CPR
You are using a bag-valve-mask to resuscitate an infant, while another rescuer is performing chest compressions. What is the correct ratio of chest compressions to ventilations?
15 chest compressions to 2 ventilations
Rationale: The AHA suggests that during a pediatric resuscitation with two or more rescuers present, the correct ratio of chest compressions to ventilations is 15:2.
PALS Epinephrine dosage
0.01 mg / kg Repeat every 3-5 minutes
Neonate Awake Heart Rate
100-205 BPM
You are doing CPR on a child with symptomatic bradycardia. An intravenous line is in place. What is the first drug of choice for the patient?
Epinephrine
Rationale: If oxygenation and ventilation fail to correct symptomatic bradycardia in a child, epinephrine should be given. While atropine is the recommended initial treatment choice for symptomatic bradycardia in adults, in children it is a secondary choice. Atropine is the initial treatment in children with AV block due to primary bradycardia, however.
Clinical signs of respiratory distress may include all of the following EXCEPT:
A) Rapid respiratory rate
B) Grunting respirations
C) Warm, pink skin
D) Diminished level of consciousness
C) Warm, pink skin
Rationale: Grunting respirations, rapid respiratory rate, and a diminished level of consciousness are signs of respiratory compromise. Warm, pink skin would not normally occur during the course of respiratory distress.
A 7-month-old appears to be unconscious and not breathing. You check for a pulse at the ________ artery.
Brachial
Rationale: Rescuers should use the brachial artery in the upper arm to check for a pulse. The artery is easily palpable in infants and young children.
PALS Synchronized Cardioversion Dose
0.5-1 J/kg, then 2 J/kg
Neonate Sleeping Heart Rate
90-160 BPM
Narrow-complex supraventricular tachycardia is best treated with:
Adenosine
Rationale: The main drug treatment for narrow QRS complex SVT is adenosine. The other drugs are used in ACLS under different circumstances.
The goal of the PALS team in the treatment of shock is to:
A) Improve oxygen delivery
B) Prevent organ injury
C) Stop the progression to cardiopulmonary failure
D) All of the above
All of the above
Rationale: These are all important goals of shock management in children. Untreated shock may lead to cardiopulmonary failure, decreased blood perfusion, decreased oxygen delivery to the tissues, and organ damage.
High-quality CPR for young children includes:
A) Compress to a depth of at least one-third of the child's chest diameter
B) Compress at a rate between 100 and 120 compressions per minute
C) Minimize interruptions to chest compressions
D) All of the above
All of the above
Rationale: All of the features listed reflect high-quality CPR for pediatric patients.
Bradycardia - PALS
Atropine
IV/IO 0.02 mg/kg
May repeat once
Minimum dose: 0.1 mg
Maximum dose: 0.5 mg
Infant normal respiratory rate
30-53 breaths/min
Anti-arrhythmic infusions of stable wide QRS tachycardia (adult)
procainamide.
amiodarone
sotalol
A victim probably has a neck injury. What is the correct way to open the airway?
Jaw thrust
Rationale: A head tilt-chin lift is effective in opening the patient's airway, but may put stress on an unstable cervical spine. In a suspected neck injury, a jaw thrust without bending the victim's neck is preferable.
which of the following victims needs CPR?
A. a victim w/ a pulse who is having trouble breathing
B. a victim w/ chest pain and indigestion
C. a victim who is unresponsive w/ no breathing (or no normal breathing) and no pulse
D. a victim who is unresponsive but is breathing adequately
C. a victim who is unresponsive w/ no breathing (or no normal breathing) and no pulse
Tachycardia - PALS
Adenosine
IV/IO First Dose: 0.1 mg/kg rapid bolus (max dose: 6 mg)
Second Dose: 0.2 mg/kg rapid bolus (max dose: 12 mg)
Neonate (96h) mean arterial pressure
45-60 mmHg
which drug and dose is recommended for the management of refractory v fib.
amioderone 300 mg. bolus
second dose: 150mg
What rate is an adult patient in respiratory arrest with a pulse is ventilated via bag valve mask?
10 to 12 times per minute.
Rationale: When there is no advanced airway in place, ventilations should be given 10 to 12 times per minute. This translates to one ventilation every 5 to 6 seconds.
After activating the emergency response system and sending someone to get the AED, you should
A. wait for the AED to arrive
B. check for a carotid pulse
C. begin rescue breathing
D. start chest compression
B. check for a carotid pulse
Bradycardia - Dopamine
IV infusion
5-20 mcg/kg per minute
Titrate to patient response; taper slowly
Adolecent normal respiratory rate
12-20 breaths/min
What is the maximum total dose of atropine for adult?
3 mg total
The most common reversible causes of PEA are called the "H's and T's" and include all of the following EXCEPT:
A) Hypovolemia
B) Hypoxia
C) Hypocalcemia
D) Tamponade
Hypocalcemia
Rationale: Hypocalcemia is not a common cause of PEA, nor is it part of the H's and T's mnemonic.