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<< Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department

Prehospital Care

Since definitive diagnosis and care of neonates, infants, and children with CHD often require advanced imaging, medication, or surgery, rapid transport of the pediatric patient to a tertiary children’s hospital, once stabilized, is the primary goal. En route, support of airway, breathing, and circulation are paramount, with a few caveats. (See the “Controversies And Cutting Edge” section.) Patients presenting with signs of shock, cyanosis, or respiratory distress should receive supplemental oxygen, with continuous monitoring of pulse oximetry and heart rate. Vascular access should be obtained, but this is often difficult in this clinical setting and intraosseous access may be necessary. In the setting of poor perfusion or hypotension, a 10-mL/kg bolus of normal saline is indicated, and all obtunded or lethargic pediatric patients should have blood glucose checked and hypoglycemia treated with 5 mL/kg of 10% dextrose in water.13

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Last Modified: 11/17/2017
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