Crash Cart
Your 10kg patient is in V-Tach and requires defibrillation.
Select the correct Joules,
charge and deliver the shock.
*Don't forget to clear the scene!
VT= 2J/kg
= 20J for the 1st shock
Your 7kg patient needs to be monitored and potentially paced.
Go to the cart and select the appropriate Quick-Combo pads.
<25kg = INFANT pads
Your infant requires BVM (bag-valve-mask).
Go to the cart, select an appropriate size mask and bag the manikin.
PROVIDE 5 breaths with adequate chest rise.
How often do we provide breaths to an infant?
2-3 seconds
You over medicated 3.0 kg patient required a dose of Narcan (Naloxone).
Go to the cart, find the 3.0 Emergency Drug Card and the Narcan dose.
Narcan Dose = 0.1mg/kg
= 0.3mg = 0.75mL
Your arresting patient needs IVF (intravenous fluid).
Locate the NS or LR and 60cc syringe on the cart.
You are a winner today.
Your 8kg patient is in SVT and requires immediate synchronized cardioversion.
Go to the cart, select the correct joules, charge and deliver the shock.
*hint- Will not shock unless you set the simulator to SVT
SVT=0/5-1.0 j/kg =4-8J
Your arresting patient requires chest compressions. Locate the backboard and place it under the child manikin and then give 30 compressions.
You are doing it!!
Your patient is in respiratory distress and needs a 3.0 oral airway.
Locate this item on the crash cart.
Yay!! You go this.
Your patient requires IV access for medication administration.
Go to the cart and find the following supplies-
Tourniquet, Clave, IV catheter, Tegaderm
Good Job
You need 3 NS flushes.
Locate these on the cart.
Maybe that was too easy.....
Your patient requires intubation.
Locate a 3.5 ETT and locate and assemble the laryngoscope and blade.
Well done!
You walk into the room of a 4 month old patient whose CR monitor is alarming and you find the patients HR is 55. After positioning the airway and administering 100% O2 via BVM, the HR drops to 49. You press the code button.
What would be your next appropriate intervention?
Check Pulse
Start Compressions
Place backboard under the patient when it arrives.
Demonstrate how to give blow by oxygen with the anesthesia bag and the BVM device.
You know it!!
Your 5.5kg patient needs a bolus.
Locate the supplies and draw up the appropriate bolus.
5.5kg x 20mL/kg = 110mL (2 - 60 mL syringes)
You need sterile gloves and an 8fr suction kit.
Locate these on the cart.
Well done. You are crushing it.
Your partner has been unsuccessful at placing an IV. The team needs and IO placed.
Locate the IO needle.
I have never used one, so well done for finding it.
When a patient progresses to asystole, the appropriate actions are? (Give one)
Start CPR
Give Epi
Treat causes
Your patient in respiratory distress requires O2.
Locate an O2 delivery device and turn the O2 up to 9L.
Your arresting patient needs epi.
Locate a Small syringe, luer lock adapter, and epi. Draw up 0.5 mL's
OMG well done. You saved your patient.
Double jeopardy-
The code team arrives and would like to follow the PALS Peds Bradycardia algorithm.
Locate the algorithm on the cart.
Double points if you can tell me med differences between the Bradycardia and Tachycardia algorithms??
Bradycardia = Epinephrine and atropine
Tachycardia = Adenosine and amiodarone
Your role in the code is to record.
Find the pediatric Resuscitation Record and fill in the following information on the top of the form:
Date initial rhythm- Vfib, intubation time- 1536, Pulse present at onset- No, Monitors- yes, Vasoactive meds prior to arrest- No.
You are a Rock Star at filling out forms.
The defibrillator has 4 main functions.
List them
1. Monitoring
2. Pacing
3. Synchronized cardioversion
4. Defibrillation
Tell me 1 way that you can determine if you are performing adequate BVM on a patient?
Symmetrical chest rise
improvement in patients color and perfusion
HR improves
Where is the best place to find any medications that you patient might need in an emergency?
The Emergency Drug Card
Your 5 year old patient has a distended abdomen from prolonged bagging; you needs to insert an NG tube.
Find the kit.
Double points- share any tricks you have used or seen to assist when placing an NG tube.
Great work!!
Soak end of tube in warm water right before placing.