Pediatrics

Question 1

Hypoglycemia criteria peds vs neonates

Answer 1

Peds <60

Neo <40

Question 2

Can you give narcan to neonates

Answer 2

No

Question 3

Hypoglycemia rx

Answer 3

D50 oral, D10 IV IO, glucagon IM

Question 4

Mild vs moderate vs severe anaphylaxis in peds with Rx?

Answer 4

Mild = skin = Benadryl & maybe dexamethasone

Mod = Resp = Epi 1:1000, Albuterol, mild rx

Severe = shock = all above plus push dose Epi (instead of IM)& fluids

Question 5

Lowest BP for neonates vs infants

Answer 5

Neo = 60

Infant = 70

Question 6

BP formula for kids > 1 year

Answer 6

70 + 2x age

Question 7

Pediatric defib joules dose?

Answer 7

4 Joules per kg

Question 8

SVT cut off for peds? Infants?

Answer 8

Ped = 180+

Infant = 220+

Question 9

Stable SVT Rx for peds

Answer 9

Vagal

Adenosine x3

Question 10

Ped stable Vtach Rx

Answer 10

Maybe adenosine

Question 11

Unstable ped tachycardia Rx

Answer 11

Cardiovert 4 J/kg x2

Consider versed or etomidate sedation

No = amio SIVP

No = cardiovert 4 J/Kg

No = rapid transport & OLMC

Question 12

When to use ped pads?

Answer 12

<15kg (30ish pounds)

Question 13

Unstable ped bradycardia

Answer 13

<60 HR despite O2 & BVM = CPR

Persists = Epi 1:10,000 consider atropine (if vagal)

Persist = consider pace

Question 14

Can you give kids zofran?

Answer 14

OLMC if <2 yrs unless spinal immobilized or receiving chemo

Question 15

Neonate rx after birth

Answer 15

Warm/dry
Suction
Stimulate
APGAR

Question 16

Neonate is gasping and HR < 100

Answer 16

BVM every 1-2 seconds

Question 17

Neonate HR < 60. What Rx

Answer 17

CPR 3:1
Bag 1 every 3 seconds w/O2

Question 18

What age/weight gets an IV

Answer 18

> 3kg

Question 19

Fluid challenge dose for neonate

Answer 19

10ml/kg

Question 20

Can you give bicarb to neonates? Why or why not?

Answer 20

Yes with OLMC for prolonged resus

Question 21

What CBG is hypo in neonates?

Answer 21

< 40 = D10

No D10 = glucagon

Question 22

Can you give zofran to kids? Are there any exceptions?

Answer 22

If <2 years = OLMC unless in spinal immobilization or chemotherapy

Question 23

What drugs to use during neonate CPR?

Answer 23

Epi
Fluid challenge for hypovolemia
Bicarb (OLMC) if prolonged CPR
Glucose in CBG low

Question 24

Can you give atropine in neonate resuscitation?

Answer 24

No

Question 25

At what point would you give O2 during neonate resuscitation?

Answer 25

Only if still cyanotic or SPO2 < 70% after 2min

Question 26

What SPO2 to maintain in neonates?

Answer 26

90-95%

Question 27

Meconium Aspiration Rx

Answer 27

If its bad = suction mouth/pharynx/nose w/ 10 FR or bigger as soon as head comes out. Intubate if necessary Suction BEFORE ventilating them

Question 28

Best way to monitor a neonate heart?

Answer 28

Auscultate heart tones or 4-lead ECG. Palapation is unreliable

Question 29

When should you intubate a neonate with meconium?

Answer 29

If their depressed and passing meconium or any baby passing particulate meconium

Question 30

How long to suction a neonate?

Answer 30

3-5s

Question 31

How many times can you attempt to intubate a neonate?

Answer 31

Provider judgement

Question 32

What can we use to suction meconium from a neonate?

Answer 32

Meconium suction adapter Neovac device (specialized meconium aspiration ETT)

Question 33

Can you give oxygen to a newborn baby?

Answer 33

Only if they are <36 weeks because it is an “abnormal birth”

Question 34

Unstable wide irregular tachycardia in peds rx

Answer 34

Defib

Question 35

What meds can you use to sedate kids? Is there an age limit?

Answer 35

All = olanzapine <12 = Benadryl then OLMC >12 = versed, geodon

Question 36

What sedation meds to avoid in autistic kids

Answer 36

Benzos & Benadryl unless they worked well last time

Question 37

Upper airway obstruction rx

Answer 37

- 6mo-6yr w/ strider at rest = nebulized epi - croup = add dex

Question 38

Acute bronchiolitis rx

Answer 38

- o2 - suction boogers - wheeze = albuterol until Hr>200

Question 39

Severe Resp distress rx

Answer 39

- suction PRN - high flow NC - nebulized epi for wheezing - consider intubation

Question 40

General shock rx

Answer 40

Fluids then norepi infusion then OLMC