By Steven M. Selbst MD FAAP FACEP
Access concise, but whole medical assistance on pediatric emergency care with Pediatric Emergency medication Secrets, a bestselling quantity within the well known Secrets Series®. excellent for speedy evaluation or examination prep, this up to date scientific reference booklet is an essential pocket advisor protecting universal and weird pediatric conditions; the straight forward secrets and techniques type makes it a valuable addition for your library!
- Focus on vital topics, comparable to cardiac arrest, respiration failure, neurosurgery emergencies, ophthalmology emergencies, burns/smoke inhalation, toxicology, neck and backbone accidents, and masses more.
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Administration of epinephrine can help coarsen fibrillation. Defibrillation is most effective with use of the largest paddle that makes complete contact with the chest wall. Using the larger (8-cm diameter) paddle lowers the intrathoracic impedance and increases the effectiveness of the defibrillation current. Take care to use an appropriate interface between the paddles and the chest wall. Electrode cream, paste, or gel pads are preferred when using paddles. Do not use saline-soaked gauze pads, ultrasound gel, alcohol pads, or bare paddles.
Historically, pediatric resuscitation has focused on pulmonary causes; defibrillation is a relatively uncommon intervention in pediatric resuscitation. Although asystole remains the most commonly observed arrhythmia during pediatric cardiac arrests, recent research indicates that VF may occur much more frequently than originally thought. The National Registry of Cardiopulmonary Resuscitation, the largest inpatient pediatric cohort reported to date, found VF occurred in 14% of pediatric arrests.
What are paradoxical respirations? Why do they occur? Infants who have increased airway resistance generate high negative intrathoracic pressures to inflate their lungs. As the diaphragm moves downward and the intrathoracic pressure becomes negative, the soft, cartilaginous bones and weak intercostal musculature cannot maintain the thoracic circumference. As the abdomen moves outward, the infant’s compliant chest may collapse inward (rather than the normal expansion) on inspiration, hence the terms paradoxical respirations, thoracoabdominal asynchrony, or seesaw breathing.