PALS Megacode: Unstable Pediatric Bradycardia Part 2
11:40 PM. You have
responded to a call from a grandmother who called and said her grandbaby was
not “breathing right.” You found the 12
month old infant unresponsive and with agonal respirations. CPR was initiated and positive pressure
respirations were being given. The
grandmother suspects that the toddler got into her pill box and took her weekly
dose of metoprolol. You have placed the
patient on the monitor and noted her to be in complete heart block. After 2 minutes of CPR there is no change in
the patient’s rhythm. An IV is
attempted without success, so an IO is placed near the proximal tibia. Preparations are made to transport the
toddler. The patients stated weight is
22 lbs (10kg)
6. How do you
verify proper placement of an IO needle?
a. The needle will
make a “popping” sound as it enters the bone
b. The needle will
stand up on its own
c. Bone marrow or
blood can be aspirated through the needle
d. The fluids will
flow freely into the bone
7. What are 4 contraindications
for using an IO needle?
a.
b.
c.
d.
8. What are 4
complications related to the use of an IO needle?
a.
b.
c.
d.
9. What is the
recommended fluid bolus for a pediatric patient in cardiogenic shock?
a. 5-10ml/kg
b. 10- 15ml/kg
c. 15-20ml/kg
d. 20-25ml/kg
10. What medication would be indicated if ventilations
and oxygenation fail to correct the bradydysrhythmia?
a. Epinephrine 0.01mg
IV or IO
b. Vasopression
40units IV or IO
c Atropine 0.5mg
IV or IO
d. Dopamine
2-10mcg/kg/min
6. c. Bone marrow or blood can be aspirated through the needle
7.
b. Cellulitis overlying the insertion site
c. Inferior vena caval injury
d. Previous attempt on the same leg bone
e. Osteogenesis imperfecta because of a higher likelihood of fractures occurring
f. Osteoporosis
8.
b. Compartment syndrome
c. Infection
d. Cellulitis at the insertion site
e. Hematoma
f. Pain at insertion site
g. Growth plate injuries
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