interchangeably with severe hypertension, shock does not only occur in the setting of severely low blood pressure. Importantly, the body will attempt to compensate for shock through various mechanisms, most commonly through increased heart rate. The heart rate will increase in an attempt to increase cardiac output that is stroke volume times heart rate. Blood flow will be shunted from less vital organs such as the skin, two more vital organs, such as kidneys and the brain. In these cases, the child or the infant may be experiencing shock but have high normal or low moral blood pressure. This is called compensatory shock and may only persist for minutes to hours before progressing to frank uncompensated shock. Unless treatment is initiated without treatment, these compensatory systems can become overwhelmed and result in the child progressing quickly to critical hypertension and cardiac arrests. The four types of shock are hypovolemic distributive cardiogenic and obstructed type of Olynyk. Shock occurs when there is low blood, often due to hemorrhage or fluid shifting out of vasculature. Cardiogenic shock occurs when the heart is not pumping adequately. Distributive shock occurs when blood vessels air dilated like in septic shock. Obstructive shock occurs when there is physical blockage of the blood flow. This concludes our overview on Shaq. Next, we will review. 36. Hypovolemic Shock: welcome to the lesson on hypovolemic shock. In this video, we'll discuss recognizing hypothalamic shock and it's signs and symptoms. Hypovolemic shock is the most common type of shock and perhaps the easiest to understand. It occurs when there's insufficient blood in the cardiovascular system, which can be due to hemorrhage externally or into the peritoneum or into the gastrointestinal system. I Bow Valley make shock, and Children can also occur from water loss. Perspiration, diarrhea, vomiting or in food moves into the tissues in high Brovelli Mick shock pre load to the heart is decreased. That is, there's less volume to fill the heart. The contract il ity is normal or increased. Likewise, after load is increase, since the vessels have constricted in an attempt to increase blood pressure. Signs and symptoms of hypothalamic shock include possible to keep mia tecca cardio, inadequate or low blood pressure, narrow pulse pressure, slow cap Ilary refilled, weak peripheral pulses, normal central pulses, possible decreased urine output and decreased level of consciousness. This concludes our lesson on hypovolemic shock. Next, we'll review distributive shock 37. Distributive Shock: welcome to the lesson on distributive shock. In this video, we will discuss what distributive shock ISS, the types of distributive shocks and how to recognize thumb distributive shock is a condition in which the majority of blood is inappropriately distributed in the vasculature . A common way to conceptualize distributive shock is as a condition in which the vasculature has relaxed and dilated to the point of inadequacy. The arterial blood supply needs to maintain a certain tension in order to maintain blood pressure. Likewise, the Venus system must maintain tension as well, so as to not retain too much of the total blood supply in distributive shock. The blood is not being maintained in the required and needed useful blood vessels. Distributive shock is most commonly caused by sepsis, and if Alexis or a neurological problem, all of which caused vascular dilation or loss of blood vessel tone in distributive shock, the pre load contract il ity and the after load vary depending on the ET ology. Distributive shock is difficult to recognize because the signs and symptoms very greatly depending on the ideology. Common symptoms include ticket mia, Tackett, cardia low to normal blood pressure, decreased urine output and decreased level of consciousness. The three types of distributive shocks are septic shock, anaphylactic shock and narrow genic shock. In septic shock, there is decreased pre load normal or decreased contract il ity, and the after load varies in septic shock. There is decreased pre load normal or decreased contract Il ity, and the after load varies in an awful Actiq shock. There is a decreased pre load contract. Il ity varies, and the after load is low in the left ventricle and high in the right ventricle. Inara genic shock. There is decreased pre load normal contract il ity and decreased after load. Distributive shock is further categorized into warm and cold shock. If the individual is experiencing warm shock, they commonly will have warm Charitha Metis peripheral skin and wide pulse pressure in the setting of hypertension. If the individual is experiencing cold shock, they commonly will