PEARS PEARS Vascular Access and Medication Administration 1 — Questions and Answers
Question 1: When IV access cannot be rapidly established in a critically ill pediatric patient, what is the preferred alternative vascular access route?
- Intraosseous (IO) access (Correct answer)
- Central venous catheter immediately
- Subcutaneous injection
- Intramuscular epinephrine as the only option
Correct answer: Intraosseous (IO) access
IO access is the recommended alternative when IV access is unavailable in a pediatric emergency, allowing rapid delivery of fluids and medications.
Question 2: Which site is most commonly used for intraosseous access in infants and young children?
- Proximal tibia (Correct answer)
- Femoral vein
- Jugular vein
- Radial artery
Correct answer: Proximal tibia
The proximal tibia is the preferred IO insertion site in infants and young children due to its flat surface and accessible marrow space.
Question 3: What is the appropriate dose of epinephrine for pediatric cardiac arrest via IV or IO route?
- 0.01 mg/kg (1:10,000 solution) (Correct answer)
- 0.1 mg/kg (1:1,000 solution)
- 1 mg flat dose regardless of weight
- 0.001 mg/kg (1:100,000 solution)
Correct answer: 0.01 mg/kg (1:10,000 solution)
The standard epinephrine dose for pediatric cardiac arrest is 0.01 mg/kg of the 1:10,000 solution given IV or IO every 3–5 minutes.
Question 4: A Broselow tape is used during a pediatric emergency primarily to:
- Estimate weight-based medication doses and equipment sizes (Correct answer)
- Measure blood pressure
- Determine IV fluid tonicity
- Calculate oxygen flow rates manually
Correct answer: Estimate weight-based medication doses and equipment sizes
The Broselow tape correlates a child's length with estimated weight to provide pre-calculated medication doses and appropriate equipment sizes rapidly.
Question 5: Which medication is the first-line treatment for symptomatic bradycardia caused by increased vagal tone in a pediatric patient?
- Atropine (Correct answer)
- Adenosine
- Amiodarone
- Lidocaine
Correct answer: Atropine
Atropine is the first-line agent for symptomatic bradycardia caused by vagal stimulation, blocking parasympathetic effects on the heart.
Question 6: What is the maximum single dose of atropine recommended in pediatric resuscitation to avoid paradoxical bradycardia?
- 0.5 mg minimum per dose; total cumulative maximum 1 mg in children (Correct answer)
- 0.01 mg/kg with no maximum
- 5 mg single dose
- 0.001 mg/kg minimum with no maximum cap
Correct answer: 0.5 mg minimum per dose; total cumulative maximum 1 mg in children
A minimum atropine dose of 0.5 mg prevents paradoxical bradycardia from very small doses, with a maximum cumulative dose of 1 mg in children.
PEARS PEARS Vascular Access and Medication Administration 1
When IV access cannot be rapidly established in a critically ill pediatric patient, what is the preferred alternative vascular access route?