Set 1

Question 1

9002 Allergic Reaction-Anaphylaxis​​​

Answer 1

ALLERGIC REACTION

Diphenhydramine:
1 mg/kg PO, IV/IO/IM to a max of 50 mg

ANAPHYLAXIS

Epinephrine:
0.01 mg/kg of 1:1,000, IM to a max of 0.3 mg
Repeat every 15 min. to a max of three (3) doses until a minimal Systolic Blood Pressure (SBP) for the patient’s age is reached or improvement of symptoms

Diphenhydramine:
1 mg/kg IV, IO or IM, to a max of 50 mg.

Albuterol: 2.5 mg (3 ml unit dose) Handheld Nebulizer (HHN) for wheezing. Reassess after the first treatment may be repeated as needed based on reassessment.
If there are no signs of improvement and the patient is in extremis (stridor, persistent hypotension, etc.), administer:

Epinephrine:
0.01 mg/ml (10mcg/ml) – 0.5-2 ml every (5-20 mcg) IV/IO every 2-5
minutes for stridor and hypotension. Titrate to a minimal systolic blood pressure (SBP) for patient’s age, improvement of symptoms, or a total of 0.3 mg is given.
NOTE: Monitor SBP while administering/titrating.

Question 2

9003 Respiratory Distress-Reactive Airway Disease, Asthma, Bronchospasm, Croup, or Stridor

Answer 2

ASTHMA/BRONCOSPASM - MODERATE

Albuterol:
2.5 mg (3 ml unit dose):
Nebulizer (HHN) or mask; reassess after the first treatment. May be repeated as needed, based on reassessment

ASTHMA/BRONCOSPASM - SEVERE

Albuterol:
5 mg via HHN, mask or BVM.

Epinephrine:
0.01 mg/kg of 1:1,000 (1 mg/ml) solution Intramuscular (IM) up to a max dose of 0.3 ml

CROUP/STRIDOR - MODERATE

Saline: 3 ml HHN reassess after first treatment.

CROUP/STRIDOR - SEVERE

Epinephrine:
0.01 mg/Kg of 1:1,000 (1mg/ml) solution IM up to a max dose of 0.3 ml

Question 3

9004 Pediatric Burns

Answer 3

Initiate vascular access in patients with major burns (> 9%). For BSA > 9% or hypotension. Administer 20ml/kg NS fluid bolus.
- When possible the preferred vascular access site is an unburned area.

Albuterol (if wheezes present):
- 5 mg via HHN, mask or BVM.

Question 4

9005 Pedatric Traumatic Cardiac Arrest

Answer 4

20 ml/Kg normal saline bolus via IV/IO. May repeat once
- Parameters for pediatric patients older than one year can be approximated by the following formulas:
90mm HG + (2 x age in years)
70mm HG + (2x age in years) – Lower limit

Question 5

9006 Pediatric Medical Cardiac Arrest​

Answer 5

Epi 1:10,000-0.01 mg/kg IV/IO q 3-5 min

Amiodarone 5mg/kg IV/IO. Single Max Dose 300 mg.
- May repeat up to 2 times. Total Max dose 450 mg.

Question 6

9007 Pediatric Diabetic Emergencies

Answer 6

HYPOGLYCEMIA

If blood glucose ≤ 60 mg/dl and the patient doesn’t tolerate oral glucose, treat as follows:
- Under 2 years old: D10, 5 ml/kg.
- 2-14 years old: D25, 2 ml/kg or D50 1 ml/kg.
- If D10 is only available give 5 ml/kg in this age group.
NOTE: if blood glucose remains < 60 mg/dl a repeat dose may be given.
If blood sugar remains ≤ 60 mg/dl, give additional Dextrose 0.5 gm/kg up to 12.5 gm.
If IV access is unavailable or delay is anticipated, treatment options are:
- Glucagon 0.5 mg Intramuscular (IM) if blood sugar ≤ 60 mg/dl OR
- Dextrose IO as per dosages above.

HYPERGLYCEMIA

Perform blood glucose determination. If blood glucose ≥ 350 mg/dl and there is no evidence of fluid overload, initiate vascular access and administer a Normal Saline bolus
of 20 mg/kg.