In-Flight Medical Emergencies by Jose V. Nable & William Brady

Author:Jose V. Nable & William Brady
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

9.3.2 Cardiac Issues

Assessing cardiovascular status . The sphygmomanometer provided in the emergency medical kit is unlikely the correct size for a child. Due to the cuff being large, it will have limited utility in a small child; it will likely report falsely low blood pressures. A better marker of perfusion is capillary refill time of the extremities, which should be less than 2–3 s in a healthy patient. Heart rate is also important in pediatric cardiac assessment. Tachycardia will persist for longer in children than adults before hypotension occurs. If an accurate blood pressure can be obtained, the following calculation can be used to help identify normal blood pressures:

Systolic blood pressure = [70 + (age × 2)]

Below this level should indicate hypotension.

Typically boluses of intravenous (IV) fluids are approximately 20 cm3/kg, as long as the patient has no known cardiac illness or renal issues, causing increased risk for fluid overload. If long-term care is expected in-flight due to inability to land, maintenance fluids can be calculated based on weight [8]:First 10 kg give 4 mL/kg/h

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