PALS Assignment

Directions: Complete this entire box for each of the 6 scenarios.
Can be done on computer or on a piece of paper.

Normal weight is kg:
Normal blood volume:
What amount is 25% loss of perfusion:
Single fluid bolus amount:
Lower limits of systolic blood pressure:
Average systolic blood pressure:
Normal heart rates (range) for the age group:
Normal urine output:
Normal respiratory rate (range) for the age group:
Normal tidal volumes:

Energy for synchronized cardio version: ___shock 1 ____shock 2 and after
Energy for unsynchronized cardio version: ___shock 1 ___shock 2 and after
For manual/hands-free shocking would you use: ____pedi pads/paddles ____adult pads/paddles
SVT minimum heart rate: ____220 ____180

What size ETT:
How far would it be advanced to the teeth/gum line:
Would you inflate the cuff on the ETT: ___yes ___no

Single fluid bolus amount:
Epi IV amount:
Epi ET Tube amount:
Atropine amount per dose:
Atropine single max dose:
Atropine total max dose:
Adenocard amount: ____dose 1 ____dose 2,3
Lidocaine amount patient with pulse: ____loading dose ____additional doses
Valium, Narcan, Morphine dose:
Dextrose: ____dose ____concentration
Sodium Bicard: ____dose ____concentration
Amniodorone:
Succicoline or Benadryl dose:
Tylenol:

Directions: For each of the 6 scenarios list your specific actions you would take as the attending paramedic. Write a protocol of care the each of the scenarios.

A 2-year old boy has fallen from a second-story window of an apartment complex. He is conscious but complains of abdominal pain and is guarding his abdomen. He refuses to straighten out his legs and cries when you attempt to examine his abdomen. He is pale in appearance and cool to the touch. Capillary refill time is 3 seconds. His blood pressure is 60, respirations are 22 and labored, breath sounds are clear, He has a weak, rapid femoral pulse at 150 per minute. He is of appropriate weight for his age.

A 6-year-old asthmatic is having difficulty breathing. She is anxious and using accessory muscles to breath with. Her inhaler ran out about three days ago. She is able to speak in two-word sentences. There is biphasic wheezing with a prolonged expiratory time. Her SAT on room air is 89%. She has a gagging cough of thick white sputum. Her pulse is strong at 122, respirations are labored at 30, and blood pressure is 80 systolic.

A six-month-old baby of low birth weight (low end of normal weight range) is irritable and not feeding well. The mother reports that the child had an inner ear infection a week ago. The child appears warm to the touch and is lethargic with a weak, dry cry. The mother reports that she has not had to change a diaper in the last 6 hours. You do not find peripheral pulses on assessment but central pulses are weak and fast. Capillary refill is 5 seconds. You are unable to get a blood pressure. Respirations are 38 per minute with grunting noted.

A 5-year-old child presents with irritability, is crying a lot, and does not eat. The child’s skin is cool, and somewhat mottled. There is no history of trauma or illness. Her pulse is very rapid centrally and weak but present peripherally. Her blood pressure is 82 systolic and capillary refill time is less than 2 seconds. Pulse oximetry reads 92% on room air. Her ECG shows a narrow-complex rhythm at a rate of 250 and regular.

You have been treating an 8-year-old asthmatic for status asthmaticus unresponsive to albuterol. The child has gone from anxious and alert and is now lethargic and responsive to painful stimulus only. ECG shows a narrow complex rhythm at a rate of 40 and pulse ox reads 84% on 100% NRB mask.

After providing positive pressure ventilation for the patient in scenario #5 for two minutes, you notice that ventilation has become more difficult and that the ECG has changed to a wide-complex slow rhythm and there is no palpable pulse. What would you do?

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