SD2 Knowledge Questions

Question 1

List the 2 indications for OPA insertion.

Answer 1

1. Unconscious pt where there is a need to maintain airway by anteriorly displacing tongue
2. Bite block for ETT

Question 2

List the 3 contraindications for the insertion of an OPA.

Answer 2

1. Trismus
2. Gag reflex
3. Any suspected neurological injury

Question 3

List the indication for the insertion of an NPA.

Answer 3

1. Unconscious with trismus where an OPA can not be inserted.

Question 4

List the 3 contraindications for an NPA.

Answer 4

1. Middle third facial fractures (brain intrusion)
2. Significant nasal trauma (gag
3. TBI/Neuro event where airway is patent and VT adequate despite trismus (gag)

Question 5

List the 3 precautions for an NPA.

Answer 5

1. Basal skull fractures
2. CSF from ears or nares
3. Remove during intubation, may obscure view of glottis

Question 6

How does the triple airway manoeuvre improve airway assessment?

Answer 6

Pulls tongue and soft tissues away from the back of the throat to open airway.

Question 7

What is the difference between the sniffing position and the neutral position?

Answer 7

Neutral - 2 to 5 cm towel under occiput, designed to open airway.
Ext. aud. meatus in line with clavicle.
Sniffing - ++padding, designed to improve view of vocal cords, ext. aud. meatus in line with suprasternal notch.

Question 8

Hyperextension of the head can cause…?

Answer 8

Trachea to flatten.

Question 9

What padding is required to assess the airway of a medium and small child?

Answer 9

Medium child - no padding

Small child/infants - 2cm pad under shoulders, due to large occiputs (can occlude easily with flexion)

Question 10

When is a pulse check required in arrest?

Answer 10

If QRS complexes present indicate a PPR at the end of a cycle.

Question 11

List the 6 correctable causes of PEA.

HEATAU

Answer 11

1. Hypoxia
2. Exsanguination
3. Asthma
4. Tension pneumothorax
5. Anaphylaxis
6. Upper airway obstruction

Question 12

When is an arrest managed as a “hypothermic” arrest, and what are the 4 management differences?

Answer 12

<30 degrees.

1. Double adrenaline interval.
2. Aim to prevent further heat loss.
3. > 3 shocks unlikely to be successful, aim for mCPR/AAV - if no additional resources available continue DCCS as per normal
4. If hypothermia suspected to be cause of arrest, consult for mCPR to hospital.

Question 13

When should compressions commence for a paediatric?

Answer 13

1. No palpable pulse
2. HR <60bpm for infants
3. HR <40 for children

Question 14

If ROSC, what 3 actions need to occur?

Answer 14

1. 12 Lead ECG - consider PHT.
2. If VF/VT, suspected cardiac cause or post-PHT then transport to closest 24hr PCI - consider AAV for transport.
3. If suspected non-cardiac cause, Tx to nearest appropriate hospital with notification.

Question 15

What is the compression technique for:

a. Infant
b. Small child
c. Medium child

Answer 15

Infant - two finger/thumbs, hands encircle chest
Small child - one handed, similar to adult
Medium child - two handed, same as adult

Question 16

What is the compression to ventilation ratio for infants (No ETT/SGA)?

Answer 16

2R = 15:2
1R = 30:2
Aim for 100 -120 compressions per minute
Pause for ventilations.

Question 17

What are the compression to ventilation rations for children (ETT/SGA)?

Answer 17

Aim for 100 - 120 compressions per minute.
10 ventilations per minute.
No pause for ventilations.

Question 18

What are the 5 elements of APGAR?

Answer 18

Appearance
Pulse
Grimace
Activity
Respiratory Effort

Question 19

What are the compression to ventilation rations for a newborn?

Answer 19

3:1
90 compressions + 30 ventilations per min.
120 events per min, 2 per second.
Pause for 0.5s for ventilations.
No pause once intubated.

Question 20

List the 5 step ECG findings for VF.

Answer 20

Ventricular rate: Nil discernible  
Ventricular rhythm: Bizarre, chaotic, >0.1mV  
P Waves: Nil discernible  
PR Interval: Nil discernible  
QRS Duration: Nil discernible

Question 21

List the 9 most common causes of cardiac arrest in paediatric patients.

Answer 21

1. Hypoxaemia
2. Hypotension
3. SIDS
4. Septicaemia
5. Drowning
6. Asthma
7. Trauma
8. Upper airway obstruction
9. Congenital heart abnormalities

Question 22

List the 6 Determinants of Death.

+ 1 optional.

Answer 22

1. No palpable carotid pulse
2. No heart sounds for 2 mins
3. No breath sounds for 2 mins
4. Fixed and dilated pupils
5. No response to central stimuli
   - supraorbital, mandibular, sternal pressure
6. No motor response or grimace to painful stimuli
   - pinch inner elbow, nail bed pressure
7. ECG strip showing 2mins asystole optional.

Question 23

List the 7 side effects of Adrenaline.

Answer 23

1. Sinus tachycardia
2. Supraventricular arrhythmias
3. Ventricular arrhythmias
4. Hypertension
5. Dilated pupils
6. May increase size of AMI
7. Feelings of anxiety.

Question 24

List the 5 benefits of administering Adrenaline in cardiac arrest (4 A, 1 Beta1)

Answer 24

Peripheral vasoconstriction leading to (A):
- increased PVR (A)
- increased venous return, CO and CPP (A)
- Aids good CPR in perfusing myocardium to obtain a shockable rhythm (A)
Increases irritability of ventricles (B1)