Pediatric Emergency

Question 1

What is the definition of shock

Answer 1

Inadequate tissue perfusion

Question 2

What is the relationship between BP and CO, SVR, and HR

Answer 2

If one increase the other will be decreased to maintain BP

Question 3

What is the stroke volume

Answer 3

Combination of preload, afterload and contractility

Question 4

What is the cardiac output?

Answer 4

Amount of blood pumped each minute by the heart from the aorta

Question 5

What is the normal cardiac output in pediatric

Answer 5

75-85 ml\kg

Question 6

Why do pediatric population have fixed stroke volume?

Answer 6

Immaturity of sympathetic innervation to the ventricle

Question 7

What maintains adequate cardiac output in pediatric?

Answer 7

Heart rate

Question 8

What is the first sign of shock in pediatric

Answer 8

Only tachycardia

Hypotension comes in late and only

Question 9

What is the most common type of shock?

Answer 9

Hypovoulemic

Question 10

What is the abnormality in hypovoulemic shock

Answer 10

Decreased SV

Question 11

What is the abnormality in disruptive shock

Answer 11

Decreased SVR

Question 12

What is the abnormality in cardiogenic shock

Answer 12

Decreased contractility

Question 13

What is the abnormality in obstructive shock

Answer 13

Decreased CO

Question 14

What is most important treatment part of hypovolemic shock

Answer 14

Fluid recessitaiton

Question 15

What is most important treatment part of disruptive shock

Answer 15

Vasopressin

Question 16

What is most important treatment part of cardiogenic shock

Answer 16

Vasopressin preferred over fluid

Question 17

What is most important treatment part of obstructive shock

Answer 17

Treat the cause

“Needle decompression or cardiac temponade”

Question 18

What are the peripheral IV access sites in infant younger than 9 months?

Answer 18

Hand, foot, arm, leg, scalp

Question 19

When to opt for intrassous infusion for resuscitation

Answer 19

After 2 failed attempts

Question 20

What is intraosseous infusion

Answer 20

Infusing medications, fluids and blood products through the bone marrow

Question 21

Name vasopressor medications

Answer 21

Dopamine, norepinephrine, epinephrine, dobutamine

Question 22

What are the effects of dopamine?

• low dose
• medium
• large

Answer 22

• Dilation of splanchinc
• increased CO
• Vasoconstriction

Question 23

What are the effects of neorepinephrine?

Answer 23

• theortical increase of cardiac output but can be cancelled by reflex bradycardia

Question 24

What are the effects of dopamine?

• low dose
• large

Answer 24

• increased CO

- Vasoconstriction