PEARS PEARS Vascular Access and Medication Administration 2 — Questions and Answers
Question 1: Adenosine is used in pediatric emergencies to treat which rhythm?
- Supraventricular tachycardia (SVT) (Correct answer)
- Ventricular fibrillation
- Asystole
- Sinus bradycardia
Correct answer: Supraventricular tachycardia (SVT)
Adenosine transiently blocks AV conduction to terminate reentry SVT and is the first-line drug for stable SVT in children.
Question 2: What technique must be used when giving adenosine via peripheral IV to ensure it reaches circulation?
- Rapid IV push followed by a large saline flush (Correct answer)
- Slow infusion over 30 minutes
- Mix with D5W and give over 10 minutes
- Dilute in 100 mL normal saline
Correct answer: Rapid IV push followed by a large saline flush
Adenosine has an extremely short half-life (<10 seconds), so it must be given as a rapid bolus immediately followed by a large saline flush to reach central circulation.
Question 3: What is the recommended initial dose of adenosine for pediatric SVT?
- 0.1 mg/kg rapid IV/IO push (max 6 mg) (Correct answer)
- 1 mg/kg slow IV infusion
- 0.01 mg/kg IV push
- 10 mg flat dose
Correct answer: 0.1 mg/kg rapid IV/IO push (max 6 mg)
The initial adenosine dose is 0.1 mg/kg (maximum 6 mg) given as a rapid IV or IO push with a flush.
Question 4: Amiodarone is indicated in pediatric cardiac arrest for which refractory condition?
- Ventricular fibrillation or pulseless ventricular tachycardia unresponsive to defibrillation (Correct answer)
- Asystole unresponsive to epinephrine
- Sinus tachycardia due to fever
- SVT not responding to adenosine
Correct answer: Ventricular fibrillation or pulseless ventricular tachycardia unresponsive to defibrillation
Amiodarone is used for shock-refractory VF or pulseless VT, given at 5 mg/kg IV/IO bolus during resuscitation.
Question 5: Which fluid is recommended as the first-line resuscitation fluid for hypovolemic shock in a pediatric patient?
- Isotonic crystalloid (0.9% normal saline or lactated Ringer's) (Correct answer)
- 5% dextrose in water (D5W)
- Albumin 25%
- Hypotonic saline (0.45%)
Correct answer: Isotonic crystalloid (0.9% normal saline or lactated Ringer's)
Isotonic crystalloids such as normal saline or lactated Ringer's are the first-line fluids for pediatric hypovolemic shock resuscitation.
Question 6: What is the standard initial fluid bolus volume for pediatric shock resuscitation?
- 20 mL/kg IV/IO over 5–10 minutes (Correct answer)
- 100 mL/kg over 1 hour
- 1 L regardless of weight
- 5 mL/kg over 30 minutes
Correct answer: 20 mL/kg IV/IO over 5–10 minutes
A 20 mL/kg isotonic fluid bolus given rapidly over 5–10 minutes is the standard initial resuscitation volume for pediatric shock.
PEARS PEARS Vascular Access and Medication Administration 2
Adenosine is used in pediatric emergencies to treat which rhythm?