have pale vase, so constricted skin and narrow pulse pressure hypertension. In each case, distributive shock is generally considered when the individual is likely to have one of the three main causes. Sepsis, an awful axis X neurological problem. This concludes our lesson on distributive shock. Next, we will review cardiogenic shock 38. Cardiogenic Shock: welcome to the lesson on cardiogenic shock. In this video, we'll discuss recognizing cardiogenic shock. Cardiogenic shock is caused by inadequate contract Il ity of the heart. One of the key differences between hypovolemic and cardiogenic shock is the work of breathing. In both cases they'll be takinmia, but in hypovolemic shock, the effort of breathing is only mildly increased. However, in cardiogenic shock, the worker breathing is often significantly increased as evidence by grunts, nasal flaring and the use of accessory thorax muscles. Additionally, since the heart is pumping ineffectively, blood remains in the pulmonary vasculature. This causes pulmonary congestion and oedema, which can clinically be heard as crackles in the lungs and visualize as jugular vein distension and cardiogenic. Shock pulses air often weak cap Hillary refill is slow, extremities are cool and cyanotic, and there may be a decrease in the level of consciousness. This concludes our lesson on cardiogenic shock. Next, we'll review obstructive shock. No 39. Obstructive Shock: welcome to the lesson on obstructive shock. In this video, we'll discuss recognizing obstructive shock. Obstructive shock is similar to cardiogenic shock in that the impaired heart function is the primary abnormality in cardiogenic shock. Contract. Ill. It is impaired but an obstructive shock. The heart is prevented from contracting appropriately common causes of obstructive shock or cardiac tamponade, tension, pneumothorax, congenital heart malformations and pulmonary embolism. Obstructive and cardiogenic shocks are most easily distinguished by the contract. Il ity of the heart In obstructive shock heart contract Ili is normal, although pumping function is not cardiac, tamponade is associated with muffled heart sounds. Since blood is present in the pericardial space pulses paradoxes, for example, a drop in blood pressure on inspiration may also be present. Tension pneumothorax is a clinical diagnosis. The trachea maybe deviated away from the side of a lesion, and there are absent breath sounds over the affected side of the chest. Consider a pulmonary embolism when the individual is cyanotic and or hypertensive, experiences chest pain and has respiratory distress without lung pathology or airway obstruction. Risk factors of obstructive shock include obesity, hormone use, family history of abnormal clotting and coagulation factor abnormalities. This concludes our lesson obstructive shock. Next, we'll review responding to shock 40. Responding to Shock: welcome to the overview on responding to shock. In this video, we'll discuss shock management. The goal of shark management is to get oxygen to the tissues and to the organs. This requires having enough oxygen in the blood, getting the blood to the tissues and keeping the blood within the vasculature. Thus, shock management is dedicated to achieving these three critical goals. To put simply, this means returning the individual to the correct blood pressure and heart rate for their age, restoring normal pulses, cap, Ilary refill and mental status, along with a urine output of at least one millimeter per kilogram an hour in the upcoming videos. We'll discuss specifics of responding to each type of shock discussed previously. This concludes our overview on responding to shock. Next, we'll review responding to hypovolemic shock. 41. Responding to Hypovolemic Shock: welcome to the lesson on responding to hypovolemic shock. In this video, we'll discuss the means of responding toe hypovolemic shock the primary means of responding to hypovolemic shock. It's provide additional volume for Children in isotonic Crystal Lloyd, such as normal saline or lactating ringers, is the preferred fluid for volume resuscitation. While volume Ripley Shin is somewhat straightforward in adults, great care must be taken when administering intravenous fluids to Children and infants. Careful estimates should be made concerning the amount of volume lost, for example, blood loss, size of the individual and the degree of deficit. Current recommendations are to administer 20 milliliters per kilogram of fluid as a Bullis over 5 to 10 minutes and repeat as needed. And hypovolemic shock administered three milliliters of fluid for everyone. Mill leader of estimated blood lost. That is a 3 to 1 ratio. A fluid bolus is Do not improve the signs of hypothalamic shock. Consider administration of packed red blood cells without delay. Al human can also be considered for additional intravenous volume for shock trauma and burns as a plasma expander. If fluid Boulis is do not improve the signs of hypovolemic shock reevaluation of proper diagnosis and occult blood loss, for example, into the G I tract should be considered. The remaining interventions are aimed at restoring electrolyte imbalances, for example, acid or base glucose and more. This concludes our lesson on responding to hypovolemic shock. Next, we'll review responding to distributed shock. 