Ventricular Fibrillation And Pulseless Ventricular Tachycardia

ECGs showing ventricular fibrillation and ventricular tachycardia are shown in Figures 6.4 and 6.5 respectively. These arrhythmias are uncommon in children but may be expected in those suffering from hypothermia, poisoning by tricyclic antidepressants and with cardiac disease. The protocol for ventricular fibrillation and pulseless ventricular tachycardia is shown in Figure 6.6. Figure 6.4. Ventricular fibrillation Figure 6.4. Ventricular fibrillation Asynchronous electrical defibrillation...

Background information on asthma and bronchiolitis

Acute exacerbation of asthma is the commonest reason for a child to be admitted to hospital in this country. Admissions for acute asthma in children aged 0-4 years increased seven-fold between 1970 and 1986 and admissions for children in the 5-14 age group tripled. In the early 1990s asthma represented 10-20 of all acute medical admissions in children but rates have fallen over the last 3-5 years. There were 24 deaths from asthma in children in England and Wales in 1998 (ONS). Consultations...

Viewing the film

The date and time that the film was taken The orientation (side marker position). View the film on a light box - not against the ceiling lights or a nearby window. Light boxes give uniform illumination and should be available in all resuscitation rooms. The ABCD approach to radiographic interpretation is shown in the box below. Adequacy, Alignment and Apparatus Bones Disc spaces (in the spine), Diaphragm (in the chest) Cervical spine immobilisation should take place before any radiographs are...

Pulseless Electrical Activity

This is the absence of a palpable pulse despite the presence of recognisable complexes on the ECG monitor. This is often a pre-asystolic state and is treated in the same way as asystole. Sometimes, pulseless electrical activity is due to an identifiable and reversible cause. In children this is most often associated with trauma. In the trauma setting PEA may be caused by severe hypovolaemia, tension pneumothorax and pericardial tamponade. PEA is also seen in hypothermic patients and in patients...

Raised intracranial pressure

The initial priority in the management of the unconscious child is the maintenance of adequate respiration, circulation, and metabolic homoeostasis. Once this has been done, the possibility of raised intracranial pressure should be considered. In very young children, before the cranial sutures are closed, considerable intracranial volume expansion may occur if the process is slow. However, if the process is rapid and in children with a fixed volume cranium, increase in volume due to brain...

Hypervolaemia

Hypervolaemia in children is uncommon and is usually due to either cardiac or renal failure. Occasionally water intoxication due to deliberate ingestion of water or excessive administration of desmopressin DDAVP may be the cause. Signs of hypervolaemia include raised venous pressure, a triple rhythm on auscultation of the heart, and pulmonary crackles. Hypertension may be present, particularly in fluid overload of renal origin.Treatment of hypervolaemia is initially with diuretics. These may be...

Causes Of Death In Childhood

Mortality Multiple Trauma

As can be seen from Table 1.1, the greatest mortality during childhood occurs in the first year of life with the highest death rate of all happening in the first month. Table 1.1. Number of deaths by age group Table 1.1. Number of deaths by age group The rate for under ones is per 1 000 population and for over ones per 100 000 population England and Wales, 1991 and 1998 Office of National Statistics ONS Australia 1998 The rate for under ones is per 1 000 population and for over ones per 100 000...

Pathways Leading To Cardiorespiratory Arrest

Cardiac arrest in infancy and childhood is rarely due to primary cardiac disease. This is different from the adult situation where the primary arrest is often cardiac, and cardiorespiratory function may remain near normal until the moment of arrest. In childhood most cardiac arrests are secondary to hypoxia, underlying causes including birth asphyxia, inhalation of foreign body, bronchiolitis, asthma, and pneumothorax. Respiratory arrest also occurs secondary to neurological dysfunction such as...