Pediatric patients tend to compensate and compensate – until finally they don’t.
LMA’s come in various sizes and these may vary slightly between manufacturers.
Typically, Size 1 is appropriate for newly born children who are less than 5000 grams and over 1500 grams or 34 or more weeks gestation.
In children less than 4 – 6 years of age, avoid jet ventilation instead ventilate with a BVM attached to the catheter. Caution should be used if jet ventilating older children due to the risk of barotrauma. Children up to 10 years or 30kg can likely be adequately ventilated with a BVM rather than jet device. To connect the BVM to the catheter: Use a 3.0mm ETT adapter with the angiocath directly
Attach a 3mL syringe to the catheter, and use an 8.0 ETT adapter.
Dilute the patient’s individualized code dose of epi (0.01 mg/kg) to a total volume of 10cc with saline.
Give 1cc of epi spritzer IV up to every 2 minutes as needed.
Kids are not aliens… Basics that work for adults also apply to children! High Quality CPR, Early Defibrillation, Early Administration of Epi, and Post ROSC management should be the focus.
You have all of the skills you need to care for an acutely ill infant. Learn a few pearls to make this a smoother endeavor.
Take out the Broselow tape and pediatric resuscitation cart. Hopefully this is out before the child arrives. For the first 10 minutes, all of my drug doses and equipment sizes are entirely based off the Broselow length. The Broselow tape may not be perfectly accurate, and I will get an accurate weight when there is time, but the Broselow is good enough to get things started.
Rosen’s advocates for the “encircling” hands technique in infant CPR, which according to animal models gives better hemodynamics than using the standard two finger technique.