Cardiac Emergencies

Question 1

What are three classifications of dysrhythmias

Answer 1

a. Slow rhythm
b. Fast rhythm
c. No rhythm

Question 2

What is the most common dysrhythmia for pediatrics

Answer 2

Bradycardia

Question 3

AEDs may be used for what age of range

Answer 3

1-8 y/o

Question 4

What is the dose for a fluid challenge for Asystole/PEA

Answer 4

20 mL/kg or 10 mL/kg for neonates

Question 5

What is the first line drug for Asystole/PEA

Answer 5

Epi 1:10,000 - 0.01 mg/kg IV (max. 1 mg) ever 3-5 mins

Question 6

If the patient is taking calcium-channel blockers or there is high suspicion of hyperkalemia what is given:

Answer 6

Calcium Chloride - 20 mg/kg IV/IO slowly

Question 7

How many cycles of CPR should be performed before reevaluating the heart rhythm

Answer 7

10 cycles

Question 8

What is the dose for Narcan (Asystole/PEA)

Answer 8

0.1 mg/kg IVP (repeat once)

Question 9

What is the compression to ventilation ratio (Asystole/PEA)

Answer 9

15:2

Question 10

After advanced airway is in place provide 1 breath ever?

Answer 10

6 seconds

Question 11

EtCO2 less than 10 mmHg

Answer 11

Improve CPR

Question 12

Goal EtCO2 during resuscitation

Answer 12

12-25 mmHg

Question 13

EtCO2 of 35-45 mmHg

Answer 13

Check for ROSC

Question 14

Causes of symptomatic bradycardia

Answer 14

a. Hypoxemia
b. Hypothermia
c. Head injury
d. Heart block
e. Heart transplant
f. Overdose

Question 15

At what heart rate should CPR be started with an infant or child with poor systemic perfusion: (Bradycardia)

Answer 15

less than 60/min

Question 16

What is the first line drug for bradycardia

Answer 16

EPI 1:10,000 - 0.01 mg/kg (max. dose 1 mg)

Question 17

What is the second line drug for bradycardia

Answer 17

Atropine 0.02 mg/kg IV/IO (min. single dose 0.1 mg) Repeat once, (max. single dose for a child 0.5 mg, max. for adolescent is 1 mg)

Question 18

When should Atropine be administered prior to EPI

Answer 18

Suspected increased vagal tone or primary AV block

Question 19

Paradoxical bradycardia may be produced with small dose of Atropine less than

Answer 19

0.1 mg

Question 20

What is the primary drug to sedate the patient prior to pacing

Answer 20

Versed - 0.1 mg/kg max. single dose 4 mg IV/IO/IM (IN - administer 0.2 mg/kg/dose use 10mg/2mL concentration; max single dose 5 mg) Max. total dose 10 mg

Question 21

What is the secondary drug to sedate the patient prior to pacing

Answer 21

Valium - 0.2 mg/kg IV/IO/IN (max. single dose 5 mg) Repeat once

Question 22

Narrow complex tachycardia is classified as a QRS of:

Answer 22

less than or equal to 0.08 seconds

Question 23

Sinus tachycardia for a child

Answer 23

Greater than 180/min

Question 24

Sinus tachycardia for an infant

Answer 24

Greater than 220/min

Question 25

SVT for an infant

Answer 25

Above 220 min

Question 26

SVT for pt. greater than 2 y/o

Answer 26

180-220/min

Question 27

ALS level 1 for a stable SVT patient

Answer 27

a. 12Lead | b. Fluid challenge

Question 28

ALS level 2 for stable SVT

Answer 28

a. Vagal maneuvers w/ ice water b. Adenosine 0.1 mg/kg w/ 6 mL flush (max. 6 mg) c. Adenosine 0.2 mg/kg w/ 6 mL flush (max. 12 mg)

