Advanced Paediatric Life Support: A Practical Approach to Emergencies (Advanced Life Support Group)

✍ Scribed by Stephanie Smith, Advanced Life Support Group (ALSG) (editor)

• Publisher: Wiley-Blackwell
• Year: 2023
• Tongue: English
• Leaves: 531
• Edition: 7
• Category: Library

✦ Synopsis

ADVANCED PAEDIATRIC LIFE SUPPORT
A PRACTICAL APPROACH TO EMERGENCIES

The gold standard for treating paediatric emergencies

Advanced Paediatric Life Support: A Practical Approach to Emergencies is the internationally renowned manual on emergency paediatric care. Written to support the course run by the Advanced Life Support Group, the book uses their structured approach: a tried and tested practical method of treating children during the crucial first few hours of a life-threatening illness or injury. Advanced Paediatric Life Support is used by doctors, nurses and allied health professionals dealing with emergencies in children. Its clear layout and straightforward style make it a highly practical tool both for training and in the event of an emergency.

In the seventh edition you will find descriptions of both common and uncommon paediatric emergencies which you may encounter in clinical practice, their causes, and how to best treat them during the first hours after presentation.

This book offers a thoroughly evidence-based approach to its subject, which includes:

• The latest International Liaison Committee on Resuscitation (ILCOR) 2021 guidelines
• A thorough introduction to the structured approach to paediatric emergencies, including important non-technical skills and communication
• Comprehensive explorations of the seriously ill child, including airway and breathing, circulation, decreased consciousness, seizures and exposure
• Practical discussions of the seriously injured child, including examinations of chest, abdominal, brain and spinal injuries
• Evidence-based life support treatment and the practical application of the Advanced Paediatric Life Support structured management

Perfect for emergency care physicians, nurses and other allied health professionals, Advanced Paediatric Life Support: A Practical Approach to Emergencies will also benefit paediatric clinicians, doctors-in-training and anyone else with an interest in the team management and treatment of paediatric emergencies.

