SOLUTIONS
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? - ANSWER-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? - ANSWER-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? - ANSWER-
Amiodarone 5 mg/kg IO
, Which statement is correct about the effects of epinephrine during attempted
resuscitation? - ANSWER-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. - ANSWER-Administer a bolus of isotonic
crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV
Which oxygen delivery system most reliably delivers a high (90% or greater)
concentration of inspired oxygen to a 7yo child? - ANSWER-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 - ANSWER-
Rapid bolus of 20ml/kg of isotonic crystalloid
Which statement is correct about endotracheal drug administration during
resuscitative efforts for pediatric patients? - ANSWER-It is the least desirable route of
administration
Which statement is correct about the use of calcium chloride in pediatric patients? -
ANSWER-Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress.
- ANSWER-Albuterol