tailieunhanh - Pocket Emergency Paediatric Care - part 3

Nếu đặt nội khí quản, nó có thể được mười lần so với liều xuống ống ET (có nghĩa là epinephrine 100 microgram / kg). Nếu boluses epinephrine không hiệu quả hoặc chỉ kéo dài trong một thời gian ngắn, truyền 0,05 -2 · 0 mg / kg / phút (tốt hơn là thông qua tĩnh mạch trung tâm). | 36 POCKET EMERGENCY PAEDIATRIC CARE 5-0 mg if 5 years nebulised with 100 oxygen or 1000 micrograms via spacer 10 X 100 microgram puffs repeated or continuously as required. Assess Circulation if no pulse start basic life support assess rhythm and treat if shocked 10 micrograms kg epinephrine IM 20 ml kg 0 9 saline colloid. NB Give epinephrine IM unless in intractable shock or cardiac arrest when it should be given IV or IO. If intubated it can be given at ten times the dose down the ET tube that is epinephrine 100 micrograms kg . If boluses of epinephrine are ineffective or lasting only a short time infusion 0-05-2-0 micrograms kg min preferably via central vein . Reassess ABC and continue 100 oxygen If airway deterioration repeat IM epinephrine 10 micrograms kg consider intubation or surgical airway. If still wheezy repeat IM epinephrine 10 micrograms kg hydrocortisone 4 mg kg over 15 minutes IV aminophylline 5 mg kg slow IV 1 mg kg h IV infusion or salbutamol 4-6 microgram kg slow IV followed by IV 0-5-1-0 micrograms kg min IV infusion. If still shocked repeat IM epinephrine 10 micrograms kg 20 ml kg 0-9 saline colloid 4-5 albumin inotropic infusion dopamine or epinephrine see page 183. Asymptomatic other than rash or itching oral antihistamine -chlorpheniramine 250 micrograms kg repeat up to 4 times in 24 hours if necessary oral steroids prednisolone 1-0-2-0 mg kg total daily dose 1 month to 12 years . Status epilepticus During a seizure Place into a left lateral decubitus position if practical . Ensure the AIRWAY IS PATENT and there is ADEQUATE RESPIRATORY function and ADEQUATE CIRCULATORY function. If seizure 5 minutes or duration unknown ANTICONVULSANT treatment. Short recurrent seizures should also be treated. Treat fever by exposure tepid sponging and rectal paracetamol 20 mg kg . Investigations Blood glucose film for malaria parasites urea creatinine calcium electrolytes and full blood count. Urinalysis BP lumbar puncture when meningitis possible .