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Sinus tachycardia - correct answers Sinus bradycardia - correct answers Supraventricular tachycardia - correct answers Asystole - correct answers Wide-complex tachycardia - correct answers Ventricular fibrillation with successful defibrillation and resumption of organized rhythm - correct answers Sinus bradycardia - correct answers Pulseless electrical activity - correct answers Torsades de pointes - correct answers Ventricular fibrillation - correct answers Wide-complex tachycardia - correct answers
SVT converting to sinus rhythm after adenosine administration - correct answers Normal sinus - correct answers In asystole, what is the effect of epi? - correct answers stimulate spontaneous contractions Routine administration of calcium chloride (is/is not) indicated in pediatric patients during cardiac arrest - correct answers is not A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal flaring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged expiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His SpO2 is 92%. What medication do you prepare to give to this patient? - correct answers albuterol You are part of a team attempting to resuscitate a child with vfib cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of epi, 0.01mg/kg IO. At the next rhythm check, persistent vfib is present. You administer a 4 J/kg shock and resume CPR. What should be administered next? - correct answers amiodarone 5mg/kg IO What oxygen delivery system most reliably delivers a high (≥90%) concentration of inspired oxygen to a 7-year-old child? - correct answers nonrebreathing face mask
Initial impression of a 2-year-old girl shows her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her SpO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. What is the most appropriate initial intervention for this child? - correct answers humidified oxygen as tolerated You are caring for a 3-year-old with vomiting and diarrhea. You have established IV access. The child's pulses are palpable, but faint, and the child is now lethargic. The HR is variable (range: 44-62 bpm). You begin bag-mask ventilation with 100% oxygen. When the HR does not improve, you begin chest compressions. The rhythm shown here is seen on the cardiac monitor. What would be the most appropriate therapy to consider next? - correct answers transcutaneous pacing A 4-year-old boy is in pulseless arrest in the pediatric ICU. High-quality CPR is in progress. You quickly review his chart and find that this baseline-corrected QTI on a 12 - lead EKG is prolonged. The monitor shows recurrent episodes of the rhythm shown here. The has received 1 dose of epi 0.01mg/kg, but the rhythm shown here continues. If this rhythm persists at the next rhythm check, what medication would be most appropriate to administer at that time? - correct answers MgSO4 25-50 mg/kg IV You and another rescuer begin CPR. Your colleague begins compressions, and you notice that the compression rate is too low. What should you say to offer constructive feedback? - correct answers 'You need to compress at a rate of 100-120/min' You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A colleague responded to your shout for help and is activating the emergency response system and is retrieving the resuscitation equipment, including a defibrillator. After delivering 30 compressions, what would be your next action? - correct answers one the airway with a head tilt-chin lift maneuver and give 2 breaths
An 18-month-old child has a 1-week history of cough and runny nose. The child has diffuse cyanosis and is responsive only to painful stimulation with slow respirations and rapid central pulses. The child's RR has decreased from 65 bpm to 10 bpm, severe inspiratory intercostal retractions are present, HR is 160 bpm, SpO2 is 65% on room air, and capillary refill is <2secs. What is the most appropriate immediate interventions for this toddler? - correct answers open the airway and provide positive-pressure ventilation using 100% oxygen and a bag-mask device A child becomes unresponsive in the ED and is not breathing. You are uncertain if a faint pulse is present. You shout for help and provide ventilation with 100% oxygen. The rhythm shown here is seen on the cardiac monitor. What is your next action? - correct answers start high-quality CPR During bag-mask ventilation, how should you hold the mask to make an effective seal between the child's face and mask? - correct answers position your fingers using the E-C clamp technique How can rescuers ensure that they are providing effective breaths when using a bag- mask device? - correct answers observing the chest rise with each breath You just assisted with the elective ET intubation of a child with respiratory failure and a perfusing rhythm. What method provides a reliable, prompt assessment of correct ET tube placement in this child? - correct answers adequate bilateral breath sounds and chest expansion + detection of ETCO2 with waveform capnopgraphy What compression-to-ventilation ration should be used for 2-rescuer infant CPR? - correct answers 15 compressions to 2 breaths
