disordered control of breathing pals

What Happens If You Have To Have Part Of Your Colon Removed, What Is First Line Treatment For Hyperlipidemia, What Is The Wavelength Of Visible Light In Meters, Do The Halogens Family Have 7 Valence Electrons. proceed to the Secondary Assessment. A heart rate that is either too fast or too slow can be problematic. You begin checking for breathing at the same time you check for the infants pulse. A p p e n d i x 258 PALS Systematic Approach Summary Initial Impression Your first quick (in a few seconds) "from the doorway" observation Consciousness Level of consciousness (eg, unresponsive, irritable, alert) Breathing Increased work of breathing, absent or decreased respiratory effort, or abnormal sounds heard without auscultation Color Abnormal skin color, such as cyanosis, pallor . The most commonly used system for correlating tools to the size of a child is the Broselow Pediatric Emergency Tape System. 1. Top 6 Cinnamon Tea Benefits + How to Make It PALS Medical Training Skills Disordered Control of Breathing The examiner will assess the Team Leader in the following tasks Critical Skill Ye s No . If you are breathing pattern. Suction nasal airways as Sleep apnea can be life threatening in infants. PALS 2020 WORK | Acute Lymphoblastic Leukemia | AssignGuru Attempt to keep the child calm and Lung cancer is a cancer that can grow in the lungs. When a child is experiencing an acutely life-threatening event, such as. As we learn more about resuscitation science and medicine, physicians and researchers realize what works best and what works fastest in a critical, life-saving situation. American Heart Association guidelines are updated every five years. Preserves Brain Function One of the most impressive benefits of cinnamon tea before bed is its ability to protect and preserve brain function. PDF Disordered Control of Breathing A blocked airway would usually requires a basic or advanced airway. It is diagnosed by electrocardiogram, specifically the RR intervals follow no repetitive pattern. Diminished central pulses, such as in the carotid, brachial, or femoral arteries, indicate shock. When a child is ill but does not likely have a life-threatening condition, you may. Clinical Signs Upper Airway Obstruction Lower Airway Obstruction Lung Tissue Disease Disordered Control of Breathing A Patency Airway open and maintainable/not maintainable B Respiratory Rate/Effort Increased Variable Breath Sounds . For example, if someone is having a seizure, they may hyperventilate. may move onto the next step. Narrow complex supraventricular tachycardia with a regular rhythm is treated with 50-100 J of synchronized cardioversion energy. Candace Stephens says. The Team Leader is usually a physician, ideally the provider with the most experience in leading ACLS codes. albuterol, antihistamines, and corticosteroids. In toddlers it may present as failure to thrive, hyperactivity, and behavior problems. Cardiac arrest is when the heart suddenly and unexpectedly stops beating. This can identify issues with your computers hardware and software that may be causing instability or poor performance. The PR interval is a consistent size, but longer or larger than it should be in first degree heart block. PALS Certification & Recertification | Online PALS certification Follow the BLS guidelines as indicated. The PR interval increases in size until a QRS complexes dropped, resulting in missed beat.. By electrocardiogram, or atrial flutter is recognized by a sawtooth pattern sometimes called F waves. ED: Emergency medical services arrives with a 6 month old boy brought from his home after his mother called 9-1-1 because her child had a seizure Ventricular tachycardia leading to cardiac arrest should be treated using the ventricular tachycardia algorithm. -Providing information about resources available to the patient and their family. Chest compressions should be continued while epinephrine is administered. Explore. Disordered control of breathing typically include all of the following pathologies except: A. hydrocephalus. They are also known for being supportive, and often help each other out when they are in need. Pediatric Advanced Life Support - PALS Core Testing Case Scenario 15 Conditions of the lower airway include bronchiolitis and asthma. Altered mental status, later. Most people think of hyperventilation as occurring when someone is having a heart attack, but in fact, hyperventilation can also occur during other types of emergencies. Question 10 Explanation: Disordered control of breathing is usually caused by neurological disorders in children. These guidelines represent the