ACP Directives (Pediatric Only)

Question 1

What age can we defibrillate during cardiac arrest?

Answer 1

at least 24 hours old to apply regular cardiac arrest directive

Question 2

What age is considered pediatric for defibrillation for medical cardiac arrest?

Answer 2

at least 24 hours to less than 8 years

Question 3

What is the joule setting for pediatric patients?

Answer 3

first shock: 2J/kg
subsequent: 4J/kg

Question 4

What age receives neonatal resuscitation protocol?

Answer 4

less than 24 hours

Question 5

what age receives regular cardiac arrest algorithm?

Answer 5

24 hours or older

Question 6

What age is considered pediatric for medications for medical cardiac arrest?

Answer 6

24 hours to less than 12 years old

Question 7

What is the pediatric dose (in mL), concentration, and max/min dose for epi for ETT tube?
(medical cardiac arrest)

Answer 7

1:1,000
0.1ml/kg
0.5ml (min) to 2ml (max)

Question 8

What is the pediatric dose (in mL), concentration, and max/min dose for epi for IV/IO/CVAD route?
(medical cardiac arrest)

Answer 8

1:10,000
0.1ml/kg
0.5ml min (no max)

Question 9

What is the dosing interval for epi during medical cardiac arrest?

Answer 9

4 minutes

Question 10

What route can amiodarone be given?
(medical cardiac arrest)

Answer 10

IV, IO, CVAD

Question 11

What is the pediatric dose, max dose, number of doses, intervals for amiodarone IV/IO/CVAD route?
(medical cardiac arrest)

Answer 11

1st:
5mg/kg (max 300mg)

subsequent:
5mg/kg (max 150mg)

q 4 mins, max # 2 doses

Question 12

What route can lidocaine be given?
(medical cardiac arrest)

Answer 12

IV, IO, CVAD, ETT

Question 13

What is the pediatric dose, max dose, number of doses, intervals for lidocaine IV/IO/CVAD route?
(medical cardiac arrest)

Answer 13

All doses 1mg/kg
q 4 minutes
max # 2 doses

Question 14

What is the pediatric dose, max dose, number of doses, intervals for lidocaine ETT route?
(medical cardiac arrest)

Answer 14

All doses 2mg/kg
q 4 minutes
max #2 doses

Question 15

What volume of fluid bolus can be infused during cardiac arrest for pediatrics?

Answer 15

20ml/kg
max 2L

Question 16

What rate should breaths be provided with advanced airway during cardiac arrest for pediatrics?

Answer 16

One breath every 3 seconds
(20breaths/min)

Question 17

Explain the steps of NRP

Answer 17

–> warm, dry, stimulate, clear airway (30s)
ASSESS: Breathing AND HR greater than 100bpm
–> PPV with room air (30s)
ASSESS: HR greater than 60bpm
–> CPR with 100% O2 (BVM/ETT)
ASSESS: HR greater than 60bpm
–> continue CPR, provide epi, transport prior to 3rd dose

Question 18

What age is NRP

Answer 18

less than 24 hours (and at least 20 weeks gestation)

Question 19

Conditions for room air PPV?
(NRP)

Answer 19

HR less than 100bpm

Question 20

Conditions for CPR
(NRP)

Answer 20

1. HR < 60 bpm
2. after 30 seconds of PPV RA

Question 21

When is epi started?
(NRP)

Answer 21

after 30 seconds of CPR

Question 22

Conditions for epi
(NRP)

Answer 22

1.HR < 60bpm
2. after 30 seconds CPR

Question 23

What is the concentration, dose (in ml), min/max single dose, and dosing interval for ETT epi for patients less than 24 hours old?
(NRP)

Answer 23

ETT
1:10,000
1.0ml/kg (max 3.0ml)
ONE SINGLE DOSE

Question 24

What is the concentration, dose (in ml), min/max single dose, and dosing interval for IV,IO epi for patients less than 24 hours old?
(NRP)

Answer 24

IV, IO
1:10,000
0.1ml/kg (min 0.5ml)
q 4 minutes

Question 25

What is the age for pediatric dose for morphine?
(analgesia directive)

Answer 25

at least 1 year old to less than 18 years

Question 26

What is the age for pediatric dose for fentanyl?
(analgesia directive)

Answer 26

at least 1 year old to less than 18 years

Question 27

What is the pediatric route, dosing, max single dose, interval and total amount for morphine?
(analgesia directve)

Answer 27

IV, Sc
0.05-0.1mg/kg (max 5mg)
q 15 minutes
max total 10mg

Question 28

What is the pediatric route, dosing, max single dose, interval and total amount for fentanyl?
(analgesia directve)

Answer 28

IV, IN
up to 1mcg/kg (max 75mcg)
q 5 minutes
max total 200 mcg