NPS Emergency and Critical Care Flashcards

A 4-year-old child presents in status epilepticus lasting 10 minutes. What is the first-line pharmacologic intervention?

Answer: IV/IM/intranasal benzodiazepine (e.g., lorazepam, midazolam)

Benzodiazepines (lorazepam IV, midazolam IM/IN/buccal) are first-line for pediatric status epilepticus due to rapid onset and efficacy in terminating seizure activity.

What is the correct sequence for managing a neonate with meconium-stained amniotic fluid who is non-vigorous at birth?

Answer: Initiate PPV immediately without tracheal suctioning

Current NRP guidelines recommend initiating PPV immediately for non-vigorous meconium-stained neonates rather than routine tracheal suctioning, which has not been shown to improve outcomes.

During neonatal transport, maintaining normothermia is critical. What is the target core temperature range for a sick neonate?

Answer: 36–37.5°C

Neonatal normothermia target is 36–37.5°C axillary; hypothermia increases oxygen consumption, metabolic acidosis, surfactant dysfunction, and mortality.

A 2-month-old presents with sudden cardiac arrest and is found to have hypertrophic cardiomyopathy (HCM). Which medication is CONTRAINDICATED in management?

Answer: Dopamine in high doses (>10 mcg/kg/min)

High-dose dopamine increases heart rate and myocardial contractility, worsening the dynamic outflow tract obstruction in HCM and precipitating hemodynamic collapse.

Which laboratory test is most urgently needed when a neonate presents with suspected necrotizing enterocolitis (NEC)?

Answer: Abdominal X-ray and complete blood count with differential, blood culture, and metabolic panel

NEC evaluation requires abdominal X-ray (for pneumatosis intestinalis/free air), CBC (for neutropenia/thrombocytopenia), blood cultures, and metabolic panel simultaneously.

What is the appropriate size endotracheal tube (uncuffed) for a term neonate?

Answer: 3.0–3.5 mm

Term neonates (approximately 3–4 kg) are intubated with a 3.0–3.5 mm uncuffed ETT; tube size can be estimated as weight (kg)/3 + 2.5 for neonates.