Pediatric

Question 1

Assessment of a pediatrics patient requires what?

Answer 1

Observation, auscultation, and palpation

Question 2

To start compression with HR <60 patient must be how old?

Answer 2

8 years old or less

Question 3

Pediatric tachycardia:
•sinus tachycardia infant and child rate?
•symptomatic tachycardia infant and child rate?

Answer 3

Sinus=Infant <220; child <180 w/ narrow QRS

Symptomatic=infant >220; child >180 w/ signs of poor perfusion

Question 4

Pediatric Tachycardia:

• Stable:N QRS(=>0.08); Infant>220/child>180(SVT)
• unstable:N QRS(=>0.08); infant>220/child>180(SVT)
• wide QRS (>0.08) Ventricular Tachycardia

Answer 4

• adenosine only
• adenosine then cardio version
• cardio version only

Note: 0.1mg/kg max first 6mg, repeat double max 12mg

~ 0.5-1J/kg if not effective increase to 2

~midazolam: 0.1mg/kg max dose 4mg

Question 5

Pediatric Shock: 
~cap refill 
~BP less than
~place patient in
~Ketamine dose 
~midazolam dose and max dose

Answer 5

• 3 or greater
• Systolic less than 70
• Supine position
• 2mg/kg
• 0.1 max 4mg

Question 6

Ventilation w/ BVM rate
~premature neonate and neonate
~infant and children

Answer 6

• 40 to 60 per min

* 12-20 per min (once every 3 to 5 sec)

Question 7

Pediatric Normal Respiratory Rates:
Infant
Toddler 
Preschooler 
School-age 
Adolescent

Answer 7

>1= 30-60
1-3= 24-40
4-5= 22-34
6-12= 18-30
12-18= 12-20

Question 8

• Mild Croup

* Moderate to Severe Croup

Answer 8

•NS 5ml nebulized

•0.5mg Epi 1:1000 in 5ml NS nebulized
~ side effects: Tachy, tremors, vomiting

Question 9

Supra-glottic airway if child is how tall? Place after how may attempts of intubation?

Answer 9

4ft or taller

After two attempts

Question 10

Pediatric Asthma:
•mild
•moderate
•severe

Answer 10

• mild/ albuterol and atrovent
• moderate/ albuterol and atrovent + mag+ solu-medrol
• severe/ epi+ cpap w/ inline albuterol and atrovent+ mag+ solu-medrol

Doses:A and A-5mg+0.5/ mag 50mg/kg in 100ml bag max 2grams/ SM-2mg/kg max125/ epi1:1000 0.1mg/kg IM only max dose 0.3mg

Question 11

What is preferred over intubation w/ pediatric Asthma

Answer 11

Treatment w/ medication and/or CPAP

Question 12

Pediatric V-fib/pulseless V-Tach
~Compressions infants and children 
•depth 
•rate 
~J/KG
~drugs

Answer 12

•1/3 diameter of chest
~infants-1 1/2 inches
~children-2 inches

• 15:2 before advanced airway then continuous breaths every 6 seconds
• 1st shock 2J/KG, second and the rest 4J/KG

•drugs: Epi; Amiodarone; Mag
~doses: Epi 1:1000- 0.01mg/kg
~Amio- 5mg/kg max300mg; same max 150
~Mag- torsades- 50mg/g max 2grams

Question 13

Pedi-Immobilizer infants and children?

Answer 13

Less than 60lbs for spinal immobilization

Question 14

Pediatric compressions and breaths with out advanced airway?

Answer 14

15:2 after advanced airway continuous rate of 120/min one breath every 6-8 seconds

Note: adult is 30:2

Question 15

Peds VFib and Pulseless VTach:

Doesn’t mention what?

Answer 15

H’s and T’s

Question 16

Peds Asystole says what that’s super weird?

Answer 16

No medication has been shown to reduce mortality in cardiac arrest!!!
???????????

Question 17

H's and T's Peds Asystole: 
 That receive drugs: 
~ hypovolemia 
~hydrogen ion= acidosis 
~hypoglycemia 
~toxin/ tablets

Answer 17

• NS 20mg/kg repeat once if needed
• Sodium Bicarb/ 1mEq/kg(max single 50mEq)

•neonate0-1/ D10W at 5ml/k if <45
•infant/child1m-12y/ D25W at 2ml/kg <60
•adolescent13-18/D50W at 1ml/kg <60
~ below 50 repeat appropriate dose

•Narcan/ 0.1mg/kg max 2mg

Question 18

Pediatric Asthma:

Mild

Moderate

Severe

Answer 18

• wheezes only= albuterol and atrovent
• wheezes/decreases breath sounds/ accessory muscle use= Ab and Atro+ Mag+ Solu-Medrol
• wheezes/stridor/decreased breath sound with little or no air movement/ accessory muscle use/tripoding= Epi 1:1000+ CPAP w/ Ab and Atro+ Mag+ Solu-Medrol

Doses: Ab and Atro normal; Mag 50mg/kg(max2grams); Solu-Med 2mg/kg(max125)
Epi 0.01mg/kg IM only max 0.3mg

Question 19

Pediatric Allergic Reaction/ Anaphylaxis:

Mild

Moderate

Severe

Answer 19

•without Respiratory compromise
Benadryl 1mg/kg may 25mg

•Respiratory compromise
AB and Atro + Benadryl+ Solu-Med

•Sever Respiratory compromise
Ab and Atro+ Epi+ Benadryl+ Solu-Med

:Doses: Alb normal unless less than 10kg 2.5
~Epi1:1000 0.01mg/kg IM only max single 0.3
~Solu-Med 2mg/kg max 125mg
~all are IV/IO/IM slow push except Epi IM only

Question 20

Pediatric Altered Consciousness:

Position patient how

Hypoglycemia:

Hyperglycemia:

Narcotic use:

Answer 20

•Hypo=normal for neo; infant/child; adolescent
~hypo w/o IV= glucagon
•less than 20kg 0.5mg IM
•20kg or greater 1mg IM which is normal
~Narcan 0.1mg/kg IV/IO/IM max single 1mg
If no change in 5min repeat 0.1mg/kg max total 2mg

Note: Narcan in adults you wait 2min not 5min before repeating also second dose is total of 1mg not 2mg. However in arrest it is 1-2mg.
I think it’s a mistake but know it!!!

Question 21

Pediatric Overdose/ Poisoning:

Seizures

Tricyclic Anti-depressant

Narcotic use

Organophosphate exposure

Acute Dystonic Reaction to Ani-psychotics

Answer 21

•Seizures= midazolam 0.1mg/kg max 4mg may repeat once

•Tricyclic= NS 20ml/kg repeat once
Sodium Bicarb 1mEq/kg max single 50mEq

• Narcan= 0.1mg/kg max single 1mg, no change in 5min repeat 0.1mg max total 2mg
• Organo= Atropine 0.05mg/kg min single dose 0.1mg and max initial dose 2mg; repeat every 3-5 min until dry

•Anti-Psychotics= Benadryl 1mg/kg max 25mg
~ signs and symptoms= painful muscle spasms to face, neck, and back

Question 22

Pediatric Seizure:

Drug:

Hypo:

Answer 22

• midazolam 0.1mg/kg max single 4mg may repeat once

* What it always is for Peds, doesn’t actually mention Glucagon

Question 23

Pediatric Fever:

Patient is febrile if temp is?

If pediatric patient has a temp greater than____ and the parents has ibuprofen or acetaminophen:

Answer 23

Rectal >105.0 or tympanic >104.0
Apply cooling measures

102.0
Ibuprofen 10mg/kg not for children under 6months

Acetaminophen 15mg/kg