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Section 3 (Pediatric Protocols) > Cardiac Emergencies > Flashcards

Cardiac Emergencies Flashcards

1
Q

What are three classifications of dysrhythmias

A

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

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2
Q

What is the most common dysrhythmia for pediatrics

A

Bradycardia

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3
Q

AEDs may be used for what age of range

A

1-8 y/o

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4
Q

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

A

20 mL/kg or 10 mL/kg for neonates

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5
Q

What is the first line drug for Asystole/PEA

A

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

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6
Q

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

A

Calcium Chloride - 20 mg/kg IV/IO slowly

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7
Q

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

A

10 cycles

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8
Q

What is the dose for Narcan (Asystole/PEA)

A

0.1 mg/kg IVP (repeat once)

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9
Q

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

A

15:2

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10
Q

After advanced airway is in place provide 1 breath ever?

A

6 seconds

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11
Q

EtCO2 less than 10 mmHg

A

Improve CPR

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12
Q

Goal EtCO2 during resuscitation

A

12-25 mmHg

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13
Q

EtCO2 of 35-45 mmHg

A

Check for ROSC

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14
Q

Causes of symptomatic bradycardia

A

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

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15
Q

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

A

less than 60/min

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16
Q

What is the first line drug for bradycardia

A

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

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17
Q

What is the second line drug for bradycardia

A

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)

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18
Q

When should Atropine be administered prior to EPI

A

Suspected increased vagal tone or primary AV block

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19
Q

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

A

0.1 mg

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20
Q

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

A

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

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21
Q

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

A

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

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22
Q

Narrow complex tachycardia is classified as a QRS of:

A

less than or equal to 0.08 seconds

23
Q

Sinus tachycardia for a child

A

Greater than 180/min

24
Q

Sinus tachycardia for an infant

A

Greater than 220/min

25
Q

SVT for an infant

A

Above 220 min

26
Q

SVT for pt. greater than 2 y/o

A

180-220/min

27
Q

ALS level 1 for a stable SVT patient

A

a. 12Lead

b. Fluid challenge

28
Q

ALS level 2 for stable SVT

A

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)

29
Q

ALS level 1 for unstable SVT

A

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

30
Q

Joule dosage for cardio version

A

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

31
Q

Wide complex tachycardia is classified as a QRS of

A

greater than 0.12 seconds

32
Q

ALS level 1 for stable VT w/pulse

A

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

33
Q

ALS level 1 for unstable VT w/pulse

A

Sedate and Cardiovert

34
Q

ALS level 2 for unstable VT w/pulse

A

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

35
Q

What is the initial defibrillation dose of VF/VT

A

2 J/kg

36
Q

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

A

4 J/kg

37
Q

Subsequent energy level should be:

A

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

38
Q

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

A

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

39
Q

What age is considered a newborn/neonate

A

Infants less than 1 month

40
Q

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

A

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)

41
Q

How do you stimulate a newborn

A

Rub the newborn’s back

42
Q

How far apart do you place and cut umbilical clamps

A

2 inches apart & 8 inches from the navel

43
Q

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

A

a. When breathing but have central cyanosis

b. No improvement in respiratory, circulatory or neuro status w/in 90 seconds of initial assessment

44
Q

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

A

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

45
Q

When should an advanced airway be placed: (Newborn)

A

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

46
Q

When should CPR be started on a newborn and how:

A

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

47
Q

EPI should be given when and what dose (Newborn)

A

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

48
Q

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

A

10 mL/kg

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

49
Q

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

A

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

50
Q

ALS level 2 for newborn resuscitation

A

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

51
Q

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

A

about 4,000

52
Q

What are the three most reported causes of infant death

A

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

53
Q

What should the paramedic document for SIDS

A

location and appearance of infant

Section 3 (Pediatric Protocols) (5 decks)

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