PEARS Cardiac Arrest Care 3 — Questions and Answers
Question 1: A child in cardiac arrest has a shockable rhythm. After the first defibrillation attempt, what should be done immediately?
- Check the pulse for 30 seconds
- Resume CPR for 2 minutes before rechecking the rhythm (Correct answer)
- Administer epinephrine before resuming CPR
- Deliver a second shock immediately
Correct answer: Resume CPR for 2 minutes before rechecking the rhythm
After defibrillation, immediately resume CPR for 2 minutes before pausing to recheck the rhythm, as the heart needs time to recover.
Question 2: What is the recommended initial energy dose for defibrillation in a pediatric patient?
- 1 J/kg
- 2 J/kg (Correct answer)
- 4 J/kg
- 10 J/kg
Correct answer: 2 J/kg
The initial defibrillation dose in children is 2 J/kg, with subsequent doses increased to 4 J/kg or greater.
Question 3: Which of the following is a 'T' in the Hs and Ts mnemonic for reversible causes of cardiac arrest?
- Tachycardia
- Toxins (Correct answer)
- Thrombophilia
- Transposition
Correct answer: Toxins
Toxins (such as drug ingestion or poisoning) are one of the Ts in the reversible causes framework for cardiac arrest.
Question 4: During resuscitation of a child, epinephrine is ordered. What is the standard IV/IO dose?
- 0.001 mg/kg
- 0.01 mg/kg (Correct answer)
- 0.1 mg/kg
- 1 mg/kg
Correct answer: 0.01 mg/kg
The standard IV/IO dose of epinephrine during cardiac arrest is 0.01 mg/kg (1:10,000 concentration) every 3-5 minutes.
Question 5: What is the maximum single dose of epinephrine given IV/IO during pediatric cardiac arrest?
- 0.5 mg
- 1 mg (Correct answer)
- 2 mg
- 5 mg
Correct answer: 1 mg
The maximum single epinephrine dose is 1 mg regardless of weight during pediatric cardiac arrest.
Question 6: Tension pneumothorax is suspected as a reversible cause of cardiac arrest. What is the immediate treatment?
- Chest tube insertion in the OR
- Needle decompression of the affected side (Correct answer)
- Pericardiocentesis
- Immediate intubation
Correct answer: Needle decompression of the affected side
Needle decompression (needle thoracostomy) is the immediate treatment for tension pneumothorax during cardiac arrest.
Question 7: During CPR, which intravenous medication is the first-line drug for ventricular fibrillation refractory to defibrillation?
- Lidocaine
- Atropine
- Amiodarone (Correct answer)
- Adenosine
Correct answer: Amiodarone
Amiodarone is the first-line antiarrhythmic for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia in children.
PEARS Cardiac Arrest Care 3
A child in cardiac arrest has a shockable rhythm.
After the first defibrillation attempt, what should be done immediately?