NPS Emergency and Critical Care Flashcards

What is the correct energy dose for the FIRST defibrillation attempt in a pediatric patient with ventricular fibrillation?

Answer: 2 J/kg

PALS recommends an initial defibrillation dose of 2 J/kg for pediatric VF/pulseless VT, with subsequent shocks at 4 J/kg.

A neonate in the NICU suddenly develops cyanosis, bradycardia, and absent breath sounds on the left. Chest transillumination is positive. What is the immediate intervention?

Answer: Needle decompression of the left chest at the 2nd intercostal space, midclavicular line

A tension pneumothorax in a neonate requires immediate needle decompression at the 2nd ICS, MCL on the affected side — waiting for X-ray confirmation is inappropriate.

During neonatal transport, a 27-week premature neonate becomes increasingly tachycardic and pale. Blood glucose is 22 mg/dL. What is the first intervention?

Answer: IV dextrose 10% at 2 mL/kg bolus

Symptomatic hypoglycemia in a neonate is treated with a D10W minibolus of 2 mL/kg IV, providing approximately 200 mg/kg glucose to rapidly restore euglycemia.

A pediatric patient with traumatic brain injury has a GCS of 7. What is the initial target PaCO2?

Answer: 35–40 mmHg (normocapnia)

Normocapnia (PaCO2 35–40 mmHg) is targeted in pediatric TBI to avoid cerebral vasoconstriction from hypocapnia; prophylactic hyperventilation is no longer recommended.

Which sign indicates that a pediatric patient in shock has transitioned from compensated to decompensated shock?

Answer: Hypotension

Hypotension marks the transition to decompensated shock in pediatric patients; children can maintain blood pressure for extended periods through vasoconstriction before decompensating.

A term neonate has a 5-minute Apgar score of 2. Which therapeutic intervention, if initiated within 6 hours, improves neurological outcomes?

Answer: Therapeutic hypothermia at 33–34°C for 72 hours

Therapeutic hypothermia (whole-body cooling to 33–34°C for 72 hours) initiated within 6 hours of birth is the standard of care for moderate-severe HIE.