What are the options for vascular access in children? There are many options for vascular access in children. Depending on the situation at hand, some might not be as available or achievable as others. Conditions permitting, peripheral venous access is generally preferred over other means. Antecubital, hand, wrist, foot, and ankle veins are the most popular access …
What are the golden rules of vascular access? 1. First attempt the technique that has yielded best personal success. 2. One small-gauge line beats none at all. The messages are obvious. During resuscitation, procedures should be done by those most talented, and they should do what they do best. Although it is better to have large-gauge vascular …
To whom and how should external cardiac compression be delivered? Apply external cardiac compression to any child with ineffective pulses. A compressions-to-ventilations ratio of 30:2 is recommended for the lone rescuer performing CPR in infants and children. If two rescuers are performing CPR, a compressions-to-ventilations ratio of 15:2 is recommended. When a tracheal tube is …
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What is the pediatric assessment triangle (PAT)? The PAT is a visual and auditory assessment tool developed for rapid standardized assessment of pediatric patients. As seasoned pediatricians know, you can often identify ill infants and children even without any equipment. The PAT emphasizes a quick evaluation of a patient in three main areas: (1) appearance, …
What are the best methods to assess a child’s circulatory status? Assessment of a child’s circulatory status should always include appraisal of the following: • Skin and mucous membrane color • Presence and quality of pulses • Capillary refill • Heart rate and blood pressure Always keep in mind that in the instance of acute blood loss, the protective …
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How to determine the proper placement of the ETT 1. Check to see that the tube is inserted at a depth that is three times the internal diameter of the ETT (from the point of the patient’s central incisors). 2. Observe for symmetric chest expansion. 3. Auscultate for symmetric breath sounds. 4. Look for distention of the abdomen, indicating …
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When selecting an endotracheal tube (ETT), what sizing guidelines are suggested? There are a number of ways to ensure selection of properly sized ETTs for children. The most often cited is the following age-based formula:ETTinternaldiameter(mm)=(16+yearsofage)/4ETTinternaldiametermm=16+yearsofage/4 Another “rule of thumb” is really a “rule of finger.” Research has demonstrated that the width of the child’s fifth …