Mixed Deck — All PEARS Topics Flashcards

Amiodarone is indicated in pediatric cardiac arrest for which refractory condition?

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.

You and a colleague are performing high-quality, two-rescuer CPR on a 4-year-old child. What is the correct compression-to-ventilation ratio that should be used?

Answer: 15 compressions to 2 breaths

For two-rescuer CPR on an infant or child, the recommended compression-to-ventilation ratio is 15:2. This ratio provides more frequent ventilations compared to the 30:2 ratio used for single-rescuer CPR, which is critical as pediatric cardiac arrest is often secondary to respiratory issues.

What is the recommended approach to ventilator settings immediately after intubation in a post-ROSC pediatric patient?

Answer: Titrate to achieve normocarbia and appropriate SpO2; avoid hyperventilation

Targeting normocarbia and SpO2 94%–99% avoids secondary brain injury from both hypoxia and excessive CO2 changes.

Which clinical sign best differentiates upper airway obstruction from lower airway obstruction in a pediatric patient?

Answer: Inspiratory stridor versus expiratory wheezing

Inspiratory stridor indicates upper airway (extrathoracic) obstruction, while expiratory wheezing indicates lower airway (intrathoracic) obstruction.

A 7-year-old with croup has moderate stridor at rest. After racemic epinephrine, symptoms improve. Why must this child be observed for at least 2-4 hours?

Answer: Rebound stridor may occur as epinephrine effect wears off

Racemic epinephrine causes transient vasoconstriction; rebound edema and worsening stridor can recur as the drug effect wanes, necessitating observation.

A 3-year-old is brought in after a fall. She is crying loudly, pushes you away when you approach, and her skin appears pink and well-perfused. How does the PAT characterize this child?

Answer: Normal appearance, normal work of breathing, normal circulation

Crying vigorously, resisting examination, and pink perfused skin all indicate a stable child with normal PAT findings.

Why is effective teamwork essential in pediatric emergencies?

Answer: To ensure coordinated and efficient care

Teamwork ensures timely, coordinated care, reducing errors and improving outcomes in pediatric emergencies.

A 7-year-old has intercostal and supraclavicular retractions with absent breath sounds on the left. Which TWO PAT components are abnormal?

Answer: Work of Breathing and Circulation

Significant retractions indicate increased work of breathing, and absent breath sounds with likely tension pneumothorax impairs circulation, making both components abnormal.

How can leaders improve team performance during pediatric emergencies?

Answer: Providing clear direction and delegating tasks

Clear delegation of tasks and calm guidance from leaders help keep the team organized and effective.

A healthcare provider is gathering a history for a 6-year-old who fell off his bike. The provider asks the parent, 'What was the last thing he had to eat or drink?' This question is part of which assessment component?

Answer: Secondary Assessment (SAMPLE history)

The Secondary Assessment involves a focused history and physical exam. The SAMPLE mnemonic is a tool used to gather this history. The 'L' in SAMPLE stands for 'Last Oral Intake,' which includes the last food and drink consumed.

A resuscitation team is managing a critically ill child. A team member notices that the medication dose the team leader just ordered is incorrect for the child's weight. What is the most appropriate action for the team member to take?

Answer: Respectfully and clearly state their concern about the dose, suggesting a correction.

This action is known as constructive intervention. Team members have a responsibility to speak up if they believe a mistake is being made, regardless of roles. This should be done respectfully and clearly to ensure patient safety.

When performing chest compressions on an infant, what is the preferred two-rescuer technique?

Answer: Two thumb-encircling hands technique

The two thumb-encircling hands technique is preferred for two-rescuer infant CPR because it generates higher coronary perfusion pressure.

A pediatric patient is hemodynamically unstable after ROSC with signs of poor perfusion. What is the first-line intervention?

Answer: IV fluid bolus of isotonic crystalloid (10–20 mL/kg)

An isotonic crystalloid bolus of 10–20 mL/kg is the first-line treatment for post-ROSC hemodynamic instability before escalating to vasopressors.

Which TICLS mnemonic element assesses whether a child makes eye contact and tracks your movement?

Answer: Look/Gaze

Look/Gaze in the TICLS mnemonic evaluates whether the child has a purposeful gaze and visually tracks people or objects.

In a pediatric patient who achieves ROSC, which parameter should be carefully monitored to detect hypoglycemia?

Answer: Blood glucose level

Blood glucose must be monitored post-ROSC because hypoglycemia causes secondary brain injury and worsens neurological outcomes.

When performing the initial 'from the doorway' assessment using the Pediatric Assessment Triangle (PAT), which component is evaluated using the TICLS mnemonic?

Answer: Appearance

The Pediatric Assessment Triangle (PAT) consists of three components: Appearance, Work of Breathing, and Circulation to Skin. The 'Appearance' component is assessed using the TICLS mnemonic, which stands for Tone, Interactiveness, Consolability, Look/Gaze, and Speech/Cry.

Which behavior may indicate altered mental status in a pediatric emergency?

Answer: Lack of responsiveness

Unresponsiveness or lack of interaction with caregivers suggests a potentially life-threatening condition.

A 2-month-old presents with rapid, shallow breathing, poor feeding, and intercostal retractions. SpO2 is 91%. Which condition is the most common cause of respiratory failure in infants this age?

Answer: Bronchiolitis caused by RSV

Respiratory syncytial virus (RSV) bronchiolitis is the most common cause of lower respiratory tract infection and respiratory failure in infants under 2 years of age.

In third-degree (complete) AV block, what is the relationship between P waves and QRS complexes?

Answer: P waves and QRS complexes are completely independent with no consistent relationship

In complete AV block, the atria and ventricles beat independently—there is no consistent PR relationship between P waves and QRS complexes.

Adenosine is used in pediatric emergencies to treat which rhythm?

Answer: Supraventricular tachycardia (SVT)

Adenosine transiently blocks AV conduction to terminate reentry SVT and is the first-line drug for stable SVT in children.