Question 29

ALS level 1 for unstable SVT

Answer 29

a. Adenosine 0.1 mg/kg w/ 6 mL flush (max. 6 mg) b. Adenosine 0.2 mg/kg w/ 6 mL flush (max. 12 mg) c. Cardio version

Question 30

Joule dosage for cardio version

Answer 30

a. 0.5 joule/kg b. 1 joule/kg c. 2 joule/kg

Question 31

Wide complex tachycardia is classified as a QRS of

Answer 31

greater than 0.12 seconds

Question 32

ALS level 1 for stable VT w/pulse

Answer 32

Administer Amiodarone 5 mg/kg IV over 20-60 mins

Question 33

ALS level 1 for unstable VT w/pulse

Answer 33

Sedate and Cardiovert

Question 34

ALS level 2 for unstable VT w/pulse

Answer 34

Amiodarone - 5 mg/kg over 20-60 mins (If pt. converts to sinus rhythm after cardioversion and pt. is normotensive)

Question 35

What is the initial defibrillation dose of VF/VT

Answer 35

2 J/kg

Question 36

For refractory VF, what is the shock dose increased to:

Answer 36

4 J/kg

Question 37

Subsequent energy level should be:

Answer 37

at least 4 J/kg, not to exceed 10 J/kg or adult max dose

Question 38

VF/VT: If the patient has torsades de pointes what drug is given

Answer 38

Magnesium Sulfate - 25-50 mg/kg IV/IO max. 2 g over 2 mins.

Question 39

What age is considered a newborn/neonate

Answer 39

Infants less than 1 month

Question 40

When and how should a newborn be suctioned with a meconium aspirator

Answer 40

If not vigorous and crying after suctioning w/ bulb syringe: a. Thru ETT b. Suction set at low pressure (less than 100 mmHg) c. Max. 5 seconds (max. 3 times)

Question 41

How do you stimulate a newborn

Answer 41

Rub the newborn's back

Question 42

How far apart do you place and cut umbilical clamps

Answer 42

2 inches apart & 8 inches from the navel

Question 43

When should blow-by oxygen be given to a newborn:

Answer 43

a. When breathing but have central cyanosis | b. No improvement in respiratory, circulatory or neuro status w/in 90 seconds of initial assessment

Question 44

Ventilate at 40-60 bpm @ 100% oxygen under what conditions (Newborn)

Answer 44

a. Apena b. HR less that 100/min c. Persistant central cyanosis after high-flow O2

Question 45

When should an advanced airway be placed: (Newborn)

Answer 45

a. BVM is ineffective after 2 mins b. Suctioning w/ meconium aspirator c. Prolonged positive pressure vent. is needed

Question 46

When should CPR be started on a newborn and how:

Answer 46

a. If HR is less than 100/min and not rapidly increasing despite ventilations for approx. 30 secs. b. Performed by 2 rescuers @ 120/min with both thumbs on sternum below nipple line

Question 47

EPI should be given when and what dose (Newborn)

Answer 47

EPI - (1:10,000) 0.01 mg/kg IV/IO ever 3-5 mins a. Asystole b. HR less than 60/min after vent. and 30 secs of CPR

Question 48

When should a fluid challenge be given and what dose (Newborn)

Answer 48

10 mL/kg a. Pallor that persist after oxygenation b. Faint pulse with good HR c. Poor response to resuscitation w/ vent.

Question 49

What should be done if newborn's glucose is below 40 mg/dL

Answer 49

D10: 5mL/kg IV/IO (dilute D50 1:4 w/ saline)

Question 50

ALS level 2 for newborn resuscitation

Answer 50

Narcan 0.1 mg/kg IV/IO/IN/IM (1 mg/mL concentration) if unresponsive w/ depressed respirations

Question 51

Each year how many infants die suddenly of no immediately, obvious cause

Answer 51

about 4,000

Question 52

What are the three most reported causes of infant death

Answer 52

a. SIDS b. Cause unknown c. Accidental suffocation/strangulation in bed

Question 53

What should the paramedic document for SIDS

Answer 53

location and appearance of infant