42. Responding to Distributive Shock: welcome to the lesson on responding to distributive shock. In this video, we'll discuss responding to septic and if lactic and narrow genic shock, the initial management of distributive shock is to increase intravascular volume. The intent is to provide enough volume to overcome the inappropriate redistribution of existing volume. To do so. Administered 20 milliliters per kilogram of fluid as a Bullis over 5 to 10 minutes. Repeat as needed. Beyond initial management, therapy is tailored to the cause of the distributive shock in septic shock. Aggressive food management is generally necessary. Broad spectrum. Intravenous antibiotics are a key. Intervention should be administered as soon as possible. In addition, a stress dose of hydrocortisone, especially with adrenal insufficiency and vast oppressors, may be needed to support blood pressure After fluid resuscitation. Fast oppressors were given if needed, and according to the type of septic shock normal tense of individuals. Air usually given dopamine. Warm shock is treated with norepinephrine, and cold shock is treated with epinephrine. Transfusing packed red blood cells to bring hemoglobin above 10 grams per decile. Leader treats decreased oxygen carrying capacity as blood cultures return focus. Antibiotic therapy to the particular microbe and its resistance patterns for anaphylactic shock. Intra muscular epinephrine is the first and most important treatment in severe cases, a second dose of epinephrine may be needed or intravenous administration may be required. Crystallized fluid can be administered judiciously. Remember that an NFL acting shock cap Hillary permeability, may increase considerably. Thus, while it's important to support blood pressure overall, there's significant likelihood that third spacing and pulmonary a demon will occur. Anti histamines and Kartika steroids can also blunt the NFL Actiq response. If breathing challenges arise, consider albuterol use to achieve bronco dilation in very severe cases of anaphylactic shock. Ah, continuous epinephrine infusion in the neonatal intensive care unit or N I C. U or pediatric intensive care unit, or P. I see you may be required. New organic shock is clinically challenging because often there is limited ability to correct the insult. Injury to the economic pathways in the spinal cord. Results in decrease systemic vascular resistance and hypertension. An inappropriately low pulsar Braddock cardio is a clinical sign of narrow genic shock. Therefore, treatment is focused on fluids first administered 20 milliliters per kilogram Bullis over 5 to 10 minutes, then reassess the individual for a response if Hypo Tension does not respond to fluid resuscitation, bass oppressors were needed. This resuscitation should be done in conjunction with the broader neurological evaluation and treatment plan. This concludes our lesson on responding to distributive shock. Next, we'll review responding to cardiogenic shock. 43. Responding to Cardiogenic Shock: welcome to the lesson on responding to cardiogenic shock. In this video, we'll discuss cardiogenic shock management, since Children and cardiogenic shock have a problem with cardiac contract. Il ity, the primary goal of therapy is to restore contract Il ity. Unlike most other types of shock, fluid resuscitation is not a primary intervention in cardiogenic shock. Often medications to support contract il ity and reduce after load our first line treatments in normal tense of individuals. This means vaso dilator is and diuretics, which both decrease. Intravascular volume contract Il ity is supported with China. Trumps. Miller known, is often used to decrease peripheral vascular resistance when additional volume is needed, food could be administered slowly and cautiously administer 5 to 10 milliliters per kilogram over 10 to 20 minutes. A pediatric cardiologists are critical care specialist should manage individuals with cardiogenic shock. This concludes our lesson on responding to cardiogenic shock. Next we'll review responding to obstructive shock 44. Responding to Obstructive Shock: