Pediatric Resuscitation Medical Slides

Present the critical medications with dosing: Epinephrine — 0.01 mg/kg (0.1 mL/kg of 1:10,000) IV/IO every 3-5 min. Amiodarone — 5 mg/kg IV/IO (max 300 mg first dose). Defibrillation — 2 J/kg first, 4 J/kg subsequent (max 10 J/kg or adult dose). Adenosine — 0.1 mg/kg first (max 6 mg), 0.2 mg/kg second (max 12 mg). Fluid bolus — 20 mL/kg NS. Emphasize the Broselow tape for rapid weight estimation in emergencies and the danger of 10-fold dosing errors (1:1000 vs 1:10,000 epinephrine). Color-coded drawers matching Broselow colors improve medication safety.

Present the key anatomical differences: proportionally larger head and occiput (sniffing position needs shoulder roll in infants), larger tongue relative to oral cavity, anterior and cephalad larynx (C3-4 vs C5-6 in adults), epiglottis is omega-shaped and floppy (may need straight Miller blade in infants), subglottis is narrowest point in children <8 (vs vocal cords in adults). ETT size: cuffed tube preferred (AHA 2020), size = (age/4) + 3.5 for cuffed. Cuff pressure <20-25 cmH2O. Surgical cricothyrotomy contraindicated under age 10 — use needle cricothyrotomy with jet ventilation as rescue.

Present the concept that most pediatric arrests are preventable — they result from progressive respiratory failure or compensated shock that goes unrecognized. Teach the Pediatric Assessment Triangle (PAT): Appearance (tone, interactiveness, consolability, look/gaze, speech/cry = TICLS), Work of Breathing (nasal flaring, retractions, positioning, audible sounds), Circulation to Skin (pallor, mottling, cyanosis). Early warning signs: tachycardia (earliest sign of shock), altered mental status, prolonged capillary refill >3 seconds, weak pulses, tachypnea. Emphasize: bradycardia in a child is a PRE-ARREST rhythm requiring immediate intervention.