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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 no 150/min with weak central pulses but no
distal pulses. Systolic blood pressure is 74 mm Hg. Which intervention should be
provided next? - ANSWERS-Rapid bolus of 20ml/kg of isotonic crystalloid
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
SpO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung
auscultation reveals transmitted upper airway sounds with adequate distal breath sound
bilaterally. Which is the most appropriate initial intervention for this child? - ANSWERS-
Humidified oxygen as tolerated
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 become
unresponsive, apneic, and pulseless. You should 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 IO line is established, and a dose of epinephrine is given. While continuing high-
quality CPR, what do you do next? - ANSWERS-Give normal saline 20 mL/kg IO rapidly
, 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? -
ANSWERS-Open the airway with a head tilt-chin lift maneuver and give 2 breaths
What ratio of compressions to breaths should be used for 1-rescuer child CPR? -
ANSWERS-30 compressions to 2 breaths
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/IO access. The patient's heart
rate is 38/min with rhythm shown here. The infant's blood pressure is 58/38 mm Hg, and
capillary refill is 4 second. His central pulses remain weak, and distal pulses cannot be
palpated. Chest compressions are started and IO access is obtained. Which medication
do you anticipate will be given next? - ANSWERS-Epinephrine 0.01 mg/Kg IV/IO
A child become 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
next action? - ANSWERS-Start high-quality CPR
Which oxygen delivery system most reliably delivers a high (90% or greater)
concentration of inspired oxygen to a 7-year-old child? - ANSWERS-Nonrebreathing
face mask
Which statement is correct about the effects of epinephrine during attempted
resuscitation? - ANSWERS-Epinephrine stimulates spontaneous contractions when
asystole is present
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