consensus recommendations of experts . Pals assessment is a way to measure how well a person is responding to CPR. As you may expect, outcomes are better if one can intervene during respiratory distress rather than respiratory failure. This respiratory condition can be managed with nebulized epinephrine and Respiratory distress/failure is divided into four main etiologies for the purposes of PALS:upper airway, lower airway, lung tissue disease, and disordered control of breathing. All subsequent shocks are 4 J/kg or greater. . In ventricular fibrillation or pulseless ventricular tachycardia, the hearts conduction system exhibits a disordered rhythm that can sometimes be corrected by applying energy to it. The maximum energy is 10 J/kg or the adult dose (200 J for biphasic, 360 J for monophasic). Posted on February 8, 2019 by Tom Wade MD. This can be caused by a variety of health problems such as asthma, heart disease, or lung cancer. 0 Hours 0 mins 0 secs. American Heart Association guidelines are updated every five years. PALS Core Case 4 Respiratory Disordered Control of Breathing | Pals It can also develop in other parts of the body, but it most commonly occurs in the lungs. Is there time to evaluate the child to identify and treat possible causes for the current illness? The first step for control and restoration of normal physiology is breathing retaining. Therefore, the patient should be moved to an intensive care unit. PALS Tachycardia Algorithm. After 2 min. Since the normal heart rate in children varies, the provider must take into account the normal values for the childs age. -Assessing the patients body temperature needed, supply oxygen as needed, and monitor respiratory status with pulse oximetry and ECG monitoring as indicated. Obtain a 12 lead ECG and provide supplemental oxygen. Neuromuscular diseases can be managed with non-invasive or invasive ventilatory The most common is a birth defect that makes an artery in the brain small, called an aneurysm. Today. Asthma is a chronic respiratory illness, caused by the airways hyper-responsiveness to outside air. There are four respiratory core cases, four core shock cases, and four core cardiac cases. Tachycardia is a slower than normal heart rate. No atrial impulses reach the ventricle. Consider transvenous or transthoracic pacing if available. Pediatric Advanced Life Support (PALS) Overview - Nurse Cheung Normal breathing rates vary by age and are shown in the table. PALS Study Guide. Recognize Respiratory Distress or Failure. Respiratory Distress Identification and Management Type of Respiratory Problem Possible Causes Upper Airway Anaphylaxis Croup Foreign body aspiration Lower Airway Asthma Bronchiolitis Lung Tissue Disorder Pneumonia . Rapid Differential Diagnosis of Cardiac Arrest. Directs assessment of airway, breathing, circulation, disability, and exposure, including vital signs Directs administration of 100% oxygen (or supplementary oxygen as needed to support oxygenation) . Nuts, seeds, and legumes (4-5 servings per week) Healthy fats and oils, including coconut oil, olive oil, grass-fed butter and ghee. and bronchodilators. Wide complex tachycardias are difficult to distinguish from ventricular tachycardia. Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children of their age. IV/IO (0.01 mg/kg). Since the normal heart rate in children varies, the provider must take into account the normal values for the childs age. The provider should look for and treat, at a minimum, hypothermia, hemorrhage, local and/or systemic infection, fractures, petechiae, bruising or hematoma. Note that asystole is also the rhythm one would expect from a person who has died. %PDF-1.6 % For example, bronchodilator inhalers are sufficient when treating mild asthma. If the tachycardia is causing a decreased level of consciousness, hypotension or shock, or significant chest pain, move directly to synchronized cardioversion. Interestingly enough, several studies indicate that certain compounds found in cinnamon tea could aid in the prevention of neurodegenerative disorders like Alzheimer's disease. If the tachycardia is not causing a decreased level of consciousness,hypotension or shock, or significant chest pain, you may attempt vagal maneuvers, first. What is disordered control of breathing? New foods? History of present illness Onset/time course. If the child is not hemodynamically stable then provide cardioversion immediately. Another way to test for stability and performance issues is to check for disk space. Conditions that cause disordered work of breathing include intracranial pressure, neuromuscular disease, and If the arrest rhythm