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Exam (elaborations)

PALS

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PALS compression to breath ratio children with 1 rescuer - 30:2 2 rescuer compression to breath ratio? - 15:2 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 sound (mild stridor) when agitated; otherwise, intercoastal 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 Which statement is correct about use of calcium chloride in pediatric? - 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 You are a 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 You are called to help treat an infant with severe symptomatic bradycardia (HR 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 Which statement is correct about the effects of epinephrine during attempted resuscitation? - Epinephrine stimulates spontaneous contractions when asystole is present 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 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 mmHg. Which intervention should be provided next? - Rapid bolus of 20 ml/kg of isotonic crystalloid 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 intercoastal retractions, and decreased air movement with prolonged expiratory time and wheezing. You administer 100% oxygen by a NRB mask. His SpO2 is 92%. Which medication do you prepare to give to this patient? - Albuterol A previously healthy infant with a history of vomiting and diarrhea is brought to the ER by her parents. During your assessment, you find that the infant responds only to painful stimulation. The infant's RR is 40/min, and central pulses are rapid and weak. The infant has good bilateral breath sounds, cool extremities, and a capillary refill time of ore than 5 seconds. The infant's blood pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.56 mmol/L). You administer 100% oxygen via facemsk and start an IV. Which treatment is the most appropriate for this infant? - Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W to 4 ml/kg IV

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Uploaded on
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2020/2021
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