Conference Notes cont…

This is part 2 of my review of Dr. Maloney’s lecture on “The Critically Ill Neonate in Your Community ED.”

After introducing the Pediatric Assessment Triangle, Dr. Maloney reviewed some unique considerations with pediatric ABC’s.

Airway

1.  Because of the baby’s big occiput and flexible neck and trachea, use a shoulder roll to help with visualization

2. Babies have a higher, more anterior glottis, so “look up, pull back”

3.  Used cuffed tubes for any pediatric intubation.  This is a change from previous PALS guidelines

Breathing

1.  Disable the “pop-off valve.”  Instead, watch for chest rise and let that guide your bagging

Circulation

1.  IO is the preferred method for access in a sick baby.

2.  The umbilical vein can be used up to 7-10 days.  Use a 20 gauge angiocath or 5 French feeding tube. Continue reading