By Advanced Life Support Group
This foreign bestseller covers the whole complicated paediatric existence aid path, with the center sections for the abbreviated one-day direction truly picked out. The ebook presents functional suggestions for coping with young children and babies within the first life-threatening "golden" hour. This new version is going past rapid administration to incorporate stabilisation and move.
Read or Download Advanced Paediatric Life Support: The Practical Approach, 4th Edition PDF
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Additional info for Advanced Paediatric Life Support: The Practical Approach, 4th Edition
1 INTRODUCTION Management of airway and breathing has priority in the resuscitation of patients of all ages; however, the rate at which respiratory function can deteriorate in children is particularly high. Effective resuscitation techniques must be applied quickly and in order of priority. The differences between adults and children must be realised and familiarity with equipment assured. Techniques for obtaining a patent and protected airway, and for achieving adequate ventilation and oxygenation, must be learned and practised.
Compressions can be recommenced at the end of inspiration and may augment exhalation. Apart from this interruption to summon help, basic life support must not be interrupted unless the child moves or takes a breath. Any time spent readjusting the airway or re-establishing the correct position for compressions will seriously decrease the number of cycles given per minute. This can be a very real problem for the solo rescuer, and there is no easy solution. In the infant and small child, the free hand can maintain the head position.
Air may also be inadvertently forced into the stomach during bag-and-mask ventilation. This may cause vomiting, vagal stimulation and diaphragmatic splinting. A gastric tube will decompress the stomach and significantly improve both breathing and general well-being. Withholding the procedure “to be kind to the child” may cause more distress than performing it. 4 PRACTICAL SKILLS The following practical skills are described in detail in Chapter 20: • • • • • • Oropharyngeal airway insertion small child older child Nasopharyngeal airway insertion Ventilation without intubation mouth-to-mask ventilation bag-and-mask ventilation Orotracheal intubation (including Rapid Sequence Induction) infant/small child older child LMA insertion Surgical airway needle cricothyroidotomy surgical cricothyroidotomy Tracheal tube placement check Following the placement of the tracheal tube in the trachea its position must be verified by: • Observing bilateral and symmetrical movement of the chest 43 ADVANCED SUPPORT OF THE AIRWAY AND VENTILATION • • Auscultation of chest and abdomen Monitoring expired carbon dioxide in the exhaled air by either colour change capnometry or carbon dioxide capnography The continued monitoring of expired carbon dioxide is a good indicator of effective ventilation, but it must be remembered that carbon dioxide will not be detected in the absence of a circulation (cardiac arrest) or where the lungs have not yet been inflated (at birth).
Advanced Paediatric Life Support: The Practical Approach, 4th Edition by Advanced Life Support Group