welcome to the lesson on responding to obstructive shock. In this video, we'll discuss obstructive shock management. Causes of obstructive shock require rapid and definitive care, since they are acutely life threatening. Cardiac tamponade requires pericardial drainage tension pneumothorax requires needle decompression and subsequent placement of a chest to that is to their economy. Pediatric heart surgeons can address vascular abnormalities. Induct its arterial sis can be induced to remain open by administering prostaglandin e one . Analog pulmonary embolism care is mostly supportive. The trained personnel could administer fiber analytic, an anti coagulant agents. Management of these complex ideologies is beyond the scope of these videos and the corresponding pls manual. This concludes our lesson in responding to obstructive shock. Next, we'll review recognizing cardiac arrest. 45. Recognizing Cardiac Arrest: Chapter 10 cardiac arrest. Welcome to the lesson on recognizing cardiac arrest. In this video, we'll discuss recognizing cardiac arrest and reversible causes of cardiac arrest. Unlike cardiac arrest in adults, which is very common due to acute coronary syndrome, cardiac arrests and pediatrics is more commonly the consequence of respiratory failure or shock. Thus, cardiac arrest can often be avoided if respiratory failure or shock has successfully managed less than 10% of the time. Cardiac arrest is a consequence of ventricular arrhythmia and occurs suddenly. It may be possible to identify a reversible cause of cardiac arrest and treated quickly. The reversible causes are essentially the same in Children and infants as they are in adults. Reversible causes of cardiac arrests are divided into the ages, and the tease the H is include high Bove, Olympia Hypoxia, H plus acidosis, Hypo and hyper Callie Mia, Hypoglycemia and hypothermia. Teas include tension, pneumothorax, tamponade, toxins, coronary thrombosis, pulmonary thrombosis and unrecognized trauma. Recognizing cardiopulmonary failure could be done by following the A B C. D. E survey, which checks for airway breathing, circulation, disability and exposure. For further details on these factors, refer to Table 22 on your corresponding pls manual. It's also helpful to be able to recognize arrest rhythms such as a sisterly pulseless electrical activity or P, a ventricular fibrillation, VF and pulses. Ventricular technique, cardia or VT. The upcoming videos will cover details on these arrest rhythms. This concludes our lesson on recognizing cardiac arrest. Next, we'll preview pulseless electrical activity and is distantly. 46. Pulseless Electrical Activity & Asystole: Welcome to the lesson on pulseless electrical activity and Assistant Lee. In this video, we will discuss recognizing post lis electrical activity, or P E A and a sisterly cardiac rhythms. P E A. And Assistant Lee are related cardiac rhythms in that they are both life threatening and unshakable. Assistant Lee is Thea, since of electrical or mechanical cardiac activity and is represented by a flat line E C G . There may be subtle movement away from the baseline that is drifting flatline, but there is no perceptible cardiac electrical activity. Make sure that a reading of Assistant Lee is not a technical error. Ensure that the cardiac leads are connected, Gainous said appropriately, and the power is on chek to different leads. To confirm P E. A is one of any number of BCG wave forms, even Sinus rhythm, but without a detectable pulse. P E A. May include any post lis wave form except VF V T or Assistant Lee. A sisterly, maybe proceeded by an agonal rhythm. An agonal rhythm is a wave form that is roughly similar to a normal wave form but occurs intermittently, slowly and without a pulse. P E. A. And assistant Li are both on Shaq Kable rhythms. This concludes our lesson on pulseless electrical activity and Assistant Lee. Next we will review ventricular fibrillation and post lis ventricular tachycardia. 47. Ventricular Fibrillation: welcome to the lesson on ventricular fibrillation and pulseless ventricular tachycardia. In this video, we'll discuss recognizing ventricular fibrillation, or VF and pulses, ventricular tachycardia or VT B F and pulseless ventricular tachycardia, or VT, or life threatening cardiac rhythms that results in ineffective ventricular contractions. VF is a rapid quivering of the ventricles instead of a forceful contraction. The ventricular motion of VF is not synchronised with atrial contractions. Pulseless VT occurs when the rapidly contracting ventricles air not pumping blood sufficiently to create a palpable pulse in both VF and pulses, VT. Individuals are not receiving adequate perfusion. B F and pulses. VT are trackable rhythms. This concludes our lesson on ventricular fibrillation and pulse. It's ventricular tachycardia. Next, we'll review responding to cardiac arrest. 