An 8-month-old infant is brought to the ED for evaluation of severe diarrhea and dehydration. On arrival to the ED, the infant becomes unresponsive, apneic, and pulseless. You should for help and start CPR. Another provider arrives, at which point you switch to 2-rescuer CPR. The rhythm shown here is seen on the cardiac monitor. The infant is intubated and ventilated with 100% oxygen. An IO line is established, and a dose of epi is given. While continuing high-quality CPR, what do you do next? - correct answers give NS 20mL/kg IO rapidly You need to provide rescue breaths to a child victim with a pulse. What is the appropriate rate for delivering breaths? - correct answers 1 breath q3-5 secs What ratio of compressions to breaths should be used for 1-rescuer child CPR? - correct answers 30 compressions to 2 breaths A pale and very sleepy but arousable 3-year-old child with a history of diarrhea is brought to the hospital. Primary assessment reveals a RR of 45 bpm with good breath sounds bilaterally. HR is 150 bpm, BP is 90/64 mmHg, and SpO2 is 92% on room air. Capillary refill is 5 secs and peripheral pulses are weak. After placing the child on a nonrebreathing face mask (10-L/min flow) with 100% oxygen and obtaining vascular access, what is the most appropriate immediate treatment for this child? - correct answers bolus of 20mL/kg isotonic crystalloid A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is intubated, and vascular access is established. The EKG monitor shows an organized rhythm with a HR of 45 bpm, but a pulse check reveals no palpable pulse. High-quality CPR is resumed, and an initial IV dose of epi is administered. What intervention should you perform next? - correct answers identify and treat reversible causes
You are caring for a 6-year-old patient who is receiving positive-pressure mechanical ventilation via an ET tube. The child begins to move his head and suddenly becomes cyanotic, and his HR decreases. His SpO2 is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation with a bag via the ET tube. During manual ventilation with 100% oxygen, the child's color and HR improve slightly but his BP remains inadequate. Breath sounds and chest expansion are present and adequate on the R side and are present but consistently diminished on the L side. The trachea is not deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the ET tube. What is the most likely cause of this child's acute deterioration? - correct answers tracheal tube displacement into the R main bronchus A 1-year-old boy is brought to the ED for evaluation of poor feeding, irritability, and sweating. The child is lethargic but arousable. He has labored breathing, very rapid pulses, and a dusky color. His RR is 68 bpm, HR 300 bpm, and BP 70/45 mmHg. He has weak brachial pulses and absent radial pulses, a capillary refill of 6 secs, SpO2 85% on room air, and good bilateral breath sounds. You administer high-flow oxygen and place the child on a cardiac monitor and see the rhythm shown here. The child has no history of congenital heart disease. IV access has been established. What therapy is most appropriate for this child? - correct answers adenosine 0.1mg/kg IV rapid push A 3-year-old boy presents with multiple-system trauma. The child was an unrestrained passenger in a high-speed MVC. On primary assessment, he is unresponsive to voice or painful stimulation. His RR is 5 bpm, HR and pulses are 170 bpm, SBP is 60 mmHg, capillary refill is 5 secs, and SpO2 is 75% on room air. What action should you take first? - correct answers while a colleague provides spinal motion restriction, open the airway with a jaw thrust and provide bag-mask ventilation Why is allowing complete chest recoil important when performing high-quality CPR? - correct answers the heart will refill with blood between compressions
A 3-year-old unresponsive, apneic child is brought to the ED. EMS personnel report that the child became unresponsive as they arrived at the hospital. The child is receiving CPR with bag-mask ventilation. The rhythm shown here is on the cardiac monitor. A biphasic manual defibrillator is present. You quickly use the length from head to hell of the child on a color-coded length-based resuscitation tape to estimate the approximate weight as 15kg. What therapy is most appropriate for this child at this time? - correct answers attempt defibrillation at 30J, and then resume CPR, beginning with compressions
