CPR Pediatric and Neonatal Resuscitation 3 — Questions and Answers
Question 1: A term neonate is born with meconium-stained amniotic fluid and is vigorous at birth. What is the correct management?
- Immediate intubation and tracheal suctioning
- Routine care without tracheal suctioning (Correct answer)
- Bulb syringe suctioning of the oropharynx before delivery of the shoulders
- Immediate PPV and tracheal suctioning
Correct answer: Routine care without tracheal suctioning
Current guidelines state that vigorous neonates born with meconium-stained fluid should receive routine care; tracheal suctioning is not recommended.
Question 2: When performing two-thumb encircling chest compressions on a neonate, the sternum should be compressed to what depth?
- One-quarter of the anterior-posterior chest diameter
- One-third of the anterior-posterior chest diameter (Correct answer)
- One-half of the anterior-posterior chest diameter
- 1-2 cm regardless of chest size
Correct answer: One-third of the anterior-posterior chest diameter
Neonatal chest compressions should compress the sternum approximately one-third of the anterior-posterior diameter of the chest.
Question 3: A 2-year-old child is unresponsive with no pulse. A single rescuer is present. What is the correct compression-to-ventilation ratio?
- 15:2
- 30:2 (Correct answer)
- 30:1
- 15:1
Correct answer: 30:2
A single rescuer performing pediatric CPR uses a 30:2 compression-to-ventilation ratio, the same as adult CPR.
Question 4: Which route is preferred for epinephrine administration during neonatal cardiac arrest when IV access is unavailable?
- Endotracheal tube
- Intraosseous (Correct answer)
- Sublingual
- Intramuscular
Correct answer: Intraosseous
IO access is preferred over the endotracheal route because endotracheal epinephrine results in unpredictable drug absorption in neonates.
Question 5: What is the correct ratio of compressions to ventilations used during two-rescuer neonatal CPR?
- 15:2
- 30:2
- 3:1 (Correct answer)
- 5:1
Correct answer: 3:1
Neonatal resuscitation uses a 3:1 compression-to-ventilation ratio, providing 90 compressions and 30 breaths per minute.
Question 6: An 8-year-old child in SVT is hemodynamically stable. Which is the FIRST intervention attempted?
- Synchronized cardioversion at 0.5 J/kg
- Adenosine 0.1 mg/kg IV
- Vagal maneuvers such as ice water immersion of the face (Correct answer)
- Amiodarone 5 mg/kg IV
Correct answer: Vagal maneuvers such as ice water immersion of the face
In a stable pediatric patient with SVT, vagal maneuvers are attempted first before adenosine or cardioversion.
Question 7: Which condition is the most common cause of cardiac arrest in infants and children?
- Primary cardiac dysrhythmia
- Respiratory failure or shock leading to hypoxia (Correct answer)
- Congenital heart defect rupture
- Hyperkalemia-induced ventricular fibrillation
Correct answer: Respiratory failure or shock leading to hypoxia
Pediatric cardiac arrest is almost always secondary to respiratory failure or circulatory shock rather than a primary cardiac event.
CPR Pediatric and Neonatal Resuscitation 3
A term neonate is born with meconium-stained amniotic fluid and is vigorous at birth.
What is the correct management?