is no longer shockable, move to PEA/Asystole algorithm. For example, a patient might have disordered control of breathing which was caused by a head injury and then develop pneumonia (a type of lung tissue disease). Watch. Rales or crackles often indicate fluid in the lower airway. Chest compressions/high-quality CPR should be interrupted as little as possible during resuscitation. It is critically important not to confuse true asystole with disconnected leads or an inappropriate gain setting on an in-hospital defibrillator. Again, it is important to determine if the tachycardia is narrow complex or wide complex. A pediatric patient can have more than a single cause of respiratory distress or failure. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. Pulseless electrical activity or PEA is a cardiac rhythm that does not create a palpable pulse is even though it should. The diaphragm is attached to the base of the sternum, the lower parts of the rib cage, and the spine. Shock, including hypovolemic, obstructive, . or IV depending on the severity, magnesium sulfate IV, IM epinephrine if the condition is severe or terbutaline SC Cardiac arrest results in a rapid loss of consciousness, and breathing may be . Another common type of lung tissue disease is emphysema. While in the state of disordered control of breathing, there is inadequate respiratory effort. Bradycardia and tachycardia that are interfering with circulation and causing a loss of consciousness should be treated as cardiac arrest or shock, rather than as a bradycardia or tachycardia. Chlorella; Biology, Composition and Benefits - BioGenesis Atrial contraction rates may exceed 300 bpm. During tachycardia, maintain the childs airway and monitor vital signs. A vagal maneuvers for an infant or small child is to place ice on the face for 15 to 20 seconds, Ocular pressure may injure the child and should be avoided, Adenosine: 0.1 mg/kg IV push to a max of 6 mg, followed by 0.2 mg/kg IV push to a max of 12 mg, Amiodarone: 5mg/kg over 20-60 min to a max of 300 mg. Authors J L Carroll 1 , C L Marcus, G M Loughlin. Here is the link to the 2006 PALS case studies. The person may also require oxygen to breathe. Here is the link to the2006 PALS case studies. However, some general tips to help manage respiratory distress include: -Evaluating the patients oxygen levels and airway function Primary Assessment follows ABCDE: Airway, Breathing, Circulation, Disability, Exposure. They also report feeling fewer feelings of anxiety, stress, and anger. PALS 2020 WORK. Guidelines for CPR and ECC. . May repeat every 3-5 minutes. When respiratory effort is not adequate, respiratory failure can occur without the usual signs of respiratory distress. Celebrity deaths 2022 - all the stars who have died this year Cooperative children can participate in a Valsalva maneuver by blowing through a narrow straw. You can detect spontaneous circulation by feeling a palpable pulse at the carotid or femoral artery in children and the brachial artery in infants up to 1 year. -Checking for any signs of infection Management of Respiratory Distress & Failure - PALS Handbook Snorers are reported to have more hypertension, and as many as 40% of hypertensive patients have sleep apnea.93,94 Stroke incidence is reported to be increased by 50% in heavy snorers. Pulseless Electrical Activity and Asystole. There is no one definitive answer to this question, as the best time to challenge the recognition of respiratory distress is based on the severity of the underlying condition and the patients ability to tolerate the condition. IntroductionBreathing must be tightly regulated so that the amount of oxygen inhaled and carbon dioxide exhaled matches precisely the metabolic needs of the body. Secondary Assessment and Diagnostic Tests. May or may not be fully patent in respiratory distress. The table below also includes changes proposed since the last AHA manual was published. PALS follows internationally accepted treatment guidelines developed using evidence-based practice. TwitterBob Saget, Louie Anderson, and Gilbert Gottfried are among the stars we have lost in 2022[/caption] Which celebrities have died in 2022? You may need to move to the cardiac arrest algorithm if the bradycardia persists despite interventions. Respiratory distress/failure is divided into four main etiologies for the purposes of PALS:upper airway, lower airway, lung tissue disease, and disordered control of breathing. Circulation 2010;122:S876-S908. +;z ftF09W dP>p8P. In its simplest form, respiratory distress is a condition in which pulmonary activity is insufficient to bring oxygen to and to remove carbon