Vascular Access and Fluid Management in Pediatric Emergencies Flashcards

What maximum fluid volume (in mL/kg) should be given before reassessing a child in septic shock and considering vasopressors?

Answer: 40–60 mL/kg

PALS guidelines suggest reassessing and considering vasoactive agents after 40–60 mL/kg of fluid if perfusion has not improved.

A child with distributive shock is fluid-resuscitated but becomes hypotensive with signs of fluid overload. Which finding suggests fluid overload?

Answer: New crackles on lung auscultation and hepatomegaly

Pulmonary crackles and hepatomegaly indicate excessive fluid accumulation, signaling fluid overload in pediatric patients.

Which drug is used as a first-line vasoactive agent for cold septic shock (decreased cardiac output) in children?

Answer: Epinephrine

Epinephrine is preferred for cold septic shock because its combined alpha and beta effects increase cardiac output and vascular tone.

During IO administration of medications, which action must be performed to ensure drug delivery into the circulation?

Answer: Flush with 5–10 mL of normal saline after each drug

Flushing with saline after IO drug administration ensures the medication reaches the systemic circulation from the bone marrow cavity.

Which of the following is a contraindication to IO placement at a specific site?

Answer: Fracture of the bone proximal to the intended site

A fracture proximal to the IO site is a contraindication because fluids and medications can extravasate through the fracture site into surrounding tissue.

In a child with obstructive shock from tension pneumothorax, what is the definitive treatment?

Answer: Needle decompression followed by chest tube thoracostomy

Tension pneumothorax causing obstructive shock requires immediate needle decompression followed by chest tube placement to relieve the obstruction.