48. Responding to Cardiac Arrest: Welcome to the lesson on responding to cardiac arrest. In this video, we'll discuss cardiac arrest management and responding to cardiac arrest with CPR, shock, energy, advanced airway and drug therapy. The first management step in cardiac arrest is to begin high quality CPR. For details on high quality CPR, please refer to the BLS videos or your corresponding BLS manual for pediatric cardiac arrest algorithm. Refer to figure 16 in your corresponding PLS manual to ensure CPR quality when responding to cardiac arrest, make sure the chest compression rate is at least 100 to 120 permitted. Compression step should be 1/3 the diameter of the chest. That is 1.5 inches in infants and two inches, and Children minimized interruptions and do not over ventilate. Additionally, rotate compressor every two minutes. If no advanced airway is available, compression of ventilation ratio should be 15 to 2. It advanced airway is available. Then give 8 10 breaths per minute with continuous chest compressions. When giving shock energy first shock should be to Jules per kilogram. Second shock should be for Jules per kilogram. Subsequent shocks should be greater than or equal to four jewels per kilogram. Maximum dose of the shock should not exceed 10 jewels per kilogram or adult dosage. When working with Advanced Airways, use super glad IQ advanced airway or E T. Intubation Use. Wave form kept NA graffiti to confirm and monitor e to placement. Once the advanced airwaves in place, give one breath every 6 to 8 seconds. That is 8 to 10 breaths per minute. Providing drug therapy epinephrine dosage via intravenous or intra CS. Access should be 0.1 milligrams per kilogram. Repeat this dosage every 3 to 5 minutes. If there's no intravenous or intra CS access, and you may give endotracheal dose of 50.1 milligrams per kilogram, amiodarone dosage should be given by an intravenous or intra Rossi s access in five milligram per kilogram Bullis during cardiac arrest. You may repeat this up to two times for refractory v f or pulses. VT. This concludes our lesson on responding to cardiac arrest. Next will review post resuscitation care 49. Post Resuscitation Care: Chapter 11 Post resuscitation care. Welcome to the lesson on post resuscitation care. In this video, we will discuss what to do after resuscitation methods to care for the individuals respiratory system, cardiovascular system, neurological system, renal system, gastrointestinal system, anti methodological system. If an individual has a return of spontaneous circulation or are OSC, start post resuscitation care immediately. The initial pals process is intended to stabilize a child or infant during a life threatening event. Post resuscitation care is meant to optimize ventilation and circulation, preserved organ and tissue function and maintain recommended blood glucose levels for the pediatric post resuscitation care algorithm to guide you in your treatment, refer to figure 17 in your corresponding pals manual when caring for the respiratory system after resuscitation followed this checklist. Chest X ray to verify e t. To placement arterial blood gas or a BG and correct acid or base disturbance, continuously monitor poll socks. Symmetry continuously monitor heart rate and rhythm. If the individual is intubated, entitle carbon dioxide. Maintain adequate oxygenation that is saturation. Between 94 99% maintain adequate ventilation to achieve PCO. Two between 35 to 45 millimeters of mercury unless otherwise indicated intubate. If oxygen and other interventions do not achieve adequate oxygenation, you need to maintain a patent airway in a child with decreased level of consciousness. Ventilation is not possible through non invasive means. For example, continuous positive airway pressure or CPAP control pain with an algae six and anxiety with sedatives. For example, benzodiazepines when caring for the cardiovascular system after resuscitation, followed this checklist. Arterial blood gas or a BG and correct acid based disturbances transfused or support hemoglobin and hematocrit as needed. Continuously monitor heart rate and rhythm continuously monitor blood pressure with arterial line. Check central venous pressure or CVP. Check urine output Chest X ray 12 Lead E. C. G. Consider echocardiography. Maintain appropriate inter vascular volume. Use vase, oppressors and titrate. Blood pressure to treat hypertension if needed. Continuously monitor Polsak symmetry. Maintain adequate oxygenation that is saturation between 94 99% correct Metabolic abnormalities. Chemistry