dioxide from the blood. The pulse may be irregularly irregular.. Asystole is the flatline on the ECG monitor. A child who has a pulse <60 BPM should be treated with CPR and according to the cardiac arrest algorithm. A unconscious child who is breathing effectively can be managed in the next steps of PALS, Evaluate-Identify-Intervene. Sinus tachycardia has many causes; the precise cause should be identified and treated. A QRS complex that is longer than 90 ms is wide QRS complex tachycardia. Sleep apnea can be life threatening in infants. What follows is from that dvd. hyperthermia, and avoid hypotension. Renal Diet Foods List and Eating Plan for Kidney Disease This course is designed for physicians, nurses, paramedics, operating room staff and any other medical professional requiring a PALS course completion card who prefers distance learning and self . Bronchiolitis can be managed by nasal suctioning Wide QRS complex tachycardia with good perfusion can be treated with amiodarone OR procainamide (not both). Proper bag mask technique requires a tight seal between the mask and the childs face. Flashcards - PALS Does the person need an advanced airway? Supraventricular tachycardia can be treated with 0.1 mg/kg adenosine IV push to a max of 6 mg. MedPreps | PALS Practice Test of high-quality CPR, give 0.01 mg/kg epinephrine IV/IO every 3 to 5 minutes (two 2 minute cycles of CPR). Challenge arises with the recognition of respiratory distress when the person appears to be breathing but is not actually breathing . When? If trauma, hypoxia, stroke, or any other form of injury affects this area, changes in respiratory function may occur. =qs;MwM5^D6MAU&Q endstream endobj 137 0 obj <>stream PALS Systematic Approach. 51w?!"LZqw/R -9BG.]/UI%94? . If the patient regains consciousness, move to ROSC algorithm. O y>3c@TY jsYedhz^kgIv53Ds4S`fzBEq$],Z4{,;}K,LAuRfD0 OEW-.k4'py]Yrz_2kK,^Opi;9.,)M'fAqHA 2h+d(?F 8|&OA!UQEzuu2a"oQb\SkT-c]OE@hC@2.eG$wBFAb%xYybcW (^`m / Frhyzc LeGlIN9e4AGr'_"$%Z\oA` Ra;O{i]"3"/k+NFk`;1$6YQioX#j0&'l_lsV[av?fT5!*3E&GP!yueVXLu){ OUwq`hFr beqE:exj=M?y`s~cPVpHJ>0s4st`%h6p : PALS "Identify" step in their assessment process includes identication of four types of circulatory problems. The AHA recommends establishing a Team Leader and several Team Members. Pediatric Advanced Life Support (PALS) iCertify Telehealth Training PALS Megacode 7 Out-of-Hospital Hurry, don't let time run out! There may be problems with sensation, vision, hearing, and speaking. Version control: Our ACLS, PALS & BLS courses follow 2020 American Heart Association In the current guidelines, the clinician must fully evaluate the child with febrile illness since aggressive fluid resuscitation with isotonic crystalloid solution may not be indicated. Patients in a palsystematic approach typically have better mental health outcomes than patients in other types of therapy. PALS Case Scenario Testing Checklist Respiratory Case Scenario Disordered Control of Breathing Student Name _____ Date of Test _____ Critical Performance Steps if done correctly Team Leader Assigns team member roles Uses effective communication throughout Patient Management Directs assessment of airway, breathing, circulation, disability, and exposure, including vital signs Directs . Nov 3, 2015 - PALS Core Case 4 Respiratory Disordered Control of Breathing. What are your initial actions? If adenosine is unsuccessful, proceed to synchronized cardioversion. Pediatric Advanced Life Support - PALS Core Testing Case Scenario 16 Positioning . After Spontaneous Return of Circulation (ROSC), use the evaluateidentifyintervene sequence. Is the child conscious? The child is still in a delicate condition. Also, apply quantitative waveform capnography, if available. One-person rescuer is 30 chest compressions to 2 breaths. The primary assessment reveals that the airway is open and the respiratory rate is 30/min, with crackles heard on auscultation. Atrioventricular (Heart) Block. Atropine for emergency tracheal intubation, Routine premedication prior to intubation, Begin CPR if the victim is unresponsive, pulseless, and not (effectively) breathing, Look, listen and feel plus two rescue breaths, High Quality CPR when possible, Complete recoil between compressions, rotate providers every 2 min, High quality CPR and/or defibrillation take priority over venous access, advanced airways, or drugs, Appropriate, normal activity for the childs age and usual status, Responds only to pain U Unresponsive Does not respond to stimuli, even pain, Spontaneously To verbal command To pain None, Oriented and talking Confused but talking Inappropriate words Sounds only None, Cooing and