Pedi Cardiac Quiz

Your patient is a 13 year-old male drowning victim. He was initially in cardiac arrest with a pulseless, wide-complex bradycardia. He is intubated and being ventilated with supplemental oxygen. After CPR and intubation, the patient is now in ventricular tachycardia with a weak radial pulse. Which of the following would be an appropriate treatment for this patient?

• Synchronized cardioversion starting at 0.5-1.0 joules/kg

• Lidocaine, 3 mg/kg IV bolus, followed by a 3 mg/minute drip

• Procainamide, 20 mg per minute, up to 800 mg

• Amiodarone, 5 mg/kg IV push

Your patient is a seven-month-old boy whose mother called because he suddenly became lethargic and pale. Your assessment reveals that he is in a supraventricular tachycardia at a rate of 244 per minute. The patient's extremities are mottled and his capillary refill time is 4 seconds. Which of the following is the best treatment plan for this patient?

• Diltiazem, 0.25 mg/kg over 2 minutes

• Adenosine, 0.1 mg/kg rapid IV push, repeated at 0.2 mg/kg if unsuccessful

• Verapamil, 0.3 mg/kg over 3 to 5 minutes

• Synchronized cardioversion beginning at 0.5-1.0 joules/kg

You are delayed getting to a residence where a 16-month-old boy is actively seizing. The mother reports that he has had a fever for the past two days. A firefighter on scene informs you that the child has been seizing since their arrival approximately 15 minutes ago. You should:

• actively cool the child with ice packs to the groin and axilla.

• apply oxygen, administer intranasal midazolam, and transport.

• apply oxygen, administer fluids, and transport.

• actively warm the child with blankets.

A woman has called 911 after not being able to wake her eight-year-old son. Upon arrival, the mother tells you that her son is a diabetic, and that his diabetic alert dog awoke her in the night indicating the child's blood sugar was low. You perform a blood glucose check and find that your glucometer reads 28 mg/dL. You should:

• administer IV dextrose at 50% concentration.

• administer 10 mg of IV glucagon.

• administer IV dextrose at 25% concentration.

• administer 1 mg of IM glucagon.

You are caring for a seven-year-old in ventricular fibrillation. The child weighs 19 kg. You have just delivered your first shock, and another paramedic reports that she has obtained IO access. You should direct the paramedic to administer what dose of epinephrine?

• 0.019 mg of 1:1,000

• 1.019 mg of 1:10,000

• 0.19 mg of 1:10,000

• 1.9 mg of 1:1,000

A nine-year-old weighing 28 kg is in supraventricular tachycardia. Which of the following is the appropriate dose of adenosine for this patient?

• 0.8 mg

• 6 mg

• 2.8 mg

• 0.28 mg

What drug is recommended to be given first for stable, symptomatic SVT in a pediatric patient

• Atropine 0.5 mg

• Adenosine 0.1mg/kg

• Adenosine 0.1 mg

• Amiodarone 1 mg/kg

Atropine is used in

• Bradycardia

• SVT

• V-Fib

• A- Fib

Which would be an appropriate initial pediatric dose for atropine for a patient weighing 66 pounds?

• 1 mg

• 0.6 mg

• 0.5 mg

• 0.3 mg

Your 5 year old patient is in V-Fib.  They weigh 40 pounds.  What is the initial dose of epinephrine to be given?

• 1 mg

• 0.18 mg

• 0.5 mg

• 1.8 mg