panel. When caring for the neurological system after resuscitation, follow this checklist. Elevate head of bed If blood pressure can sustain cerebral profusion, maintain temperature by avoiding hypothermia and treating fever aggressively. Do not rewarm hypothermic cardiac arrest individuals unless hypothermia is interfering with cardiovascular function and treat hypothermia complications as they arise. Maintain blood glucose by treating hypo and hyperglycemia. Hyperglycemia is to find as less than or equal to 60 milligrams per desolate er. Monitor and treat seizures with seizure medications and by removing metabolic and toxic causes continuously monitor blood pressure with arterial line. Maintain cardiac output and cerebral profusion. Normal. Ventilate in less temporizing due to intracranial swelling. Perform frequent neurological exams. Consider C T and or e G electroencephalogram. Keep in mind that dilated, unresponsive pupils hypertension, bradycardia, respiratory irregularities or apnea may indicate cerebral herniation when caring for the renal system. After resuscitation, follow this checklist. Monitor urine output. Infants and small Children should urinate more than one milliliters per kilogram an hour. Larger Children should urinate more than 30 milliliters an hour. Exceedingly high urine output could indicate neurological or renal problems or diabetes. Insipid ISS. Perform routine blood chemistries, arterial blood gas or a BG and correct acid or base disturbances. Your analysis. When indicated, maintain cardiac output and renal perfusion. Consider the effect of medications on renal tissue or NAFO toxicity. Consider urine output in the context of fluid resuscitation. Toxins can sometimes be removed with urgent or emergent hemodialysis when antidotes fail or are not available when caring for the gastrointestinal system After resuscitation, follow this checklist. Monitor nasal Gastric or N G and Orel Gastric were O G tube for Peyton C and residuals. Perform a thorough abdominal exam. Tense abdomen may indicate bowel perforation or hemorrhage. Consider abdominal, ultrasound and or abdominal C t. Perform routine blood chemistries, including liver panel, arterial blood gas or a BG, and correct acid or base disturbances. Be vigilant for bleeding into the bow, especially after hemorrhagic shock when caring for the He Mata logical system. After resuscitation followed this checklist. Monitor complete blood count and coagulation panel transfused as needed by correcting thrown both sido pina. Fresh frozen plasma is to replenish clotting factors. Consider calcium chloride or gluconate if massive transfusion required correct metabolic abnormalities or chemistry panel, especially after transfusion. This concludes our lesson on post resuscitation care. Thank you for choosing in HCPs as your provider 50. Infant 1 Person BLS: if the scene ISI approached the victim and assess their responsiveness. Send another person to activate the emergency response system and getting a D. If possible, assess breathing and check the infants pulse. If the end is not breathing or only gasping and you can't find a pulse, begin CPR, starting with compressions. Perform 30 compressions at a rate of 100 to 120 compressions per minute at a depth of at least one through the chest. For infants, this is about 1.5 inches. When the A G is brought a scene, begin by turning the device on. Remove any clothing from the victim and apply the au de pads one on the front of them, thin chest in one on their back. Plug in the connector and clear the victim while the A D analyzes the rhythm. If no shock is advice, resume CPR, beginning with chest compressions. If a shock is advice, clear the victim again before delivering the shock. Once the A G has charged hit the shock. But after delivering the shop, resume CPR, beginning with 30 chest compressions, open the airway and deliver two breaths, each lasting one second watch for chest rice, begin again with 30 trust compression and continue at this ratio of 30 compressions to two breaths until the 80 prompt you to stop or further help arrives. 