Paediatric Advanced Life Support E-Book

Philip Jevon

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 320

Veröffentlichungsjahr: 2012

Beschreibung

In the event of a paediatric cardiac arrest, it is essential to be able to respond rapidly, providing safe and effective care. The second edition of this successful text provides nurses with a practical and systematic guide to the rapid assessment and delivery of appropriate resuscitation to infants and children.

• Conforms to current European Resuscitation Council Guidelines
• Based on up-to-date research and evidence-based practice protocols
• Synoptic approach enables rapid delivery of effective treatment
• Written by experts in the field of both resuscitation and paediatrics

Paediatric Advanced Life Support is a succinct yet comprehensive guide and is an essential purchase for any health professional likely to encounter an emergency situation.

Leseprobe

Table of Contents

Cover

Title page

Copyright page

Foreword

Contributors

Chapter 1 An Overview of Paediatric Advanced Life Support

Introduction

Learning objectives

Causes of death in childhood

Survival rates following paediatric resuscitation

Pathophysiology of cardiac arrest

Importance of treating children differently from adults

Cardiopulmonary resuscitation: standards for clinical practice and training

Summary

Chapter 2 Resuscitation Equipment for Paediatric Resuscitation

Introduction

Learning objectives

Resuscitation equipment required for paediatric resuscitation

Aids to estimating paediatric drug doses and equipment sizes

Routine checking of resuscitation equipment

Checking resuscitation equipment following use

Summary

Chapter 3 Recognition of the Seriously Ill Child

Introduction

Learning objectives

Aetiology of cardiorespiratory arrests in children

ABCDE approach

Summary

Chapter 4 Paediatric Basic Life Support

Introduction

Learning objectives

Sequence of actions in basic life support

Principles of basic airway management

Principles of mouth to mouth ventilation

Principles of performing chest compressions

The recovery position

Management of foreign body airway obstruction

Principles of safer handling during CPR

Summary

Chapter 5 Airway Management and Ventilation

Introduction

Learning objectives

Relevant anatomy and physiology

Causes of airway obstruction

Recognition of airway obstruction

Simple techniques to open and clear the airway

Principles of cricoid pressure

Oropharyngeal and nasopharyngeal airways

Role of the laryngeal mask airway

Principles of tracheal intubation

Principles of oxygen delivery and ventilation

Principles of oxygenation administration

Summary

Chapter 6 ECG Recognition and Management of Cardiac Arrhythmias

Introduction

Learning objectives

The conduction system of the heart

The ECG and its relation to cardiac contraction

Problems encountered with ECG monitoring

Management of cardiac arrhythmias

Treatment of sinus bradycardia and sinus tachycardia

Recognition and treatment of supraventricular tachycardia and ventricular tachycardia

Summary

Chapter 7 Defibrillation and Electrical Cardioversion

Introduction

Learning objectives

Ventricular fibrillation

Mechanics of defibrillation

Safety issues and defibrillation

Procedure for manual defibrillation

Procedure for automated external defibrillation

Procedure for synchronised electrical cardioversion

Summary

Chapter 8 Paediatric Advanced Life Support

Introduction

Learning objectives

Resuscitation Council (UK) PALS algorithm

Intraosseous infusion

Resuscitation medications

Potential reversible causes of cardiac arrest

Summary

Chapter 9 Management of Anaphylaxis

Introduction

Learning objectives

Definition

Incidence and mortality statistics

Pathophysiology

Causes

Clinical features and diagnosis

Treatment of anaphylaxis

Summary

Chapter 10 Resuscitation in Special Situations

Introduction

Learning objectives

Epiglottitis

Hypothermia

Drowning

Acute severe asthma

Electrocution

Poisoning

Trauma

Life-threatening electrolyte abnormalities

Summary

Chapter 11 Post-resuscitation Care

Introduction

Learning objectives

Goals of post-resuscitation care

Initial assessment and treatment priorities following the ABCDE approach

Measures to minimise secondary cerebral damage

Guidelines for referral to a paediatric intensive care unit

Basic principles of safe transport

Summary

Chapter 12 Bereavement

Introduction

Learning objectives

Ideal layout for the family room

Principles of breaking bad news

Telephone notification of family members

Practical arrangements following a death

Importance of written guidelines and policies

Family members witnessing resuscitation

Summary

Chapter 13 Records, Record-keeping and Audit

Introduction

Learning objectives

Importance of accurate record-keeping

Principles of effective record-keeping

What post-resuscitation records should include

Records as a legal document

National Cardiac Arrest Audit

Summary

Chapter 14 Legal and Ethical Issues

Introduction

Learning objectives

The scope of a nurse’s accountability

Issues related to Do Not Attempt Resuscitation orders

Factors influencing the decision to stop CPR

Risk management strategy for CPR

Summary

Chapter 15 Resuscitation Training

Introduction

Learning objectives

Why resuscitation training is important

Recommendations concerning resuscitation training

Principles of adult learning

Methods of resuscitation training

Nationally recognized courses in paediatric resuscitation

Key learning objectives of paediatric resuscitation training

Paediatric training manikins and models

Summary

Index

This edition first published 2012 © 2012 by Phil Jevon

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing.

