PALS Study Tips

Respiratory distress
a clinical state characterized by abnormal rate or effort.
Respiratory Failure
a clinical state of inadequate oxygenation, ventilation or both. The end stage of respiratory distress
resp problem types
upper airway obstruction, lower airway obstruction, lung tissue disease, disordered control of breathing
upper airway obstruction location
the airway outside the thorax, can occur in nose, larynx, or pharynx
signs of upper airway obstruction occur most during
inspiration
lower airway obstruction location
the airways with in the thorax, can occur in the lower trachea, the bronchi, or the bronchioles
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a prolonged expiratory phase is most often a sign of
lower airway obstruction
a primary presentation finding of lung tissue disease is
a drop in O2 sat
lung tissue disease is a
term given to a heterogenous group of clinical conditions that generally affects the lung at the level of gas exchange. characterized by alveolar and small airway collapse or fluid filled
disordered control of breathing
an abnormal breathing pattern that produces signs of inadequate resp rate, effort, or both
the postictal patient has
disordered control of breathing
types of shock
hypovolemic, distributive, cardiogenic, obstructive
hypovolemic shock causes
most common cause in children, fluid loss from diarrhea is most common, other causes are vomiting, hemorrhage, inadequate fluid intake, osmotic diuresis, third space losses, large burns
hypovolemic shock
result of an absolute deficiency of intravascular blood volume, typically represents a depletion of both intravascular and extravascular
Distributive Shock
inappropriate distribution of blood volume with inadequate organ and tissue perfusion
common forms of distributive shock
septic, anaphylactic, neurogenic
physiology of distributive shock
inappropriate distribution of blood or fluid
Septic Shock caused by
infections organisms, or their byproducts that stimulate the immune system and trigger release or activation of inflammatory mediators, most common form of distributive shock,
anaphylactic shock
an acute multi system allergic response caused by a severe reaction
Neurogenic Shock
spinal shock, a cervical or thoracic injury, that disrupts the sympathetic nervous system innervation of blood vessels and the heart
cardiogenic shock
inadequate tissue perfusion secondary to myocardial dysfunction, impaired cardiac contractility
causes of cardiogenic shock
congenital heart disease, myocarditis, cardiomyopathy, arrhythmia, sepsis, poisoning, or drug toxicity, myocardial injury
obstructive shock
cardiac output is impaired by a physical obstruction of blood flow, obstructed blood flow
causes of obstructive shock
cardiac tampinade, tension pneumothorax, ductal-dependent congenital heart lesions, massive pulmonary embolism
H’s
hypovolemia, hypoxia, hydrogen ion, hypoglycemia, hypo/hyperkalemia,
T’s
Tension Pneumothorax, Tamponade-cardiac, Toxins/tablets, Thrombosis-pulmonary, Thrombosis-coronary
evaluate, identify, intervene
to help determine the best treatment or intervention at any point from the info gathered, problem is identified by type and severity and actions are appropriate
needle decompression technique is used for
tension pneumothorax
needle decompression technique
18-20 gauge over-the-needle catheter over the top of the child’s third rib in the midclavicular line, a gush of air is a sign of success, indicates a relief of pressure buildup in pleural space
fluid bolus 20ml/kg infused over
5-10 minutes
nebulized epinephrine is used for
stridorous respirations
use of IOs in cases of
more than 90 sec or more than 2 attempts at IV access

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