51. Infant 2 Person BLS: If the scene is safe, approach the victim and assess their responsiveness. Send the other person to activate the emergency response system and gain a D. Assess breathing and check the brake you Opal's. If the victim is not breathing or only gasping and has no polls, begin CPR, starting with compressions. Perform 30 compressions battery of 100 to 120 compressions per minute at a depth of at least 1/3 the chest. For infants, this is about 1.5 inches. Open the airway and deliver to breath, each lasting one second and watch for chest rise. Resume compressions when the A D is brought to seen. The second rescuer should begin by turning the device on. Remove any clothing from the victim and apply the I E. D pads. One on the front have been chest and one on their back, while the other rescuer continues performing CPR. Plug in the connector and clear the victim, while the A D analyzes the rhythm. If a shock is advised, clear the victim again before delivering the shock. Once the 80 has charged, hit the shock button after delivering the shock resume CPR, beginning with 15 chest compressions using then circling hand technique. After the compressions, the second rescuer opens the airway and delivers two breaths. Continue CPR at this ratio of 15 compressions to two breath until the 80 prompts you to stop or further help arrives the rescue issues, which rules every two minutes or after about five cycles of CPR. 52. Infant Airway: place one hand on the infant's forehead and the other on the chin. Tilt the head back to a neutral position and deliver two breaths. 53. Airway Management: airway management is a fundamental lifesaving skill. Your management of the airway depends upon your abilities, training and scope of practice. The best message of airway management will vary depending on patient condition, equipment available and skill level of the provider. The 1st 2 steps in any airway management response involved opening and clearing the airway . First, open the airway using a head tilt chin lift by placing one hand on the forehead and the other on the chin. Push with the palm to move the head back while lifting the jaw to bring the chin forward. Second, clear the airway suctioning baby necessary to remove foreign material or secretions. Now that the airway is open and clear, consider a couple airway adjuncts to maintain pansy. There are two main types, including the Aural Fair and Julia Lowell Airway, for unconscious patients in the nasal flaring Jaleel Airway. For conscious patients, selection of the proper size Orel Fair and Julia Will Airway is owned by assessing the playing at the lips of the patient, and the tip of the airway should be at the angle of the job. Insertion is achieved by pointing the tip toward the hard palate and then rotating 100 and 80 degrees until the tip touches the posterior all fair and Julia Wall selection of the proper size Nasal flaring tool airway is done by assessing the flange at the nostril, and the tip should just to reach the trace of the year to insert, place the tip perpendicular with the maxillary bone, using gentle pressure in a spiral motion until the device is in place. Beyond the nasal firings, providing a patent airway after placement. Listen to the chest. Ensure that the patient is receiving adequate breath sounds. Now that we have our airway at junk in place, we now move to bag mask ventilation. To properly use the bag mask. Use the EEC formation with your hands to do so for must see with the index finger in a thumb on one hand on the top side of the mask on the bridge of the nose. This securely applied the master the face now the three remaining fingers for money and use these fingers to lift the job, forming the airway. Now, maintaining this position, the provider squeezes the back, taking one second to purified one ventilation. If a second providers available to assist with bag mask ventilation. One provider will deliver ventilation with the bag mask, while the other provider provides the same E C formation with both hands to the mask. So you have completed the airway management skills training. Please feel free to review as often as you would like, and we encourage you to practice your skills with a skilled health care provider, so please go out there and save lives. 54. Who is NHCPS?: Welcome to National Health care provider Solutions, the most trusted name in online medical certification. Today, our certification courses can be accessed 100% online and completed from any device designed by board certified physicians. Adhering to the latest H A standards, you can now join thousands of health care providers around the world who have received certifications completely online in less than an hour. Our A, C. L s, BLS and Pals courses are eligible for A M, a Category one credits and our CPR courses eligible for a. M. A Category two CMI partnered with the Save A Life Initiative. We seek to empower others to save lives by providing advanced healthcare education. Here's how enroll in the course you need. Review the online handbooks, watch the skills videos and passed the exam. Your digital provider card is instantly available, and your physical card will be mailed to you. Choose the certification you need and get started today and HCPs the Save a Life Initiative and you together. Let's save lives