2025/2026 Pediatric Protocols

Question 1

Compression rate for pediatric?

Answer 1

100-120/minute

Question 2

Ventilation rate (compression-to-ventilation ratio)

Neonate
Pediatric

Answer 2

Neonate: 20-30/minute (3:1)
Pediatric: 10-12/minute (15:2)

Question 3

Minimize compressions to what time?

Answer 3

<5 seconds during ECG rhythm checks

Question 4

If EtC02 rises rapidly during CPR, do what?

Answer 4

Pause CPR and check for pulse

Question 5

What type of compressions are an acceptable alternative for pediatric CPR

Answer 5

Continuous

Question 6

Pediatrics:

V-Fib/V-Tach

Answer 6

CPR
Defib per drug chart as soon as monitor ready
Defib per drug chart q2 minutes while VF/VT persists
Epi 1:10,000 per drug chart IV/IO q3-5 minutes, begin after second defibrillation
————————————————————————————————————————————
Persistent VF/pulseless VT after 3 defibrillation attempts
- amiodarone per drug chart IV/IO, MR per drug chart x2
—OR—
- Lidocaine per drug chart IV/IO, MR per drug chart x1 q5 minutes

Question 7

PEA/Asystole (before H’s and T’s are considered)

Answer 7

CPR
EPI 1:10,000 IV/IO q 3-5 minutes per drug chart

Question 8

Pediatric:

Reported/witnessed AICD firing 2 or more

Answer 8

Amio per drug chart, MR BHPO

—or—

Lidocaine per drug chart, MR BHPO

Question 9

Pediatric

Respiratory distress w/bronchospasm

Answer 9

Albuterol/Levalbuterol

Atrovent (first dose only)

Question 10

Respiratory distress with stridor at rest

Answer 10

Epi 1:1,000 per drug chart (combined with 3 mL normal saline) via nebulizer, MR x 1

Question 11

Pediatric (Respiratory distress with stridor at rest)

What can you do if your pediatric patient is not improving after EPI x2 nebulizer or impending respiratory/airway compromise is occurring?

Answer 11

EPI 1:1,000 per drug chart IM, MR x 2, q5minutes

Question 12

Pediatrics:

Distributive/Cardiogenic shock

Answer 12

IV/IO fluid bolus per drug chart, MR if no rales

Question 13

Pediatric

For traumatic cardiac arrest

Answer 13

NO EPI

Give IV/IO fluids only per drug chart

Question 14

IV Tylenol is contraindicated for what pediatrics?

Answer 14

< 2 years old (a 2 year old can receive Tylenol)

Question 15

Drowning for PEDS (BLS)

Answer 15

Get a temperature right away
Emphasize ventilations
High-flow oxygen if spontaneous respirations
Remove wet clothing
Spinal motion restriction PRN

Question 16

Pediatrics:

Cardiac arrest with hypothermia

Defib limitations?

EPI limitations?

Antiarrhythmic medications?

Answer 16

Defibrillation may not be effective until body temperature reaches 86 degrees or greater

EPI should only be given once until body temperature reaches 86 degrees or greater

Withhold antiarrhythmic medications until body reaches 86 degrees or greater

Question 17

Compression depth for infant (< 1 year old)

Answer 17

About 1 1/2 inches

Question 18

Compression depth for child (1 year to onset of puberty)

Answer 18

About 2 inches