✦ Table of Contents

Cover
Title Page
Copyright Page
Contents
Contributors to seventh edition
Foreword
Preface to first edition
Preface to seventh edition
Acknowledgements
Contact details and further information
PART 1 Introduction
Chapter 1 Introduction and structured approach to paediatric emergencies
1.1 Introduction
1.2 The APLS approach
1.3 Important differences in children
1.4 Structured approach to paediatric emergencies
1.5 Preparation
1.6 Teamwork
1.7 Communication
1.8 Triage
1.9 Summary
CHAPTER 2 Getting it right:non-technical factors and communication
2.1 Introduction
2.2 Extent of healthcare error
2.3 Causes of healthcare error
2.4 Improving team and individual performance
2.5 Communication
2.6 Team working, leadership and followership
2.7 Situation awareness
2.8 Improving team and individual performance
2.9 Summary
PART 2 The seriously ill child
CHAPTER 3 Structured approach to the seriously ill child
3.1 Introduction
3.2 Primary survey and resuscitation of the airway
3.3 Primary survey and resuscitation of breathing
3.4 Primary survey and resuscitation of the circulation
3.5 Primary assessment and resuscitation of disability (neurological evaluation)
3.6 Primary survey and resuscitation of issues found during exposure
3.7 Secondary survey and emergency treatment
3.8 Summary
CHAPTER 4 Airway and Breathing
4.1 Introduction
4.2 Susceptibility to respiratory failure
4.3 Clinical presentations of the child with breathing difficulties
4.4 Primary survey and resuscitation
4.5 Secondary survey and looking for key features
4.6 General approach to the child with upper airway obstruction
4.7 Specific approach to the child with upper airway obstruction
4.8 Approach to the child with wheeze
4.9 Approach to the child with fever and breathing difficulties
4.10 Other conditions that may present as breathing difficulties
4.11 Summary
CHAPTER 5 Circulation
5.1 Introduction
5.2 Normal physiology of oxygen delivery
5.3 Pathophysiology of shock
5.4 Classification of causes of shock
5.5 Approach to the child in circulatory failure
5.6 Primary survey and resuscitation
5.7 Key features of the child in shock
5.8 Approach to the child with gastrointestinal fluid loss
5.9 Approach to the child with septic shock
5.10 Approach to the child with anaphylaxis
5.11 Approach to the child with profound anaemia
5.12 Approach to the child with sickle cell crisis
5.13 Approach to the child with cardiogenic shock
5.14 Approach to the child with abnormal rhythm or pulse rate
5.15 After resuscitation and emergency treatment of shock
5.16 Use of fluids in resuscitation
5.17 Summary
CHAPTER 6 Decreased conscious level (with or without seizures)
6.1 Introduction
6.2 Primary survey and resuscitation
6.3 Pathophysiology of raised intracranial pressure
6.4 Management of raised intracranial pressure
6.5 Lumbar puncture
6.6 Secondary survey and looking for key features
6.7 Approach to the child with meningitis/encephalitis
6.8 Approach to the child poisoned with opiates
6.9 Approach to the child with metabolic coma
6.10 Approach to the child with malaria
6.11 Approach to the child presenting with stroke
6.12 Approach to the child with systemic hypertensive crisis
6.13 Further stabilisation and transfer to definitive care
6.14 Approach to the child with seizures
6.15 Summary
CHAPTER 7 Exposure
7.1 Introduction
7.2 Temperature
7.3 Rashes
7.4 Indicators of chronic conditions
7.5 Signs of ingestion
7.6 Managing pain
7.7 Summary
PART 3 The seriously injured child
CHAPTER 8 Structured approach to the seriously injured child
8.1 Introduction
8.2 Injury prevention
8.3 Epidemiology
8.4 Trauma systems
8.5 Trauma teams
8.6 Primary survey and resuscitation
8.7 Secondary survey and looking for key features
8.8 Emergency treatment
8.9 Further stabilisation
8.10 Summary
CHAPTER 9 The child with chest injury
9.1 Introduction
9.2 Thoracic Injuries posing an immediate threat to life
9.3 Serious injuries discovered later
9.4 Other injuries
9.5 Practical procedures
9.6 Referral
9.7 Further stabilisation
9.8 Summary
CHAPTER 10 The child with abdominal injury
10.1 Introduction
10.2 History
10.3 Assessment of the injured abdomen
10.4 Definitive care
10.5 Summary
CHAPTER 11 The child with traumatic brain injury
11.1 Introduction
11.2 Triage
11.3 Primary survey and resuscitation
11.4 Secondary survey and looking for key features
11.5 Emergency treatment
11.6 Detailed review and further stabilisation
11.7 Transfer to definitive care
11.8 Summary
CHAPTER 12 The child with injuries to the extremities or the spine
12.1 Extremity trauma: introduction
12.2 Assessment of extremity trauma
12.3 Primary survey and resuscitation of extremity trauma
12.4 Secondary survey and looking for key features of extremity trauma
12.5 Emergency treatment of extremity trauma
12.6 Spinal trauma: introduction
12.7 Injuries of the cervical spine
12.8 Injuries of the thoracic and lumbar spine
12.9 Spinal cord injury without radiographic abnormality
12.10 Summary
CHAPTER 13 The burned or scalded child
13.1 Introduction
