Neonatal vs Pediatric
At what age is the code pink coding call changed from NICU to pediatric
What is 1 month?
What is the compression to ventilation rate on a 6 year old in cardiac arrest?
What is 15:2 with more than one person and
30:2 if alone?
You stumble upon a pediatric emergency outside of the coffee shop. What would you do?
remain with the person, call for help, call 911. Initiate resuscitation.
What is one special consideration that can cause pulse assessments more difficult during a pediatric code?
What is Hypothermia?
A term baby remains cyanotic despite 100% FiO2 and effective ventilation. What might you be considering?
What is PPHN? - pulmonary hypertension causes blood vessels to constrict which causes the blood to bypass lungs which in turn causes low o2 levels circulating in the blood. Because of this, giving 100% FiO2 will not help raise the O2 saturations.
When would one RN attend a code pink?
What is initial response to a code pink pediatric to determine need for the NICU team?
The team has intubated a 15 year old who is still needing compressions- what it the rate of breaths to compressions?
since you have an established airway you now move to continuous compressions with breaths provided every 2-3 seconds for an approx. rate of 20-30 bpm.
You attend a code pink pediatric in ED and once there realize this baby is 15 days old. What do you do?
reactivate proper code- call switchboard or dial code phone (19422) to initiate a code pink neonatal. you can also click the correct button if available
Name three things that are reversible that a MRP might consider looking at/treating during a pediatric trauma resuscitation?
What is tension pneumothorax, hemorrhage and cardiac tamponade?
Which electrolyte abnormality can cause significant life threatening arrythmias, especially to those neonates with renal disfunction?
What is Hyperkalemia? (can see widening QRS complexes, peaked T waves along with bradycardia)
Name 12 HCP's that may attend a code pink pediatric
What is Physician, RT, NICU RN, ED ER, ICU RN, manager or shift coordinator, PCC, CPE, lab, ECG tech, SW, Students?
Spiritual health is a bonus
Name 3 of the 8 key componets of PALS
What is
systemic pediatric assessment
High quality CPR
airway and resp management
recognition and management of shock
cardiac rhythm recognition and management
post-cardiac arrest care
pharmacology and defibrillation
effective team dynamics and communication
You notice that during an active resuscitation of a 4 month old, the person doing chest compressions is getting tired. What do you do?
Head to where they are standing and gently say to them " At the next pulse check, I will be here to switch you out"
Recognizing fatigue early is key. Communicating fatigue with the team leader and planning a switch in advance are key concepts in PALS. This maintains higher quality CPR and decreases burden on team
What is an easy check early in a pediatric code because this condition can mimic neurological deterioration and cardiac instability?
What is check for hypoglycemia?
Which lab value can cause unexplained neonatal deterioration, can mimic sepsis, can cause seizures and cardiovascular collapse?
What is blood glucose?
If two codes are called at once, who does what?
What is
- second code team will respond with nearest code pink cart
-if another physician is required, ped will dictate who goes where
- ICU RT will go to second call
How often would the team consider defibrillating a pediatric patient during active resusitation?
What is this can be considered every 2 minutes?
You have been at a pediatric code for 10min and notice that the room is starting to fill up with additional staff crowding the bedside with no active role in the resuscitation. You are currently supporting the distraught parents. What do you do?
direct unnecessary personnel away from bedside and ensure clear access to patient and equipment is available.
remind personnel that if they do not have an active role in the resuscitation process that can they please leave the room.
Since this can be the cause of many pediatric resuscitations, what situation would you consider that needs immediate ventilation as a priority unlike when there is sudden cardia arrest?
What is Drowning?
You are caring for a 34 weeker who has previously been stable. You note some temperature instability throughout the day and some worsening abdominal distention. They suddenly develop profound desaturations with bradycardias which require IPPV at times and some FiO2 that they previously never needed. What would you be considering?
What is NEC?
What are 5 things the NICU RN can do during a code pink pediatric on a 3 year old?
What is chest compressions, PIV starts, medication administration, provide family support, assists RT to manage airway?
What are the 2 most commonly used meds in PALS? Bonus points for correct doses.
What is Epinephrine (0.01mg/kg) and Atropine (0.02mg/kg)?
During a code of a 45 day old you are asked to do a BGM. The team is heavily focused on CPR and medication. Your result is 1.8. What do you do?
You need to bring this to the attention of the team leader immediately. Be sure to close communication loop!
What would you anticipate doing when attending a code of a 2 year old with sudden onset of resp distress, hypotension and widespread hives?
What is administration of EPI for anaphylaxis?
You notice a large amount of air is infused through an IV before you can stop infusion. This neonate starts to deteriorate quickly with cyonosis, weak rapid HR and hypotention. What do you consider and what are your nursing interventions?
What is Air embolism? You would stop infusion immediately, turn neonate onto its left side to allow air to enter the right atrium and then the pulmonary artery where small bubbles will be absorbed, give FiO2 as required and notify MRP