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Intervene!
Shock
Vitals
Meds
Cases
100
Your 20kg patient is in v-fib how many joules is your initial shock?
40 joules
100

What vital signs indicates if a patient has uncompensated shock?

Heart Rate and Blood Pressure

100

Your patient's HR drops to 80/min with RR of 6/min. How many rescue breaths should you provide per min?

20-30/min

100

What type of medicine should be an early intervention to a patient with septic shock?

Fluids and antibiotics

100

A young child is brought to the ER after a seizure. The child has slow, irregular respirations. What do you think is happening to his breathing and how would you intervene?

Disordered Control of Breathing. Reposition Airway, O2 if needed.

200

Your 9 year old patient's heart rate is 190 and their blood pressure is 70/45. You cannot feel a pulse. The tracing shows SVT. What intervention is indicated?

Synchronized cardioversion

200
Your 6 yr old hypovolemic shock patient has a blood pressure of 88/65 and cap refill of 4 seconds. Are they still in shock, if so, what kind?
Yes, compensated
200
What is the ideal range for oxygen saturation for a child after cardiac arrest?
94%-99%
200

If your patient is in hypovolemic shock, what is the best intervention?

Bolus of 10-20mL/kg

200
A child has 2 day history of lethargy and polyuria with new onset rapid, deep breathing. What diagnostic test should be ordered first?
Glucose
300

Your 8 year old patient has a heart rate of 45, a respiratory rate of 6/min, O2 sat is 60% and they are cyanotic. What action should you take next?

Provide bag mask ventilation with 100% oxygen.

300

Your patient is lethargic with retractions and nasal flaring. RR of 70. Her O2sat drops to 88%. What is the medical term for this life-threatening condition? 

Respiratory failure

300

Which of these findings is normal for a 2 year old patient? A: BP 57/32; B: HR 220; C: O2 sat of 90% D: RR of 24/min

D: RR of 24/min

300

You are intubating a 2 month old child and suddenly the HR drops to 85. What medication could have been given to prevent bradycardia? 

Atropine

300
12 month old child presents with nasal congestion, cough and fever for 2 days. On exam: HR 140, RR 45, BP 75/60, Temp 38.0, Sat 93%. She has retractions, nasal flaring and crackles in bilateral lungs. What do you think she has? What interventions can you try?
Bronchiolitis. Try suctioning, may need O2 if desats. If signs of impending respiratory failure, may need to increase support to Heated High Flow Nasal cannula or positive pressure ventilation.
400

Your 7 year old patient is SOB with fever, cough and stridor. Lungs are clear. What is the likely cause of this child's respiratory distress and what is the treatment?

Upper airway obstruction, likely croup. Keep the child as calm as possible. Give nebulized racemic epinephrine

400

13 year old has a fever, HR 118, RR rate of 36. Lactic acid is elevated. Which type of shock does she most likely have?

Distributive, Septic shock. 

400

10 year child has the following findings. Which one is normal? a. BP 60/30 b. Temp of 103 c. HR of 90 d. RR of 8

C. HR of 90

400
What is PEA and what is the first med and dose?
Any organized rhythm without a pulse and Epi 0.01mg/kg
400
You respond to an infant who is unresponsive and not breathing with no pulse. You shout for help but no one arrives. What action should you take next?
Begin CPR for 2 minutes before leaving to activate emergency response system
500

Which condition in a child should IO access most likely be attempted before vascular access? a. Cardiogenic shock b. Non-hemorrhagic shock c. Obstructive shock d. Cardiac Arrest

Cardiac Arrest

500

A 9 year old child was involved in an MVA. There is significant left femur deformity. Vital signs are HR 135, RR 22, BP 90/70, Sat 99%. Point-of-care Hg is 8.6. What kind of shock does this represent? 

Hemorrhagic shock. 

Extra credit! What is your intervention? 

500

What is a good rule of thumb for calculating goal blood pressure in neonates?

MAP = Gestational Age

500

6 year old boy who presents with chest pain and palpitations. HR 266, BP 90/60, Temp 36.8, RR 22. He seems uncomfortable but he has a pulse and has good perfusion. What is your intervention? 

Start with vagal maneuvers. Then adenosine (can give multiple doses). After that, procainamide in consultation with Cardiology.

500
You have 4 children you are caring for. Which 3 year old child requires your immediate intervention? a. Child who is grunting b. child with Sat of 95% c. SBP of 92 d. Child has temp of 99.3
a. Child who is grunting