Paediatric resuscitation.
What size non cuffed ETT should you look to use on a 6yr old boy.
This is for uncuffed endotracheal tubes. For cuffed endotracheal tubes you drop down by 0.5 so the formula is Age/4 + 3.5. Practically, use the formula as a starting point and have a tube 0.5 higher and lower ready and available if you find you need them.
Which of the following is incorrect about intraosseous needles in infants.
The EZ IO has meant putting in IOs has become far easier. It does however require practice as its use will occur in a very stressful situation.
All of the following about an infants compared to an adults airway are correct except one.
The infants vocal cords in fact slant anteriorly not posteriorly. Adults are fairly horizonttal.
When doing chest compressions on a neonate what is the correct rate?
If the neonate is intubated then you can do uninterrupted compressions at 120/min. Remember that fixing the hypoxia is usually the way to get the heart rate up and that chest compressions are usually only required for a short time.
When performing hand bagging of an infant which is the best starting position of the neck in order to open the airway?
Things like the rounded occiput, short neck and anterior larynx supports using a neutral neck position to open the airway in those < 1yr. Mind you if it is not working fiddle the position as there is variation from infant to infant.
Which of the following is not an emergent priority in a patient who is conscious with evolving meningicoccal disease?
Intubation of infants developing septic shock can precipitate cardiovascular collapse. If required it needs to be thought through carefully. This means optimising fluid resuscitation, getting inotropes started and agreeing on which induction and maintenance drugs will be used.
What average weight do you think a 4yr old would be?
APLS used to use the formula (Age + 4) times 2. Then it changed to 3 different formulae depending on age ---for 1 to 5yr olds it is (Age times 2) + 8. Mild you that gives you 16kg, the same as the old APLS equation. Essentially use a calculated weight if you are forced to but get a real weight as soon as possible.
Which of the following is correct about umbilical vein catheterisations?
Cut the umbilicus to about 1.5cm from the skin after looping and gently typing umbilical tape around it and have your umbilical vein catheter and mosquito forceps primed and ready. It varies a little but generally the umbilical vein remains patent and able to be catheterised for up to a week after birth.
Pick the incorrect statement about the use of the NeoPuff.
Technically there would be no time limit to its use. You have of course not protected the airway but if you are ventilating well you can use it as a bridge until assistance arrives or the patient improves.
Who of the following tragically had a twin that died at birth?
Elvis was born 35min after his stillborn twin Jesse.