2.24.2006

PALS: Pediatric Emergencies

I finished my PALS (pediatric advance life support) course today. I was given my Pin reward for completing the 2 day course in addition to the standard wallet size card certification.

Everybody in that room was an emergency nurse. I was the only one who were not from that department. Rounding the table for names and work background, I always joke around and told them I was a lost sheep among wolves. I have worked as a cardiac / stepdown nurse my entire career and I am ready to take on a more challenging position. Taking ACLS was the first step, then PALS to seal my certification toward the career choice that I have wanted. The only missing piece now is the actual full time position on an emergency department.

Ok, back to PALS...

I hate working with children. Not because i hated children but i just don't have the emotional restriction in caring for children. It just breaks my heart to see a child suffer. I have a child myself which makes it more difficult for me to take care of other children who are sick. I did not want to take this course but as i have said above, i had to if i want an advancement in my career and it also looks good in my resume.

Anyway, PALS is much simpler than ACLS as i remember. There are slight differences in BLS procedure, less drugs to memorize and the chain of survival involves prevention of injuries and accidents that may lead to the emergency.
This are the summary of the things that i have learned during that course.

1. BLS Procedures

- Check for responsiveness
- Check airway (do not do blind sweep on mouth!)
- Check breathing
- Give 2 full breaths
- Check for circulation
- Give 5 compressions if no pulse
- Alternate 1 breathe and 5 compressions for one whole minute
(with at least 100 bpm)
- Call 911 for assistance
- Use defibrillator if indicated / as needed

2. Chain of Survival

- prevention of injuries or emergencies requiring resuscitation
(VERY IMPORTANT!)
- early CPR
- early defibrillation
- early advanced life support


3. Medications

- coming soon


4. PALS Megacode

- if you need to practice megacodes, i have found a great site for you to practice
http://www.mdchoice.com/cyberpt/pals/pals.asp

5. Important points to consider

- Respiratory cases are more prevalent in pediatrics on acute amercgency situation than cardiovascular cases.
- If you witness a pediatric patient fall down without warning, there's a big chance the case is cardiovascular. But if you dont witness the fall, assume it to be a respiratory case.
- Remember: AIRWAY MANAGEMENT is the very first thing to consider in pediatric emergencies. Open, maintain and support airway!
- Intraosseous site is much better than intravenous site since there is very little or no chance of infiltration.
- Rapid cardiopulmonary assessment is very very important on the first 30 seconds! Learn it by heart!
- Do not forget to treat the cause of emergency first! (Remember your 4H & 4T!)

Posted by nixinne :: 23:52 :: 1 comments

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