13.2 Primary survey and resuscitation
13.3 Secondary survey and looking for key features
13.4 Emergency treatment
13.5 Further stabilisation and transfer to definitive care
13.6 Toxic shock syndrome
13.7 Summary
CHAPTER 14 The child with an electrical injury
14.1 Introduction
14.2 Injury pattern
14.3 Initial treatment
14.4 Secondary survey and looking for key features
14.5 Stabilisation and transfer to definitive care
14.6 Summary
CHAPTER 15 Special considerations
15.1 Introduction
15.2 Penetrating injury
15.3 Blast injury
15.4 Paediatric traumatic cardiac arrest
15.5 Bariatric trauma
15.6 Trauma in pregnancy
15.7 Summary
PART 4 Life support
CHAPTER 16 Basic life support
16.1 Introduction
16.2 Primary assessment and resuscitation
16.3 Basic life support and infection risk
16.4 The choking child
16.5 Summary
CHAPTER 17 Support of the airway and ventilation
17.1 Introduction
17.2 Airway and breathing management: principles
17.3 Primary survey and resuscitation
17.4 Secondary survey
17.5 Emergency treatment
17.6 Team aspects of airway management
17.7 Equipment for providing oxygen and ventilation
17.8 Equipment for managing the airway
17.9 Monitoring an intubated patient
17.10 Management of a blocked tracheostomy
17.11 Summary
CHAPTER 18 Management of cardiac arrest
18.1 Introduction
18.2 Non-shockable rhythms
18.3 Shockable rhythms
18.4 When to stop resuscitation
18.5 Family presence during resuscitation
18.6 Summary
PART 5 Practical application of APLS
CHAPTER 19 Practical procedures: airway and breathing
19.1 Ventilation without intubation
19.2 Oropharyngeal airway insertion
19.3 Nasopharyngeal airway insertion
19.4 Tracheal intubation and rapid sequence induction
19.5 Drugs
19.6 Intubation algorithm
19.7 Supraglottic airway
19.8 Surgical airway
19.9 Management of a blocked tracheostomy
19.10 Summary
CHAPTER 20 Practical procedures: circulation
20.1 Introduction to vascular access
20.2 Intraosseous access
20.3 Peripheral venous access
20.4 Central venous access
20.5 Arterial cannulation
20.6 Defibrillation
CHAPTER 21 Practical procedures: trauma
21.1 Tourniquet
21.2 Pelvic binder
21.3 Cervical spine immobilisation
21.4 Needle thoracocentesis
21.5 Finger thoracocentesis followed by chest drain placement
21.6 Clamshell thoracotomy
21.7 Pericardiocentesis
21.8 Femoral nerve block
21.9 Summary
CHAPTER 22 Imaging in trauma
22.1 Introduction
22.2 Specific body region imaging (top to bottom)
22.3 X-ray interpretation
22.4 Summary
PART 6 Appendices
APPENDIX A Acid–base balance and blood gas interpretation
A.1 Introduction
A.2 Hydrogen ion concentration, acidity and pH
A.3 Carbonic acid reaction
A.4 Standard bicarbonate
A.5 Stewart’s strong ion theory
A.6 Applying this in practice
A.7 Summary
APPENDIX B Fluid and electrolyte management
B.1 Introduction
B.2 Fluid balance
B.3 Diabetic ketoacidosis
B.4 Summary
APPENDIX C Paediatric major trauma
APPENDIX D Safeguarding
D.1 Introduction
D.2 Recognition of child abuse and/or neglect
D.3 Assessment
D.4 Initial management
D.5 Child in need/safeguarding
D.6 Medicolegal aspects
D.7 Summary
APPENDIX E Advance decisions and end of life
E.1 Introduction
E.2 Advance care planning
E.3 Resuscitation decisions
E.4 End of life
E.5 When a child dies
E.6 Take care of the staff/‘debrief’
E.7 Summary
APPENDIX F General approach to poisoning and envenomation
F.1 Poisoning: introduction
F.2 Primary assessment and resuscitation in poisoning
F.3 Emergency treatment in poisoning
F.4 Emergency treatment of specific poisons
F.5 Envenomation (envenoming): introduction
F.6 Resuscitation and support in envenomation (envenoming)
F.7 Specific envenomation (envenoming) issues
F.8 Button battery ingestion
F.9 Strong magnet ingestion
APPENDIX G Resuscitation of the baby at birth
G.1 Introduction
G.2 Normal physiology
G.3 Pathophysiology
G.4 Equipment
G.5 Strategy for assessing and resuscitating a baby at birth
G.6 Resuscitation of the newborn baby
G.7 Response to resuscitation
G.8 Supraglottic airway
G.9 Tracheal intubation
G.10 Preterm babies
G.11 Actions in the event of poor initial response to resuscitation
G.12 Birth outside the delivery room
G.13 Communication with the parents
G.14 Summary
APPENDIX H Drowning
H.1 Introduction
H.2 Primary survey of drowning and resuscitation
H.3 Hypothermia
H.4 Secondary survey and looking for key features in drowning
H.5 Emergency treatment and stabilisation in drowning
H.6 Prognostic indicators in drowning
H.7 Outcome of drowning
H.8 Summary
APPENDIX I Point of care ultrasound
I.1 Introduction
I.2 Summary of the potential uses for POCUS in APLS algorithms
I.3 POCUS in cardiac arrest
I.4 POCUS in the child with breathing difficulties
I.5 POCUS in the child with shock
I.6 POCUS in trauma
I.7 Ultrasound-guided procedures
I.8 Summary
APPENDIX J Formulary
J.1 General guidance on the use of the formulary
J.2 N-acetylcysteine doses <40 kg
J.3 Drugs
List of algorithms
Working group for seventh edition
References and further reading
Index
How to use your textbook
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