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 block present. Which is the first
drug you should administer?
Epinephrine
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. 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. Which is the most
appropriate initial intervention for this child?
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, persistent ventricular fibrillation
is present. You administer a 4 J/kg shock and resume CPR. Which drug and dose should be
administered next?
Amiodarone 5 mg/kg IO
,Which statement is correct about the effects of epinephrine during attempted resuscitation?
Epinephrine stimulates spontaneous contractions when asystole is present
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.
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4
ml/kg IV
Which statement is correct about endotracheal drug administration during resuscitative efforts
for pediatric patients?
It is the least desirable route of administration
Which statement is correct about the use of calcium chloride in pediatric patients?
Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress.
Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of
inspired oxygen to a 7yo child?
Nonrebreathing face mask
, 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
Rapid bolus of 20ml/kg of isotonic crystalloid
A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing
Identify and treat reversible causes
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
What compression-to-ventilation ratio should be used for 2-rescuer infant CPR?
15 compressions to 2 breaths
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
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