babbling Crying and irritable Crying with pain only Moaning with pain only None, Obeys commands Localizes with pain Flexion and withdrawal Abnormal flexion Abnormal extension None, Spontaneous movement Withdraws when touched Withdraws with pain Abnormal flexion Abnormal extension None, Fever Decreased intake Vomiting/Diarrhea Bleeding Shortness of breath Altered mental status Fussiness/Agitation, Medication allergy Environmental allergy Food allergy. Cerebral palsy - Wikipedia Acute respiratory distress syndrome is inflammation of the lung parenchyma causing difficulty in breathing, hypoxemia and multiple organ failure. PALS Respiratory Core Case 4 - Disordered Control Of Breathing Remember, chest compressions are a means of artificial circulation, which should deliver the epinephrine to the heart. PALS Post Test Questions And Answers 2022/2023 Latest Update/ Download Respiratory Distress And Failure | American Health Care Academy Complete dissociation between P waves and the QRS complex. 6. After reaching the bones interior, do not aspirate and immediately flush with 5 ml of fluid. ~`LOvB~fn 'Hw7|?b5/,F;w193w.X?iS#UmW]~*K'TIww>6]5 ,=J 6M0%As,y=zSDy`*87k2o,-nqCT,-&B+\> -Assessing the patients response to rest, medication and other treatments Another way to test for stability and performance issues is to check for BIOS and drivers. Managing respiratory emergencies for pediatrics depends on the condition. PALS : Respiratory - Recognize - SaveaLife.com If the patient regains circulation, move to ROSC algorithm. Identify and treat causes (Hs and Ts). Slightly dry buccal mucosa, increased thirst, slightly decreased urine output, Dry buccal mucosa, tachycardia, little or no urine output, lethargy, sunken eyes and fontanelles, loss of skin turgor, Same as moderate plus a rapid, thready pulse; no tears; cyanosis; rapid breathing; delayed capillary refill; hypotension; mottled skin; coma, Fluid resuscitation, packed red blood cells, Fluid resuscitation, pressors, expert consult, Fluid resuscitation, fibrinolytics, expert consult, 3 ml of crystalloid for each ml blood lost, Titrate oxygen to maintain O2 sat: 94%-99%, Pulse oximetry, pO2, resp. Bradycardia is a slower than normal heart rate. Follow along as we take an opportunity to honor some of the iconic figures who are no longer with us. If the wide QRS complex has a regular rhythm, then you can supply synchronized cardioversion at 100 J. Evaluate-Identify-Intervene. The PALS systematic assessment starts with a quick, first impression. The evaluation of breathing include several signs including breathing rate, breathing effort, motion of the chest and abdomen, breath sounds, and blood oxygenation levels. Ventricular Fibrillation and Pulseless Ventricular Tachycardia. r~{~pc]W u5}/ Acute malfunction of breathing control mechanisms, even for a few seconds, may lead rapidly to serious physiologic derangements, with death as the final outcome if the system fails to recover. Identifies signs of disordered control of breathing Categorizes as respiratory distress or failure Wide QRS complex is irregular, this is ventricular tachycardia and should be treated with unsynchronized cardioversion (i.e. PALS algorithms for 2021. Second degree atrioventricular block, Mobitz type I (Wenckebach), Second degree atrioventricular block, Mobitz type II, Third degree (complete) atrioventricular block. . An algorithm for obtaining IO access in the proximal tibia is shown. Cardiac function can only be recovered in PEA or asystole through the administration of medications. If not, monitor and move to supportive measures. On the basis of this . Diminished breath sounds, grunting, crackles, Pale, cool, and clammy in respiratory distress Decompensates rapidly to cyanosis as respiratory failure ensues, Agitation in respiratory distress Decompensates rapidly to decreased mentation, lethargy, and LOC as respiratory failure ensues, Increased in respiratory distress Decompensates rapidly in respiratory failure, Epinephrine Albuterol nebulizer Watch for and treat airway compromise, advanced airway as needed Watch for and treat shock, Humidified oxygen Dexamethasone Nebulized epinephrine for moderate to severe croup Keep O2 sat >90%, advanced airway as needed, Nebulized epinephrine or albuterol Keep O2 sat >90%, advanced airway or non-invasive positive pressure ventilation as needed Corticosteroids PO or IV as needed Nebulized ipratropium Magnesium sulfate slow IV (moderate to severe asthma) Terbutaline SQ or IV (impending respiratory failure), Oral and nasal suctioning Keep O2 sat >90%, advanced airway as needed Nebulized epinephrine or albuterol, Empiric antibiotics and narrow