Critical Care

Question 1

Rate >220 in infant, >180 children, narrow QRS, NOT variable with absent P waves. Treatment?

Answer 1

Vagal maneuvers, Adenosine 0.1mg/kg. If unstable and no IV access: synchronized cardioversion

Question 2

Bradycardia with pulse/poor perfusion. Meds>

Answer 2

Epinephrine 0.01mg/kg IV/IO (or 0.1mg/kg ETT), Atropine 0.02mg/kg

Question 3

Risk factors for poor prognosis in near drowning:

1. Age ?
2. Submersion longer than ? minutes
3. Resuscitation > ? minutes
4. Need for continued resuscitation in ER
5. Water temp ?

Answer 3

1. Age < 3 yo
2. Submersion > 10 minutes
3. Resuscitation > 25 minutes
4. Need for continued resuscitation in ER
5. Water temp >10 C

Question 4

Burn fluid replacement equation

Answer 4

(4cc/kg x %BSA) + maintenance. Give first half over 8 hours, remaining over 16 hours

Question 5

Requirements for apnea test consistent with brain death

Answer 5

pCO2 must rise at least 20mmHg above baseline and be greater than 60mmHg

Question 6

Cushing’s triad

Answer 6

bradycardia, hypertension, irregular respirations