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. 7 & A.& 0
Identify the rhythm. ANS >> Ventricular Fibrillation (VF) Identify the rhythm . ANS >> Normal Sinus Rhythm Identify the rhythm. ANS > VF with successful defibrillation and resumption of organized rhythm Identify the rhythm. ANS >> SVT converting to sinus rhythm after adenosine administration Identify the rhythm Identify the rhythm. Identify the rhythm. Identify the rhythm. Identify the rhythm. Identify the rhythm. Identify the rhythm. . ANS >> ANS >> ANS >> ANS >> ANS >> ANS >> ANS >> Torsades de pointes Supreaventricular Tachycardia (SVT) Sinus Tachycardia Sinus Bradycardis Asystole Wide-Complex Tachycardia Pulseless Electrical Activity Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients? ANs>> It is the least desirable route of administration Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7-year-old child? ANs>> Nonrebreathing face mask Paramedics are called to the home of a 1-year-old child. Their initial assessment reveals a child who responds only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen, abdominal distention, and cyanosis. Bag- mask ventilation with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74 mm Hg. Which intervention should be provided next? ANS >> Rapid bolus of 20 mL/kg of isotonic crystalloid A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency department by her parents. During your assessment, you find that the infant responds only to painful stimulation. The infant's respiratory rate is 40 breaths per minute, and central pulses are rapid and weak. The infant has good bilateral breath sounds, cool extremities, and a capillary refill time of more than 5 seconds. The infant's blood pressure is 85/65 mm Hg, and glucose is 30 mg/dL (1.65 mol/L). You administer 100% oxygen via face mask and start an IV. Which treatment is the most appropriate for this infant? ANs >> 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 Sp02 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. Which is the most appropriate initial intervention for this child? ANs>> Humidified oxygen as tolerated Which statement is correct about the use of calcium chloride in pediatric patients? ANsS>> Routine administration is not indicated during cardiac arrest You find a 10-year-old boy to be unresponsive. You shout for help, and after finding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response system, brings the emergency equipment, and places the child on a cardiac monitor/defibrillator, which reveals the rhythm shown here. You attempt defibrillation at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg. If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer another shock. Which drug and dose should be administered next? ANs>> Lidocaine 1 mg/kg IV A 4-year-old boy is in pulseless arrest in the pediatric intensive care unit. High-quality CPR is in progress. You quickly review his chart and find that his baseline-corrected OT interval on a 12- lead ECG is prolonged. The monitor shows recurrent episodes of the rhythm shown here. The patient has received 1 dose of epinephrine 0.01 mg/kg, but the rhythm shown here continues. If this rhythm persists at the next rhythm check, which medication would be most appropriate to administer at that time? ANs >> Magnesium sulfate 25 to 50 mg/kg IV What ratio of compressions to breaths should be used for 1- rescuer child CPR? Ans >> 30 compressions to 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 respiratory rate has decreased from 65/min to 10/min, severe inspiratory intercostal retractions are present, heart rate is 160/min, Sp0z is 65% in room air, and capillary refill is less than 2 seconds. Which are the most appropriate immediate interventions for this toddler? ANs >> Open the airway and provide positive-pressure ventilation using 100% oxygen and a bag-mask device A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is intubated, and vascular access is established. The ECG monitor shows an organized rhythm with a heart rate of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is resumed, and an initial IV dose of epinephrine is administered. Which intervention should you perform next? ANS» Identify and treat reversible causes You are evaluating an irritable 6-year-old girl with mottled skin color. The patient is febrile (temperature 40°C [104°FI), and her extremities are cold with capillary refill of 5 seconds. Distal pulses are absent and central pulses are weak. Heart rate is 180/min, respiratory rate is 45/min, and blood pressure is 98/56 During bag-mask ventilation, how should vou hold the mask to make an effective seal between the child's face and the mask? ANS >> Position your fingers using the E-C clamp technique An 8-month-old infant is brought to the emergency department for evaluation of severe diarrhea and dehydration. On arrival to the emergency department, the infant becomes unresponsive, apneic, and pulseless. You shout 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 10 line is established, and a dose of epinephrine is given. While continuing high-quality CPR, what do you do next? ANs>> Give normal saline 20 mL/kg IO rapidly You are supervising a student who is inserting an IO needle into an infant's tibia. The student asks you what she should look for to know that she has successfully inserted the needle into the bone marrow cavity. What do you tell her? ANs>> "Fluids can be administered freely without local soft tissue swelling." 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? ANS» Open the airway with a head tilt chin lift maneuver and give 2 breaths You and another rescuer begin CPR. Your colleague begins compressions, and you notice that the compression rate is too slow. What should you say to offer constructive feedback? ANs >> "You need to compress at a rate of 100 to 120 per minute." A 3-year-old unresponsive, apneic child is brought to the emergency department. 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 heel of the child on a color-coded length-based resuscitation tape to estimate the approximate weight as 15 kg. Which therapy is most appropriate for this child at this time? ANs> Attempt defibrillation at 30 J, and then resume CPR, and resume chest compressions You just assisted with the elective endotracheal intubation of a child with respiratory failure and a perfusing rhythm. Which provides a reliable, prompt assessment of correct endotracheal tube placement in this child? ANs>> Adequate bilateral breath sounds and chest expansion plus detection of ETCO, with waveform capnography How can rescuers ensure that they are providing effective breaths when using a bag-mask device? ANS>> By observing the chest rise with each breath Why is allowing complete chest recoil important when performing high-quality CPR? ans» The heart will refill with blood between compressions You find an infant who is unresponsive, is not breathing, and does not have a pulse. You shout for nearby help, but no one arrives. What action should you take next? ANS» Provide CPR for about 2 minutes before leaving to activate the emergency response system A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins ventilation with a bag-mask device with 100% oxygen. A second team member attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to establish IV/O access. The patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure is 58/38 mm Hg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest compressions are started and I0 access is obtained. Which medication do you anticipate will be given next? ANS > Epinephrine 0.01 mg/kg IV/IO 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 heart rate is variable (range, 44/min to 62/min). You begin bag-mask ventilation with 100% oxygen. When the heart rate does not improve, you begin chest compressions. The rhythm shown here is seen on the cardiac monitor. Which would be the most appropriate therapy to consider next? ANS >> Atropine 0.02 mg/kg IV 
