1. You are called to help resuscitate an infant with severe symptomatic bradycardia associated
with respiratory distress. The bradycardia persists
... [Show More] despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present. Which of the following
is the first drug you should administer?
A. Dopamine
B. Adenosine
C. Atropine
D. Epinephrine - D
2. A 3-year-old boy presents with multiple system trauma. The child was an unrestrained
passenger in a motor vehicle crash. On primary assessment he is unresponsive to voice or
painful stimulation. His respiratory rate is less than 6/min, heart rate is 170/min, systolic blood
pressure is 60 mm Hg, cap refill is 5 seconds, and SpO2 is 75% in room air. Which of the
following most accurately summarizes the first interventions you should take to support this
child?
A. Establish immediate vascular access, administer 20 mL/kg isotonic crystalloid, and
reassess the patient; if the child's systemic perfusion does not improve, administer 10
to 20 mL/kg packed red blood cells.
B. Provide 100% oxygen by simple mask and perform a head-to-toe survey to identify the
extent of all injuries; begin an epinephrine infusion and titrate to maintain a systolic
blood pressure of at least 76 mm Hg
C. Open the airway (jaw-thrust technique) while stabilizing the cervical spine, administer
positive-pressure ventilation with 100% oxygen, and establish immediate IV/IO
access.
D. Provide 100% oxygen by simple mask, stabilize the cervical spine, establish vascular
access, and provide maintenance IV fluids. - C
3. Parents of a 1-year-old female phoned EMS when they picked up their daughter from the
babysitter. Paramedics perform an initial impression revealing an obtunded infant with
irregular breathing, bruises over the abdomen, abdominal distension, and cyanosis. Assisted
bag-mask ventilation with 100% oxygen is initiated. On primary assessment heart rate is
36/min, peripheral pulses cannot be palpated, and central pulses are barely palpable. Cardiac
monitor shows sinus bradycardia. Chest compressions are started at 15:2. In the ED the infant
is intubated and ventilated, and IV access is established. The heart rate is now up to 150/min,
but there are weak central pulses and no distal pulses. Systolic BP is 74. Of the following,
which would be most useful in management of this infant?
A. Synchronized cardioversion
B. Epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IV
C. Rapid bolus of 20 mL/kg of isotonic crystalloid
D. Atropine 0.02 mg/kg IV - C [Show Less]