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Neonatal and Pediatric Cardiovascular Crises

Warren G. Guntheroth, MD
JAMA. 1975;232(2):168-171. doi:10.1001/jama.1975.03250020042026.
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CRISES of the cardiovascular system in the pediatric age group occur most often in the infant, whose size makes monitoring blood pressure difficult and the dosage of fluids and medications critical. Therefore, some general comments about monitoring and drug dosage may serve well as an introduction to the critical care of infants and children.

Blood Pressure Determination  The blood pressure determination is crucial to the diagnosis as well as to the treatment of circulatory shock. No matter whether auscultation or ultrasonic or other electronic methods are employed, the cuff size is of enormous significance. A cuff that is too small will indicate systolic pressures higher than the true value of the intra-arterial pressure, and a cuff too large will produce readings that may suggest shock in the presence of a normal circulatory state.The width of the air bladder in the cuff should be 20% to 25% wider than the


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