NPS Emergency and Critical Care Flashcards

During neonatal resuscitation, chest compressions are indicated when the heart rate remains below what threshold after 30 seconds of effective positive pressure ventilation?

Answer: 60 bpm

NRP guidelines specify initiating chest compressions when HR remains <60 bpm after 30 seconds of effective PPV with 100% oxygen.

The correct compression-to-ventilation ratio during neonatal CPR is:

Answer: 3:1

NRP recommends a 3:1 compression-to-ventilation ratio (90 compressions + 30 breaths per minute) for neonatal CPR to prioritize ventilation in asphyxia-driven cardiac arrest.

A 6-week-old infant presents with apnea, bradycardia, and poor perfusion. Heart rate is 40 bpm. After initiating CPR, which vascular access is the fastest to establish?

Answer: Intraosseous access (IO)

Intraosseous access is the fastest vascular access in pediatric emergencies when peripheral IV fails, allowing immediate delivery of resuscitative medications.

What is the initial fluid bolus volume and type for a pediatric patient in septic shock?

Answer: 20 mL/kg isotonic crystalloid

Current PALS guidelines recommend 20 mL/kg isotonic crystalloid (normal saline or LR) as the initial fluid bolus for pediatric septic shock, reassessing after each bolus.

A 3-year-old child has an anaphylactic reaction at a peanut-free facility. What is the first-line treatment?

Answer: Epinephrine IM (0.01 mg/kg) into the anterolateral thigh

Intramuscular epinephrine 0.01 mg/kg (max 0.5 mg) into the anterolateral thigh is the first-line treatment for anaphylaxis in children — antihistamines and steroids are adjuncts.

Which is the most common cause of cardiac arrest in the pediatric population outside of the neonatal period?

Answer: Respiratory failure leading to hypoxic cardiac arrest

Unlike adults, pediatric cardiac arrest is predominantly caused by respiratory failure (asphyxia) rather than primary cardiac arrhythmia, making airway management the priority.