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Diagnosis of Emergency resuscitation in children 

The identification of the requirement is very necessary to determine whether the children need the resuscitation to overcome the situation or medication could able to handle the issue successfully. In order to make that diagnosis the medical persons used to use a scale called Paediatric Cerebral performance scale. This scale contains a score of 1 to 6 which indicates the functioning of the cerebral part of the brain to respond to the treatment.

Children or infants except the newborns have usually provided 2 breaths (1 sec each) after every 30 chest compression at 100-120 minutes. Similarly, on the two resuscitations, the CPR provided would be 2 breaths (1 sec each other) after every fifteen of chest compression at 100-120 minutes each. This is able to provide small puffs to the patient from the cheeks of the rescuer.

MANAGEMENT OF emergency resuscitation among infants

The national institute for Health and Care Excellence has provided resuscitation guidelines in 2015 for the children. These include a systematic review along with the provision of grading for the quality of evidence and with strength of recommendations (resus.org.uk, 2018). This is also recommended for the management of cardiopulmonary resuscitation and emergency cardiovascular treatment. In addition to that involvement of all the stakeholders from all over the world to provide facilities of CPR in public to the cardiac arrest survivors irrespective of age could help to bring a positive impact for the situation.

EMERGENCIES resuscitation condition IN PAEDIATRIC PATIENTS

The children are usually given resuscitation in the cardiopulmonary attack stage. In case of any sudden attack or accident could result in a sudden sock among the children. This may create an unusual cardiac arrest that needs to get an immediate cardiopulmonary resuscitation if the patient is not responding. In addition to this, a prolonged cardiac illness of heart as an inborn disorder could also lead to creating an emergency condition for that patient to perform CPR to that condition.

1. What are the common signs and symptoms of resuscitation?

The sign and symptoms that indicate the need of resuscitation for Maggi are given below -

● Sudden collapsing

● Unconsciousness

● Problems in breathing

● pulse cannot be felt

● injuries related to electrocution and so on

2. What are the situations that make worse the resuscitation condition?

Before performing a resuscitation process to a childlike Maggi in a homely setup or in public, a proper training is necessary. A lack of proper knowledge in the process to perform could lead to creating a pressure of air in the heart. In addition to that if the food pipe contains the provided air instead of air pipe then there could be a deposition of air in the empty spaces of lungs. There is a space between the lungs and pleura that are more prone to the air deposition that is known as pneumothorax. This condition can, even more, worsen the situation of the child or could lead to death.

3. How would it be differentiated whether the symptoms of Maggie requires resuscitation?

Usually, the condition of resuscitations is very clear and crucial. Therefore, the unconsciousness after a chest pain followed by shortness of breath provides some definite indications towards resuscitation to the child.

4. What other conditions may look similar to an indication of resuscitation among the young children?

The symptoms of sudden hypoglycaemic attack among children resemble the condition that may indicate the child requires resuscitation due to give air to the heart. However, a thin indication between the two conditions is the absences of chest pain, shortness of breath. Presence of these two conditions shows direct indication to the resuscitation. On the other hand, dizziness and unconsciousness is the similarity between the two conditions.

5. How would Maggi be assessed now? What all investigation would be done in this case?

The difference and similarities mentioned above have to be monitored to identify the exact situation about the disorder. Apart from the biochemical parameter test, the mentioned signs are the clinical indication of the demand of resuscitation to the patient (ncbi.nlm.nih.gov, 2018). Based on the current situation, the biochemical investigation that supposes to be done in that condition is a random blood glucose test, ECG, lipid profile level of Maggi on a long-term care process.

1. What are the common types of medications given to paediatric cardio logical disorder patient?

Despite the disease condition of Rick, such as whether it is congenital or not the below-mentioned drugs can be given to them -

● Angiotensin receptors blockers or ACE inhibitors

● Antiarrhythmics

● Anticoagulants

● Beta-blockers

● Diuretics

● Bosentan

● Warfarin

● Antiplatelets and so on (secondscount.org, 2018).The six rights of medication have to be followed here by the medical caregiver by letting the caregivers aware of the treatment.

2. What are the parameters that would play role in prescribing an appropriate medication regime to Rick after receiving resuscitation?

In order to ensure the heart rate and normal rate of cardiac rhythm an Electrocardiogram with Halter monitoring to rick could help to understand the appropriate condition of Rick. Moreover, the lipid profile test and Spo2 and Spco2 report could help to prescribe medicine for the patient.

3. What are cardiac support devices and how they work?

In order to provide a supportive care in the sudden cardiac arrest to a child like Rick cardiac resynchronization therapy by using a biventricular pacemaker can be done to give rest to the cardiac muscle. Along with that, the usage of Left ventricular assist device (LVAD) can also be used as a long-term therapy (heart.org, 2018).

4. What essential information or instructions must be given to the carer/parent of a newly diagnosed chronic cardiac disorder in a paediatric patient?

The meditational therapy has to be monitored properly if the use of beta blockers and Warfarin are prescribed to be used. These two drugs have an interaction with the potassium (K+) ion to hamper the positive impact of the medicine. Thus, the avoidance of fruit juices are recommended (raspberry, cranberry) along with a mild to moderate activity and sufficient bed rest to the patients (Hockenberr and Wilson, 2018, p.88).

1. What do you think has happened to George?

In accordance with the given case scenario, it can be stated that George is suffering from an abnormal and rapid heart rate that can be denoted as tachycardia. It could be due to Wolff-Parkinson-White syndrome as it has mentioned that George has felt the rapid heart rate since after birth. This congenital condition could have occurred due to the development of an extra aberrant to the heart.

2. What essential information and education must be given to children and their parents regarding Wolff-Parkinson-White syndrome treatment?

In case of an early diagnosis, the parents could suggest going for a catheter ablation surgery to completely remove the aberrant with an aim of restoring normal heart rate. The education for medication therapy by making them aware of the food-drug interaction and avoidance of vigorous physical activity needs to provide to ensure the patient care for the mentioned condition.

3. What immediate steps would be taken in George’s case?

In order to pump the heart to stop the beating of cardiac muscles of George, an immediate resuscitation could have performed to bring back his consciousness.  

References:-

resus.org.uk (2018) The guideline process Available at https://www.resus.org.uk/resuscitation-guidelines/paediatric-basic-life-support/[Accessed on 7th September 2018]

secondscount.org (2018) Medications for Treatment of Congenital Heart Disease (CHD) Available at http://www.secondscount.org/treatments/treatments-detail-2/medical-treatments-children-copy#.W7iVrdczbIU [Accessed on 7th September 2018]

health.wa.gov.au (2018) The six rights of safe medication administration Available at https://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/safety/PDF/Medication%20safety%20resources/Six%20rights.pdf [Accessed on 7th September 2018]

heart.org (2018) Devices and Surgical Procedures to Treat Heart Failure Available at: http://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/devices-and-surgical-procedures-to-treat-heart-failure [Accessed on: 7th September 2018]

ncbi.nlm.nih.gov (2018) Drug therapy of cardiac diseases in children. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19383992 [Accessed on: 7th September 2018]

Hockenberry, M.J. and Wilson, D., 2018. Wong's nursing care of infants and children-E-book

. London: Elsevier Health Sciences.

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