Pediatrics

Hypoxia

Diagnosis

↓ SpO2

Diagnosis

↓ SpO2

  1. Increase O2 to 100%

  2. Confirm presence of EtCO2, look for any changes in capnogram

  3. Hand-ventilate to assess compliance

  4. Listen to breath sounds

  5. Consider DOPE: displacement, obstruction, pneumothorax, equipment failure

  6. Check:

    • ETT tube position and patency. Correct if mainstem or supraglottic, suction to r/o mucous plug, secretions, or kink
    • Consider circuit integrity: kink in circuit or ETT, bronchspasm, obstruction, mucous plug
    • Pulse oximeter: try new probe or changing placement
    • Check BP and HR
    • Consider recruitment maneuvers
    • Consider deepening anesthetic or muscle relaxant if patient-ventilator asynchrony

  7. Further assessment: Draw blood gas. Perform bronchoscopy, CXR, TEE, ECG

  8. Consider DDx

  9. Crisis Management (If Severe)

    Notify surgeon, call for help and code cart

  10. Call for Transesophageal Echocardiography

  11. Start chest compressions

  12. Give epinephrine 10 MICROgrams/kg IV/IO

  13. If cardiac arrest, go to CARDIAC ARREST

  14. Consider ECMO

Patient weight

Between 0.5 kg and 120 kg

Reset the checklist?

Checked steps, the timer and this crisis log are cleared. The patient’s weight is kept.

Finish the crisis?

The timer pauses, and you can review the case and the event log.