CPR - Certified Paramedic Response Pediatric and Neonatal Resuscitation Questions and Answers 1 — Questions and Answers
Question 1: Two paramedics are resuscitating a 5-year-old child in cardiac arrest. What is the correct compression-to-ventilation ratio they should use?
- 30:2
- 15:2 (Correct answer)
- 3:1
- 100 compressions with 1 breath every 6 seconds
Correct answer: 15:2
For two-rescuer CPR on a child, the American Heart Association (AHA) recommends a compression-to-ventilation ratio of 15:2. This is different from the 30:2 ratio used for single-rescuer child CPR and all adult CPR. The 15:2 ratio provides more frequent ventilations, which is critical in pediatric arrests as they are often respiratory in origin.
Question 2: You are treating an 18-month-old in ventricular fibrillation. What is the recommended initial energy dose for defibrillation?
- 0.5 J/kg
- 2 J/kg (Correct answer)
- 8 J/kg
- A standard adult dose of 200 J
Correct answer: 2 J/kg
The current PALS guidelines recommend an initial energy dose of 2 J/kg for the defibrillation of pediatric patients in ventricular fibrillation or pulseless ventricular tachycardia. Subsequent shocks may be increased to 4 J/kg or higher, but the first shock should be 2 J/kg.
Question 3: A paramedic is preparing to administer intravenous epinephrine to a 22-pound (10 kg) child in asystole. Which of the following is the correct dose and concentration?
- 1 mg of 1:1,000 solution
- 0.1 mg of 1:1,000 solution
- 1 mg of 1:10,000 solution
- 0.1 mg of 1:10,000 solution (Correct answer)
Correct answer: 0.1 mg of 1:10,000 solution
The standard IV/IO dose of epinephrine for pediatric cardiac arrest is 0.01 mg/kg of the 1:10,000 concentration. For a 10 kg child, this calculates to 0.1 mg (0.01 mg/kg * 10 kg). The 1:10,000 concentration is crucial for IV/IO administration to avoid dosing errors.
Question 4: During the resuscitation of a newborn, the baby remains apneic with a heart rate of 45 beats per minute despite effective positive-pressure ventilation. Which of the following is the most appropriate next step?
- Administer a fluid bolus of 20 mL/kg.
- Begin chest compressions. (Correct answer)
- Intubate immediately.
- Administer atropine 0.02 mg/kg.
Correct answer: Begin chest compressions.
According to the Neonatal Resuscitation Program (NRP) guidelines, if a newborn's heart rate is below 60 bpm despite 30 seconds of effective positive-pressure ventilation, chest compressions should be initiated. Compressions should be coordinated with ventilations at a 3:1 ratio.
Question 5: Which of the following is the most common initial cause of cardiac arrest in infants and children?
- Respiratory failure or shock (Correct answer)
- Primary cardiac arrhythmia
- Traumatic injury
- Congenital heart defects
Correct answer: Respiratory failure or shock
Unlike adults, where sudden cardiac events are common, the vast majority of pediatric cardiac arrests are secondary to progressive respiratory failure or shock. This is why effective ventilation is a cornerstone of pediatric resuscitation.
Question 6: A paramedic is performing CPR on a 4-year-old child. To ensure high-quality compressions, what is the recommended compression depth?
- At least one-fourth the anterior-posterior diameter of the chest
- At least one-third the anterior-posterior diameter of the chest (Correct answer)
- At least one-half the anterior-posterior diameter of the chest
- A depth of at least 3 inches (7.5 cm)
Correct answer: At least one-third the anterior-posterior diameter of the chest
For children, high-quality chest compressions should have a depth of at least one-third the anterior-posterior (AP) diameter of the chest, which is approximately 2 inches (5 cm). This ensures adequate circulation without causing injury.
CPR - Certified Paramedic Response Pediatric and Neonatal Resuscitation Questions and Answers 1
Two paramedics are resuscitating a 5-year-old child in cardiac arrest.
What is the correct compression-to-ventilation ratio they should use?