SVT converting to sinus rhythm after adenosine administration
Sinus bradycardia
Sinus bradycardia - version 2
Normal sinus rhythm
Asystole
Wide complex tachycardia
Wide complex tachycardia - version 2
Torsades de pointes
Supraventricular tachycardia
VF with successful defib and resumption of organized rhythm
Pulseless electrical activity
Ventricular fibrillation
Sinus tachycardia
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 p
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV
A 9yo 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 retrac
Albuterol (duh)
Paramedics are called to the home of a 1yo 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 venti
Rapid bolus of 20ml/kg of isotonic crystalloid
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min) associated with respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation, and ventilation. There is no heart blo
Epinephrine
Which statement is correct about the use of calcium chloride in pediatric patients?
Routine administration is not indicated during cardiac arrest
Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients?
It is the least desirable route of administration
Initial impression of a 2yo 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.
Humidified oxygen as tolerated
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check,
Amiodarone 5 mg/kg IO
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child?
Nonrebreathing face mask
Which statement is correct about the effects of epinephrine during attempted resuscitation?
Epinephrine stimulates spontaneous contractions when asystole is present
A 10mo 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 t
Epinephrine 0.01 mg/kg IV/IO
A 7yo 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 q
Identify and treat reversible causes
You find a 10yo 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 t
Lidocaine 1 mg/kg IV
A 3yo 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 respiratory rate is 5/min, heart rate and pulses are 170/min, systo
While a colleague provides spinal motion restriction, open the airway with a jaw thrust and provide bag-mask ventilation
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 defibri
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?
You need to compress at a rate of 100-120 per minute.
You are caring for a 6yo patient who is receiving positive-pressure mechanical ventilation via an endotracheal tube. The child begins to move his head and suddenly becomes cyanotic, and his heart rate decreases. His spO2 is 65%. You remove the child from
Tracheal tube displacement into the right main bronchus
You are giving chest compressions for a child in cardiac arrest? What is the proper depth of compressions for a child?
Compress the chest at least one third the depth of the chest, about 2 inches (5 cm)
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 successfully inserted the needle into the bone marrow cavity. What do you tell her?
Fluids can be administered freely without local soft tissue swelling.
A pale and very sleepy but arousable 3yo child with a hx of diarrhea is brought to the hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally. Heart rate is 150/min, BP is 90/64 mmHg, and spO2 is 92% on room
Administer a bolus of 20 ml/kg isotonic crystalloid
Why is allowing complete chest recoil important when performing high-quality CPR?
The heart will refill with blood between compressions
An 8yo child was struck by a car. He arrives in the ED alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10L/min flow of 100% oxygen by nonrebreathing face mask. His respiratory rate is 60/min, HR 150/mi
Perform needle decompression of the right chest
You 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?
Adequate bilateral breath sounds and chest expansion plus detection of ETCO2 with waveform capnography
Which ratio of compressions to breaths should be used for 1-rescuer child CPR
30 compressions to 2 breaths
You are caring for a 3yo 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%
Atropine 0.02 mg/kg IV
What compression-to-ventilation ratio should be used for 2-rescuer infant CPR?
15 compressions to 2 breaths
You are assisting in the elective intubation of an average-sized 4yo child with respiratory failure. A colleague is retrieving the color-coded length-based tape from the resuscitation cart. Which of the following is likely to be the estimated size of the
5mm tube
A 4yo boy is in pulseless arrest in the PICU. High-quality CPR is in progress. You quickly review his chart and find that his baseline-corrected QT interval on a 12-lead ECG is prolonged. The monitor shows recurrent episodes of the rhythm shown here. The
Magnesium sulfate 25-50 mg/kg IV
You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it is appropriate to use the smaller, pediatric-sized paddles?
If the child weighs less than 10kg or is less than 1 year old
An 18mo child has a 1 week hx 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 i
Open the airway and provide positive-pressure ventilation using 100% oxygen and a bag-mask device
A child becomes unresponsive in the emergency department 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 n
Start high-quality CPR
You need to provide rescue breaths to a child victim with a pulse. What is the appropriate rate for delivering breaths?
1 breath every 3-5 seconds
How can rescuers ensure that they are providing effective breaths when using a bag-mask device?
By observing the chest rise with each breath
You are evaluating an irritable 6yo girl with mottled skin color. The patient is febrile (temperature 40C [104F]), 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
Compensated shock associated with tachycardia and inadequate tissue perfusion
An 8mo 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 arri
Give normal saline 20 ml/kg IO rapidly
A 1yo boy is brought to the emergency department 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 respiratory rate is 68/min, heart rate 3
Administer adenosine 0.1 mg/kg IV rapid push
During bag-mask ventilation, how should you hold the mask to make an effective seal between the child's face and the mask?
Position your fingers using the E-C clamp technique
A 3yo 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
Attempt defibrillation at 30 J, and then resume CPR, beginning with 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?
Provide CPR for about 2 minutes before leaving to activate the emergency response system