Pediatric CPR

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Pediatric CPR
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????????????????? systolic ?????? 1- 10 ??
90 ( ?????????????? 2 ) mmHg ??????????????
????????????????? systolic ?????? 1- 10 ??
70 ( ?????????????? 2 ) mmHg
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??????????????????????????????
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A Airway B Breathing C Circulation D Drug
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Endotrachial tube Size uncuff Age(yr)
4 4 cuff Age(yr)
3 4 Depth Age(yr) 12
or 2 3xsize ETT
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• Circulation
• ???????????
• Carotid pulse
• Brachial pulse
• Femoral pulse

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Chest compression
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• Two Thumbs Technique
• Two Fingers Technique
• One Hand Technique
• Two Hands Technique

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???????????????
Two-thumb technic ???????????????????????
????????????????????????????????????? 2
?????????????? sternum ????????????? ???????
transnipple line 1 ?.?. ???????????????????????
2 ??? ????????????????????????????
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Two-fingers technic
????????????????????????????????
????? ???????????????? sternum ???????
transnipple line 1?.?. ??? ???????????????????????
???????????? ??????????????? 1.5-2??.??? ???????
???????????????????????? ????????
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Two Fingers Technique
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One Hand Technique
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Drug
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Route Peripheral line ?????? NSS 5 ml push
???????????? Intraosseous ??????????????????????
????? IV ??? Tracheal ?????????????????? 3-5
??. ??????? NSS 3-5 ??. ??????
??????? Bag 5 ??????????????
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????????????????????????????????????????????
?? Infant Child ????????
Atropine 0.02 mg/kg/dose iv, io, ET 0.02 mg/kg/dose iv, io, 0.03 mg/kg/dose ET Min 0.1 mg Max 0.5 mg
Naloxone 0.1 mg/kg/dose iv, io, ET lt 5 yr / lt 20 kg 0.1mg/kg/dose gt 5 yr / gt 20 kg 2mg/dose iv, io, ET
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????????????????????????????????????????????
?? Infant Child ????????
Epinephrine 110,000 0.1-0.3 ml/kg/dose iv, io, ET 110,000 0.1-0.3 ml/kg/dose iv, io 11,000 0.1ml/kg/dose ET Repeat q 3-5 min Max. dose 1 mg iv,io 10 mg ET
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????????????????????????????????????????????
?? Infant Child ????????
7.5NaHCO3 1 ml/kg/dose iv,io 1 ml/kg/dose iv,io ??????????? SW ??????? ??????????
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NCPR
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???????????????????????????? ??????? (????)
???? (??.) ??????????????????????? (??.)
1000 2.5
7 2000 3
8 3000 3.5
9 4000 3.5-4
9-10 ??????? 6
?.?.???? ?.?. ?????????????????????? 750
???? ????????????????? 6 ?.?.?????????
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????????????????????????????
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???????????????????????? 1. ???????????? 2.
??????????? 3. ???????????????????????????????? 4.
????????????
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??????????????????????? ????????
???????????????????? ?????
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Positive pressure ventilation ( PPV ) 1. ??? face
mask ?????????????? ????????????????????
??????? ??? seal ????????????? ???????????????
ambu bag 2. ??? ambu bag ?????????????????????????
?????????? 3. ????????????????? 40
???????????? 4. ?? PPV ??? 30 ????????????????????
????
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PPV
????????????????????
???????????????????? lt 60 ?????/????
gt 60 ?????/????
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?????????????? 30 ??????
??????????????????? ????????????????????????????
????????
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?????????????????
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??????????????????????? Epinephrine
(110,000) 0.1-0.3 ??./??. ET ????
IV Naloxone (0.4 ??./??.) 0.1 ??./??.
ET, IV, IM NaHCO3 (1 mEq/??.) 1-2
mEq/??. IV
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- ?????????????????????????????????
?????????????? ????????????????????????????
????????????? ????????????? -
?????????????????????????????????????
????????????????????????????????????????
???????????????????????????????? ?????????
????????????????????? meconium aspirator -
???????????????????????? ????????????????????
????????????????????????????? ????????????
????????????????????????????????? ??????????
??????????????????????????????????
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Meconium-stained amniotic fluid
????????????????????? 1. ???????
???????????? 2. Heart rate gt 100 / min
3. Muscle tone ?? ?????????? ET tube
suction
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Noninitiation of resuscitation in 1.Confirmed GA
lt 23 weeks 2.Birth weight lt 400 gm. 3.
Anencephaly 4. Confirmed trisomy 13 or 18
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Discontinuation of resuscitative efforts may be
appropriate if resuscitation of an infant with
cardiorespiratory arrest does not result in
spontaneous circulation in 10 minutes.
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????
????????
?????? ???? lt 1 ??
1-8 ??
gt 8 ?? ???????????? 40
15-20
15-20 ??????????? ???????
Below nipple lower 1/2
lower 1/2
line 1 cm. Sternum
Sternum ???????
Two thumbs Two thumbs
One hand
Two fingers Two fingers
Two hands
One
hand
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????
????????
?????? ??????????? ???????
1/3-1/2 ??????????????????? ???????????
90 80 100
80 10 ???????
1 ???2 ??? 3 1 ???2 ??? 3 ??? 4 ???
5 ??? RRCC 13
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15 ?????????? P Brachial/Femoral
Carotid Carotid
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?????????????????????
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????????????????????

• ?????????????????????????????
• ??????????????????????? 3 ??
• ????????????????????????? 1 ???
• ???????????? ???? ?????????? ????????
  ????????? ??????????????? ?????

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???????????????????????????????

• ????????????????
• ?????????? choking
• ????????????
• ????????????????????
• ???????????
• ??????????????????
• ???????? ????
• ???????????
• Peripheral perfusion ??

• ?????????????????????
• ??????????
• ??????????
• ????????? ??????????????
• ????? ????? ????
• ??? ??????
• Peripheral perfusion
• ?????

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??????????????????????????????????????????????

• Five back blows and chest thrusts
• Heimlich maneuver
• Stop blind finger sweep
• A-B-C
• tongue-jaw lift
• Head -tilt,chin-lift
• bronchoscope

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Back blows-Chest thrusts

• ????????? ??????? ??????? 60 ????
• ????????????????????????????????? 2 ???? 5 ?????
• ???????????????????????????? 5 ?????
• ??????? jaw thrusts technique
• ??????????????????????????????
• ????????????? ?????????????????
• ??????????????????????????????????????

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Heimlich maneuver

• ??????????????????????
• ??????????????????????????????????????????
• ??????????????????????????????????????????????????
  
• ????????????????????????? 6-10 ???????????????????
  ????????????????????????????????????????
  ????????????????????????????
• ??????????????????????????
• ???????????????????? mouth to mouth, mouth to
  nose
• ??????????????????

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?????????