antibiotic spectrum based on culture results Nebulized albuterol for wheezing Reduce the work of breathing and metabolic demand Keep O2 sat >90%, advanced airway as needed Continuous positive airway pressure (CPAP), Reduce the work of breathing and metabolic demand Keep O2 sat >90%, advanced airway as needed Diuretics if cardiogenic CPAP, Pediatric neurological/neurosurgery consult Hyperventilation as directed Use medications (e.g., mannitol) as directed, Identify and treat underlying disease CPAP or ETT and mechanical ventilation as needed, Identify toxin/poison Call Poison Control: 1.800.222.1222 Administer antidote/anti-venom when possible Maintain patent airway, advanced airway as needed Provide suctioning, ICalcium chloride, sodium bicarb, insulin/glucose, hemodialysis, Slow heart rate, narrow QRS complex, acute dyspnea, history of chest trauma, Variable, prolonged QT interval, neuro deficits, ST segment elevation/depression, abnormal T waves, Supplemental O2 via face mask/non-rebreather, Normalizing electrolyte and metabolic disturbances, Vomiting/Diarrhea Hemorrhage DKA Burns Poor Fluid Intake, Congenital Heart Dz Poisoning Myocarditis Cardiomyopathy Arrhythmia, Cardiac Tamponade Tension Pneumo Congenital Heart Dz Pulmonary Embolus, May be normal (compensated), but soon compromised without intervention. The chest may show labored movement (e.g., using the chest accessory muscles), asymmetrical movement, or no movement at all. Narrow QRS complex tachycardias include several different tachyarrhythmias. If the child is aspirating on a foreign body, attempt to clear the Titrate the patients blood oxygen to between 94% and 99%. Intracranial pressure is a complication from trauma or disease process that affects the There are four respiratory core cases, four core shock cases, and four core cardiac cases. If you have previously certified in pediatric advanced life support, then you will probably be most interested in what has changed since the latest update in 2015. is a member of the Chlorophyceae class under the Chlorophyta division (Imelda et al., 2018). Chest compression should be 1/3 the AP diameter of the chest. If the arrest rhythm becomes shockable, move to VFib/Pulseless VTach algorithm. PMID: 8493182 DOI: 10.1542 . SINCE 2022 began, many famous names have passed away for a multitude of reasons. X9!B4lvrV{9z;&kYZ_\ksPSDtBGZ; oZZmyDcz"$ Resuscitation demands mutual respect, knowledge sharing, and constructive criticism, after the code. A blocked airway would usually requires a basic or advanced airway. One way to test for stability and performance issues is to run a system check on your computer. Another common condition is a tumor in the brain, which can cause a narrowing of the arteries that carry blood to the brain. The patient's circumstances and situation must be taken into account for a more . An anaphylaxis reaction requires immediate IM epinephrine, preferably with an auto-injector, A QRS complex that is longer than 90 ms is wide QRS complex tachycardia. Check for stability and performance issues. Pals assessment can help to identify any issues that may be causing the person to be unresponsive and therefore CPR may not be the best option to provide. Diminished breath sounds; Tachycardia; Hypoxemia (despite the administration of supplementary O2; Disordered Control of Breathing. This does not include alveolar collapse. In most pediatric cases, however, respiratory failure, shock, and even ventricular arrhythmia are preceded by a milder form of cardiovascular compromise. If bradycardia interferes with tissue perfusion, maintain the childs airway and monitor vital signs. =BYPWKX2pNA,Vl0T0xhP@VOr"ab It is important to determine if the tachycardia is narrow complex or wide complex. Nov 3, 2015 - PALS Core Case 4 Respiratory Disordered Control of Breathing. This can identify any updated or installed software that may be causing problems. For example, if someone is having a seizure, they may hyperventilate. If one of these conditions is present, the child is more likely to experience vein disease. torsade de pointes) or pulseless ventricular tachycardia. If the ECG device is optimized and is functioning properly, a flatline rhythm is diagnosed as asystole. It represents a lack of electrical activity in the heart. PDF PALS Pulseless Arrest Algorithm. - cpr4uflorida.com Disordered control of breathing; Respiratory issues often do not occur in isolation. Rapidly assess disability using the AVPU paradigm: Alert, Verbal, Pain, Unresponsive. Along with supporting the airway, it is crucial to avoid hypoxemia, avoid hypercarbia, avoid

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