Neonatal/Pediatric Cardiopulmonary Care

I. Define and describe all aspects of mechanical ventilation of the neonatal and
pediatric patient including the following: (C5, C6, C7, F1, F2, F5, F8, F11)
A. Volume and pressure control ventilation
B. Indications for ventilatory support
C. Modes of ventilation
D. Setting initial ventilator parameters
E. Monitoring mechanical ventilation
F. Hazards & complications
G. Weaning mechanical ventilation
II. Describe and explain the process of sampling, analysis, and interpretation of
arterial, capillary blood along with cardiovascular monitoring (C5, C6, C7, F1, F2, F5,
F8, F11).
A. Describe indications, complications, and procedure used to obtain various
blood gas samples.
B. Interpret a complete hemodynamic profile including blood gas information
of a patient.
C. Illustrate and describe the different catheters and measurements used for
cardiovascular monitoring.
D.
III. Explain and understand the noninvasive monitoring available in the neonatal and
pediatric realm. Review and interpret basic radiographic results in the neonatal and
pediatric realm. (C5, C6, C7, F1, F2, F5, F8, F11).
A. Describe the principles of operation, application, and disadvantages of
pulse oximetry.
B. Describe the principles of operation, application and disadvantages of
transcutaneous monitoring.
C. Describe the principles of operation of capnometry. Interpret various
capnograms and detect and correct ventilation problems.
D. Describe the principles of operation, application, and disadvantages of
impedance pneumography.
IV. Describe and explain ways to establish and maintain a patent airway to include
manual ventilation for neonatal and pediatric patients. (C5, C6, C7, F1, F2, F5, F8, F11).
A. Identify the indications, procedure, and complications of artificial airway
access.
B. Describe and explain the procedure for suctioning in the neonatal and
pediatric patient.
C. Identify the criteria and procedure for extubation and decannulation.
D. Describe and explain the process of manual ventilation for a neonatal and
pediatric patient
V. Describe the use of high frequency ventilation. (C5, C6, C7, F1, F2, F5, F8, F11).
A. Describe the types of HFV.
B. Describe the advantages of using HFV.
C. Describe the indications, clinical uses and hazards of HFV.
D. Define and describe the ventilators associated with HFV
E. Describe indications for HFV
F. Explain initial settings and adjustments for the most common types of
HFV
G. Explain monitoring and adjustments made during HFV.
H. Describe indications and complications of weaning HFV
VI. Define and describe all aspects of radiographic interpretation, continuous positive
airway pressure and non-invasive ventilation including the following: (C5, C6, C7, F1,
F2, F5, F8, F11)
A. Determine placements of lines and tubes on radiographic imaging
B. Identify differential diagnostic findings on radiographic imaging for
different neonatal and pediatric processes/diseases
C. Indications and uses
D. Types of devices
E. Types of interfaces
F. Complications
G. Contraindications
H. Hazards
VII. Identify and explain the embryologic development of the pulmonary system (C5,
C6, C7, F1, F2, F5, F8, F11).
A. Identify the five periods of embryonic lung growth and describe the
features of each period.
B. Explain/describe roles of surfactant and application to alveolar mechanics.
C. Describe the role and function of fetal lung fluid.
D. Explain the function of amniotic fluid.
VIII. Identify and explain the embryologic development of the cardiovascular system
and the changes that occur after birth (C5, C6, C7, F1, F2, F5, F8, F11).
A. Describe the embryologic development of the heart.
B. Describe and explain fetal circulation and the three fetal shunts that are
encountered.
C. Identify the anatomical structures of the placenta and umbilical cord.
D. Review and describe the physiological changes that occur to fetal
circulation during the first breath of life and post delivery.
IX. Explain and describe the essentials of antenatal assessment and management of
high-risk conditions with pre-term through post-term delivery (C5, C6, C7, F1,
F2, F5, F8, F11).
A. Identify various high-risk conditions and their adverse effects on
pregnancy.
B. Describe current methods used for antenatal and intrapartum assessment
of fetal well being.
C. Explain preterm labor and post term pregnancy evaluation and
management.
D. Recommend techniques for taking care of the newborn during the neonatal
period.
X. Identify and distinguish the significant information that can be found while
assessing a neonatal infant and pediatric patient (C5, C6, C7, F1, F2, F5, F8, F11).
A. Determine approximate gestational age using physical assessment
findings.
B. Explain normal and abnormal findings during the assessment of a neonatal
infant.
C. Differentiate laboratory values and their significance in the overall
determination of assessment of a neonate.
D. Identify and use historical and physical findings to develop a differential
diagnosis of a child’s respiratory condition.
E. Determine the severity of a child’s respiratory condition.
F. Assist in planning and executing evaluation and management.
XI. Extend the knowledge of basic respiratory care procedures as it pertains to the
neonatal and pediatric realm. (C5, C6, C7, F1, F2, F5, F8, F11)
A. Describe indications, complications, and hazards of oxygen therapy
including the role of oxygen delivery devices.
B. Discuss the advantages and disadvantages of SVN, MDI and DPI therapy.
C. Describe the indications, contraindications and techniques used in airway
clearance therapy.
XII. Extend the knowledge of basic respiratory pharmacology with the most
commonly used medications for the neonatal and pediatric realm. (C5, C6, C7,
F1, F2, F5, F8, F11)
A. Define and describe the most common medications in the following
categories including the names, indications, and clinical use:
1. Sympathomimetic
2. Parasympatholytic
3. Xanthines
4. Mucolytics
5. Anti-asthmatic agents
6. Corticosteroids (inhaled and systemic)
7. Aerosolized antibiotics
8. Antiviral agent
9. Magnesium Sulfate & Ketamine
XIII. Describe and discuss the different neonatal and pediatric disorders and
complications of respiratory care. (C5, C6, C7, F1, F2, F5, F8, F11)
A. Describe the pathophysiology, diagnosis, clinical signs, and treatment of
the following disorders:
1. RDS
2. BPD
3. TTN
4. RSV
5. Air Leak Syndrome
6. Neonatal apnea
7. Meconium Aspiration Syndrome
8. Foreign Body Aspiration
9. CDH
10. Choanal Atresia
11. TE Fistula
12. Abdominal Wall Defects
13. Epiglottitis
14. Croup
XIV. For each of the following cardiac anomalies, identify the defect and describe the
diagnosis and treatment(C5, C6, C7, F1, F2, F5, F8, F11).
A. Patent ductus arteriosus (PPHN), (L-R shunt)
B. Tetralogy of Fallot
C. Coarctation of the Aorta (pre-ductal), (post-ductal)
D. Complete Transposition of the great vessels
E. Atrial septal defect
F. Ventricular septal defect