Intro

Question 1

Most common primary arrest rhythm in children (2)

Answer 1

VF, pulseless VT

Question 2

Every 1 minute delay in fibrillation of primary child arrest increases mortality by?

Answer 2

10%

Question 3

Primary or secondary cardiac arrest more common in children and most common cause? (2)

Answer 3

Secondary
Hypoxia

Question 4

Most common arrest rhythms with hypoxia? (2)

Answer 4

Asystole/ PEA

Question 5

Rate of successful CPR for secondary oohca

Answer 5

4-12%

Question 6

In hospital cardiac arrest successful cpr for secondary CA + discharge survival

Answer 6

60-80%
54%

Question 7

Can epiglottis stimulation lead to vagal response

Answer 7

Yes

Question 8

Larynx in children vrs adult

Answer 8

Higher
Ellipsoid in shape - cylindrical anterior-posterior diameter but cone shaped in the transverse diameter with vocal cords at the apex of the cone.

Question 9

Air-alveolar surface area for gas exchange at birth vrs adult and what increase in number of small airways

Answer 9

3m2 vrs 70m2
10 fold increase

Question 10

Main muscle of breathing in infants

Answer 10

Diaphragm

Question 11

Normal respiratory rates in less than 1, 1-2, 2-5, 5-12, >12

Answer 11

30-40
26-34
24-30
20-24
12-20

Question 12

Heart rate mean 0-3mth, 3mth - 2 year, 2-10, >10

Answer 12

140
130
80
75

Question 13

Bp mean map for 1mth, 1 year, 5, 10, 15

Answer 13

55, 70, 75, 75, 80

Question 14

Cardiac output relative to weight at birth vrs adult

Answer 14

300ml/kg/min vrs 70-80

Question 15

Neonatal leading cause of death (3)

Answer 15

Congenital -> perinatal -> sudden infant death syndrome

Question 16

Most common causes of death in infancy (2)

Answer 16

Congenital, resp/cvs,

Question 17

Most common causes of death 1-4 (4)

Answer 17

Malignancy, trauma, congenital, CNS

Question 18

Most common causes of death 5-9 (3)

Answer 18

Malignancy
Trauma
CNS

Question 19

Most common teenager

Answer 19

Trauma, suicide, risk taking behaviour

Question 20

Difference between primary, secondary and tertiary prevention of death

Answer 20

Primary - prevention of the accident
Secondary - reduction of severity
Tertiary - diminishing the consequences of event

Question 21

Age cut off when chest wall recession is more significant

Answer 21

5 years old

Question 22

What is grunting

Answer 22

The result of exhaling against a partially closed glottis in an attempt to create PEEP

Question 23

Starting threshold of o2 therapy in infants or children with chronic lung issues

Answer 23

3% below known baseline

Question 24

Peripheral cyanosis and central cut offs

Answer 24

<85%
<80%

Question 25

5 types of shock

Answer 25

Hypovolaemic Distributive Cardiogenic Obstructive Dissociative

Question 26

% blood loss before hypotension in children

Answer 26

Up to 40%

Question 27

Sizing bp cuff

Answer 27

Cuff width >80% of the child’s upper arm length and bladder should cover more than 40#’circumference

Question 28

Threshold urine output in infant

Answer 28

2ml/kg/hr

Question 29

Cardiorespiratory failure immediate intervention signs

Answer 29

Coma Exhaustion Cyanosis RR > 60 HR < 100 for newborn HR > 180 or < 80 before 1 year cpr at 60 Hr > 160 after 1 year Seizure

Question 30

Cushing’s triad

Answer 30

Bradycardia, hypertension, abnormal breathing

Question 31

See saw respiration meaning and cause

Answer 31

Abdomen protrudes markedly and chest is drawn inwards paradoxically reducing lung volume. Airway obstruction.

Question 32

Max suction pressure in infants

Answer 32

120mmhg

Question 33

NPA sizing length

Answer 33

Nostril to tragus of ear

Question 34

HFNO2 flow rate/kg

Answer 34

2L/kg/min up to 12kg plus 0.5L/kg/min Eg 20kg = 28L 32kg = 34L

Question 35

ETT placement in 7 situations

Answer 35

Ineffective bmv Deformity of anatomy Aspiration protection High pressures Mechanical ventilation Suctioning Transfer

Question 36

ETT sizing - pre term, term, six month, 1 year, then older

Answer 36

2.5-3, 3-3.5, 3.5, 4 (uncuffed) age/4 + 4

Question 37

Length at month, nose

Answer 37

Age/2 + 12, 15

Question 38

Sudden deterioration of the intubated patient causes acronym

Answer 38

DOPES Displacement Obstruction Pneumothorax Equipment Stomach

Question 39

Rate and depth of chest compressions

Answer 39

100-120/min 1/3rd on the chest depth ~ 4cm in infant, 5cm in child (6cm adult)

Question 40

Timeframe removal of IO

Answer 40

Within 24hrs

Question 41

Common locations to insert IO including cm

Answer 41

Proximal tibia (1cm below and medial to tuberosity in infants and 2-3cm in older children) Distal tibia (1-2cm proximal to mm in infants and 3cm in older) and distal femur (less than 6y - 1-2cm above and medial to patella) as alternatives Proximal humerus in older children (place their hand on abdo 1-2cm above surgical neck (hand over shoulder anterior feels like a ball where it should be inserted)

Question 42

IO sizing vrs age

Answer 42

18g 0-6mnth 16g 6-18mnth 14g for children > 18minths EZ-IO are all 15 gauge 15mm, 25, 45 for different ages

Question 43

Other IO equipment

Answer 43

Wipe Consider local Primed three way tap extension Syringe for aspiration bone marrow Meds/ fluid

Question 44

Rough upper limit of fluid resuscitation in hypovolaemic child and septic child and fluid used (3)

Answer 44

40-60ml/kg 60-80ml/kg Balance crystaloid (nacl as an alternative)

Question 45

Percentage chance of head injury with child with multi trauma

Answer 45

70-80%

Question 46

Percentage chance of head injury with child with multi trauma

Answer 46

70-80%

Question 47

Percentage chance of head injury with child with multi trauma

Answer 47

70-80%

Question 48

Absolute cut off for massive haemorrhage protocol

Answer 48

>40ml/kg