Pals Checklist Form

Remediation. Make a note here of which skills require remediation refer to Instructor Manual for information about remediation. Stops fluid bolus if signs of heart failure worsen Recognizes the need to obtain expert consultation from pediatric cardiologist Cardiac Case Scenario 9 Supraventricular Tachycardia Identifies narrow-complex tachycardia ie SVT with adequate perfusion and verbalizes how to distinguish between ST and SVT How do you distinguish between ST and SVT Directs performance of appropriate vagal maneuvers Directs preparation and administration of appropriate doses first and if needed second of adenosine States the rationale for the strong recommendation for expert consultation before providing synchronized cardioversion if the stable child with SVT fails to respond to vagal maneuvers and Directs or describes appropriate indications for and safe delivery of attempted cardioversion at 0. 5 to 1 J/kg subsequent doses increased by 0. 5 to 1 J/kg not to exceed 2 J/kg Performs reassessment of patient in response to treatment Discusses indications and appropriate energy doses for synchronized cardioversion Bradycardia Identifies bradycardia associated with cardiopulmonary compromise/failure Reassesses heart rate and systemic perfusion after initiation of bag-mask ventilation Recognizes indications for high-quality CPR chest compressions plus ventilation in a bradycardic patient Directs or discusses preparation for and appropriate administration and dose 0. 1 mg/kg of epinephrine Verbalizes consideration of 3 potential causes of bradycardia in infants and children Tell me 3 potential causes of bradycardia in infants and children. Asystole/PEA Identifies cardiac arrest Directs immediate initiation of high-quality CPR and ensures performance of high-quality CPR at all times Directs placement of pads/leads and activation of monitor/defibrillator Identifies asystole or PEA Directs checking rhythm approximately every 2 minutes while minimizing interruptions in chest compressions Verbalizes at least 3 reversible causes of PEA or asystole VF/Pulseless VT Identifies VF or pulseless VT cardiopulmonary arrest Directs safe performance of attempted defibrillation at 2 J/kg After delivery of every shock directs immediate resumption of CPR beginning with chest Directs safe delivery of second shock at 4 J/kg subsequent doses 4 to 10 J/kg not to exceed 10 J/kg or standard adult dose for that defibrillator lidocaine at appropriate time lidocaine and consideration of reversible causes of arrest H s and T s If VF persists despite the therapies provided what else should you administer or consider. Tamponade massive pulmonary embolus Directs appropriate treatment for obstructive shock needle decompression for tension pneumothorax fluid bolus and pericardiocentesis for cardiac tamponade oxygen ventilatory support fluid bolus and expert consultation for massive pulmonary embolus prostaglandin infusion and expert consultation for neonate with ductal-dependent congenital heart disease and constriction/ closure of the ductus arteriosus Distributive Shock with careful reassessment to treat shock Directs initiation of vasoactive drug therapy within first hour of care for fluid-refractory shock Directs early administration of antibiotics within first hour after shock is identified Cardiogenic Shock Directs slow administration of a 5 to 10 mL/kg fluid bolus of isotonic crystalloid over 10 to 20 minutes and reassesses patient during and after fluid bolus. Stops fluid bolus if signs of heart failure worsening respiratory distress development of hepatomegaly or rales/crackles develop States therapeutic end points during shock management What are the therapeutic end points during shock management Obstructive Shock Verbalizes DOPE mnemonic for intubated patient who deteriorates What mnemonic is helpful to recall when the intubated patient deteriorates What does this mnemonic mean States at least 2 causes of obstructive shock Tell me at least 2 causes of obstructive shock. Test Results Check PASS or NR to indicate pass or needs remediation PASS NR Instructor Initials Instructor Number Date 2016 American Heart Association Lower Airway Obstruction additional laboratory studies for bronchiolitis Lung Tissue Disease and evaluates response Identifies indications for bag-mask ventilation and/or additional airway or ventilation support Describes methods to verify that bag-mask ventilation is effective Identifies need for involvement of advanced provider with expertise in pediatric intubation and mechanical ventilation Disordered Control of Breathing Shock Case Scenario 5 Hypovolemic Shock Directs rapid administration of a 20 mL/kg fluid bolus of isotonic crystalloid repeats as needed to treat signs of shock Reassesses patient during and after each fluid bolus. PALS Case Scenario Testing Checklist Respiratory Case Scenario 1 Upper Airway Obstruction Student Name Date of Test if done correctly Critical Performance Steps Team Leader Assigns team member roles Uses effective communication throughout Patient Management Directs assessment of airway breathing circulation disability and exposure including vital signs Directs administration of 100 oxygen or supplementary oxygen as needed to support oxygenation Directs application of cardiac monitor and pulse oximetry Identifies signs and symptoms of upper airway obstruction Categorizes as respiratory distress or failure and IV corticosteroid for anaphylaxis States indications for bag-mask ventilation and/or other airway or ventilation support If the student does not verbalize the above prompt the student with the following question What are the indications for bag-mask ventilation and/or other airway or ventilation support Directs establishment of IV or IO access if indicated Case Conclusion/Debriefing The following step is evaluated only if the student s scope of practice applies Describes how to estimate correct endotracheal tube size for this patient How would you estimate the endotracheal tube size for this infant with upper airway obstruction STOP TEST Instructor Notes Place a in the box next to each step the student completes successfully.