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

2121 State Avenue, Ames, Iowa 50014-8300, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data

Data available

ISBN 978-14051-9776-2

ISBN 978-11182-7462-0 (epdf)

ISBN 978-11182-7463-7 (epub)

ISBN 978-11182-7461-3 (mobi)

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Foreword

The death of any child is a tragedy, but is more so if that death could have been prevented.

In England and Wales, the mortality rate for infants and children has fallen by more than 50% in the last three decades and is now at its’ lowest ever level.

This fall is due in part to an increasing understanding of the causes of death in infants and children and the recognition that many of these deaths are preventable and are preceded by a recognisable period of deterioration in respiratory and circulatory function secondary to an underlying condition which is often potentially treatable. Failure to intervene early in such infants and children can lead to cardiac arrest which has a dismal outcome. This is seen most markedly by contrasting the survival rates of patients in asystole (survival rates of less than 5% being reported), with those of children in respiratory arrest who have received prompt resuscitation (survival rates of over 50% being reported).

Paediatric Advanced Life Support (PALS) is a succinct yet comprehensive guide to the knowledge, skills, drugs and equipment necessary to identify and effectively treat infants and children who have potential life threatening conditions, and thus prevent a cardiac arrest. It provides an evidence-based approach to paediatric advanced life support based on the latest Resuscitation Council UK 2010 guidelines. The text is complimented by the inclusion of the latest Resuscitation Council algorithms. The book emphasises the logical and systematic team approach required to recognise and manage the seriously ill child and provides a concise source of essential information.

This second edition is pocket sized and presents the most recent information in an accessible format and serves as an excellent reference source for all involved or potentially involved in the treatment and management of the sick child particularly nurses, junior doctors and allied health professionals. I can highly recommend it.

Derek Burke

Consultant in Paediatric Emergency Medicine

Sheffield Children’s NHS Foundation Trust

UK

Contributors

Consulting Editors

Kathleen Berry, Consultant Paediatrician A & E, Birmingham Children’s Hospital, Birmingham, UK

Gale Pearson, Consultant Paediatrician PICU, Birmingham Children’s Hospital, Birmingham, UK

Contributors

Jayne Breakwell, Senior Sister Paediatrics, Walsall Healthcare NHS Trust, Manor Hospital, Walsall, UK

Kirsti Soanes, Matron Paediatrics, Birmingham Children’s Hospital, Birmingham, UK

Richard Griffin, Lecturer in Law, Swansea University, Wales

Chapter 1

An Overview of Paediatric Advanced Life Support

Introduction

Paediatric advanced life support (PALS) includes the knowledge and skills necessary to identify and effectively treat infants and children who have potential respiratory or circulatory failure, and to provide the appropriate early treatment for a paediatric cardiac arrest.

The aim of this chapter is to provide an overview of PALS.

Learning Objectives

At the end of this chapter, the reader will be able to:

Discuss the causes of death in childhoodDiscuss survival rates following paediatric resuscitationOutline the pathophysiology of paediatric cardiac arrestDiscuss the importance of treating children differently from adultsOutline the provision of a resuscitation service in hospital

Causes of Death in Childhood

The most common causes of death in children under 6 years of age worldwide are detailed in Table 1.1.

Table 1.1 Most common causes of death worldwide in children under 6 years of age

Reproduced from Stevenson & Tedrow (2010).

According to the Office for National Statistics (2009), the highest death rates in childhood occur during the first year of life, particularly the first month (Table 1.2). Causes of death in childhood vary according to age. The most common causes are:

Newborn period – congenital abnormalities and factors associated with prematurity1 month to 1 year – cot death, infection and congenital abnormalityFrom 1 year – trauma

Table 1.2 Causes of death by age in England and Wales, 2008

Reproduced from Office for National Statistics (2010).

In England and Wales, infant mortality rates (number of deaths of children under 1 year of age in one calendar year per 1000 live births in the same calendar year) have fallen by more than 50% in the last 28 years, from 12 in 1980 down to 4.5 in 2008, the lowest on record (Advanced Life Support Group, 2011).