Vascular Access and Fluid Management in Pediatric Emergencies Flashcards

A 5 kg infant requires epinephrine via IO for cardiac arrest. What is the correct dose?

Answer: 0.01 mg/kg (0.1 mL/kg of 0.1 mg/mL solution)

The PALS epinephrine dose for cardiac arrest is 0.01 mg/kg IV/IO, given every 3–5 minutes during CPR.

Which type of shock is characterized by warm, flushed skin with bounding pulses and wide pulse pressure?

Answer: Distributive (septic) shock

Distributive shock (e.g., septic) causes vasodilation, leading to warm skin, bounding pulses, and wide pulse pressure from decreased systemic vascular resistance.

A child in cardiogenic shock is being resuscitated. Why should large fluid boluses be avoided?

Answer: They can further increase cardiac preload and worsen pulmonary edema

In cardiogenic shock, the failing heart cannot handle extra volume, so large fluid boluses increase preload and worsen pulmonary congestion.

What is the correct IO flush volume to confirm placement and ensure patency before drug administration?

Answer: 5–10 mL of normal saline

A 5–10 mL saline flush is used to confirm IO placement and patency, and should be given before medications.

Which vasoactive drug is preferred for warm distributive (septic) shock with vasodilation?

Answer: Norepinephrine

Norepinephrine's potent alpha-adrenergic vasoconstriction makes it the preferred agent for warm distributive shock where peripheral vasodilation is the primary problem.

In a child with hemorrhagic shock, which fluid is preferred over isotonic crystalloid once available?

Answer: Packed red blood cells (pRBCs)

In hemorrhagic shock, packed red blood cells restore oxygen-carrying capacity along with volume, making them superior to crystalloid alone.