Resucitation

Question 1

In Resus scenario:

1st dose amiodarone

2nd dose

when given

Answer 1

300

150

After 3rd shock, after 5th shock

Question 2

Stridor indicates what?

Answer 2

Obstruction in the larynx or upper trachea

It is a harsh crowing inspiratory noise

Question 3

Absolute contraindications to organ donation

Answer 3

CJD
HIV disease
Ebola virus disease
Active cancer with spread outside the affected organ

Question 4

BRUE definition

Answer 4

Infant <12 months
Sudden onset episode
Lasting <1 min
Return to baseline

Not explained by identifiable medical condition(s)

Can be associated with central cyanosis / pallor / irregular breathing / Marked change in tone / Altered level of consciousness

Question 5

What makes a BRUE high risk (3)

Answer 5

Infant <2 months old
Hx of prematurity (especially <32 weeks)
More than 1 event

Question 6

CXR findings in thoracic aortic dissection

Answer 6

Widened mediastinum
Hazy left lung field
Obliteration of aortic knob
Fractures of 1st and 2nd ribs
Deviation of trachea to the right
Presence of a pleural cap
Elevation and a rightward shift of right mainstem bronchus
Depression of left mainstem bronchus
Obliteration of space between pulmonary artery and aorta
Deviation of the oesophagus (or NG tube) to the right

Question 7

The most common arrest rhythm in children?

Answer 7

Asytole

Question 8

Adrenaline dose in paediatric cardiac arrest

Dose given via an ETT

Answer 8

10 micrograms/kg

100 micrograms/kg

Question 9

Shockable rhythm in a paediatric arrest, shock strength

Answer 9

4J/kg

Question 10

Amiodarone dose in paediatric cardiac arrest

Answer 10

5mg/kg

Question 11

Alternative to amiodarone in paediatric cardiac arrest

Answer 11

Lidocaine

Question 12

Lidocaine dose in paediatric cardiac arrest

Answer 12

1mg/kg

Question 13

Magnesium dose in paediatric cardiac arrest

Answer 13

25-50mg/kg (max 2g)

Question 14

ETT size calculation in children (1yr+)

Uncuffed

Cuffed

Answer 14

(Age/4) + 4

(Age/4) + 3.5

Question 15

ETT tube length calculation in children

Oral

Nasal

Answer 15

(Age/2)+12

(Age/2)+15

Question 16

TTM in post arrest care

Answer 16

32-36 degrees for 24hrs

Prevent fever for 72hr

Question 17

Cardiac arrest due to hyperkalaemia, calcium chloride dose

Answer 17

10%, 10ml IV

Question 18

Cardiac arrest due to hyperkalaemia, insulin dex initial dose

Answer 18

10 units of short acting insulin + 25g glucose IV

Question 19

Cardiac arrest due to hyperkalaemia, additional medication to give if in renal failure or severe acidosis

Answer 19

50 mmol IV, sodium bicarb

Question 20

Position of traumatic aortic rupture in patients who survive

Answer 20

incomplete laceration near the ligamentum arteriosum of the aorta (proximal descending)

Question 21

Findings on chest X-ray can be helpful in making the diagnosis of traumatic aortic rupture:

Answer 21

Fractures of 1st and 2nd ribs
Grossly widened mediastinum
Hazy left lung field
Obliteration of the aortic knob
Deviation of the trachea to the right
Presence of a pleural cap
Elevation and rightward shift of right mainstem bronchus
Depression of the left mainstem bronchus
Obliteration of the space between pulmonary artery and aorta
Deviation of the oesophagus (or NG tube) to the right

Question 22

Amiodarone in cardiac arrest, dose diluted in?

Answer 22

300 mg as an IV bolus diluted in 5% dextrose to a volume of 20 mL

Question 23

Amiodarone MOA in cardiac arrest

Answer 23

membrane-stabilising antiarrhythmic drug that increases the duration of the action potential and the refractory period in atrial and ventricular myocardium

Question 24

Adult patient with burns, minimum ETT diameter

Answer 24

7.5mm

Question 25

Low risk BRUE, what investigations should be considered prior to discharge (2)

Answer 25

ECG Pertussis swab

Question 26

Lung protective ventilation in burns patients

Answer 26

Lung protective ventilation should be used with low tidal volumes (4-8 mL/kg) and peak inspiratory pressures <30 cmH2O.

Question 27

TXA loading dose Then infusion

Answer 27

1g over 10 mins 1g over 8hrs

Question 28

Perimortem Caesarean section should be performed within what time frame?

Answer 28

5 mins of cardiac arrest

Question 29

Four regions are assessed during a standard FAST scan:

Answer 29

Subxiphoid transverse view Longitudinal view of the right upper quadrant Longitudinal view of the left upper quadrant Transverse and longitudinal views of the suprapubic region

Question 30

Massive transfusion defined as

Answer 30

> 10 units of blood in 24hrs >4 units of blood in 1hr

Question 31

The American Burn Life Support (ABLS) indications for early intubation include:

Answer 31

Signs of airway obstruction (hoarseness, stridor, accessory respiratory muscle use, sternal retraction) Extent of the burn (total body surface area burn >40%–50%) Extensive and deep facial burns Burns inside the mouth Significant oedema or risk for oedema Difficulty swallowing Signs of respiratory compromise: inability to clear secretions, respiratory fatigue, poor oxygenation or ventilation Decreased level of consciousness where airway protective reflexes are impaired Anticipated patient transfer of large burn with airway issue without qualified personnel to intubate en route.

Question 32

The life-threatening thoracic injuries that should be treated in the primary survey are:

Answer 32

Airway obstruction Tracheobronchial tree injury Tension pneumothorax Open pneumothorax Massive haemothorax Cardiac tamponade

Question 33

Within what time period should tranexamic acid be used in the trauma setting?

Answer 33

Within 3hrs

Question 34

Contraindications to Needle cricothyroidotomy include the following (3)

Answer 34

Local infection Non-identifiable anatomy Previous failed attempts

Question 35

Elevation of the baseline on capnography indicates?

Answer 35

Re-breathing

Question 36

ET size 6 month old 6 month - 1yr old

Answer 36

size 4 size 4.5

Question 37

IO access In children <7 where is preferred

Answer 37

Proximal tibia Distal femur