30 Questions
What is a recommended action for patients at risk after ROSC?
Undergo EEGs and seizure prophylaxis
What is a common cause of in-hospital cardiac arrests?
Cardiogenic causes
What is a key responsibility of a team leader during resuscitation?
Coordination of individuals involved in resuscitation
What is emphasized as a predictor of CPR quality and positive outcomes?
Good leadership and clear, concise communication
What is recommended for patients with unknown causes of death?
Undergo autopsy with possible subsequent genetic analysis
What is vital to achieving the ROSC of a patient?
Training of team members
What is recommended early during the code for in-hospital arrests?
Consideration of ECMO/ECPR
What is a cause for significant morbidity and mortality even in young populations after resuscitation?
Post-arrest brain injury
What is a common outcome of in-hospital cardiac arrests?
Around 40% survived to be discharged
What is correlated with a smaller chance of survival in children?
Younger age
Which of the following is a unique consideration in pediatric and neonatal resuscitation compared to adult resuscitation?
Different medication dosing requirements
What is the basis of achieving the return of spontaneous circulation in cardiopulmonary resuscitation?
Sequential algorithm
In pediatric and neonatal resuscitation, what is less likely compared to adult resuscitation?
Requirement of CPR
What is a key objective in pediatric and neonatal resuscitation?
Maximizing success in a pediatric code
What is dissimilar in pediatric and neonatal resuscitation compared to adult cardiorespiratory resuscitation?
Medication dosing
What does pediatric and neonatal resuscitation involve in terms of achieving the return of spontaneous circulation?
Algorithmic approaches
What may alter a clinician's approach to a decompensating pediatric patient?
Unique risk and pathophysiologic factors
What are the objectives of pediatric and neonatal resuscitation?
Describing criteria to begin resuscitation
What is a critical step in resuscitation of the pediatric and neonatal patient?
Achieving return of spontaneous circulation
What is a dissimilarity in pediatric and neonatal resuscitation compared to adult resuscitation?
Unique and/or more common differential diagnoses
What is a common cause of Sudden Infant Death Syndrome (SIDS)?
Cardiomyopathies
Which medication is recommended for pulseless ventricular tachycardia and ventricular fibrillation in pediatric patients?
Amiodarone
What is the first-line vasopressor for warm shock in children?
Epinephrine
What is the main consideration for pediatric fluid management?
Balanced crystalloid fluids
In pediatric resuscitation, when should defibrillation be performed?
Pulseless ventricular tachycardia and ventricular fibrillation
What is a common cause of pediatric decompensation?
Suffocation from household objects
What is the main factor affecting resuscitation in neonatal and pediatric patients?
Anatomical and physiological differences from adults
What is the main issue with giving sodium bicarbonate and calcium in pediatric resuscitation?
They have been associated with a higher mortality rate
What is the recommended treatment for pediatric patients with pulmonary hypertension or right-sided heart failure?
Inhaled nitric oxide
Where is definitive treatment or long-term care for pediatric patients usually restricted to?
Larger or child-specific centers
Study Notes
Pediatric and Neonatal Resuscitation Guidelines 2020
- Neonatal and pediatric patients have anatomical and physiological differences from adults that can affect resuscitation, such as a shorter jaw, narrower hypopharynx, and larger head to body size.
- Causes of cardiac arrest in children include trauma, tamponade, pneumothorax, shock, cardiomyopathies, myocarditis, and metabolic derangements.
- Channelopathies are a common cause of Sudden Infant Death Syndrome (SIDS), accounting for 2-10% of cases.
- Resuscitation should begin immediately if a patient becomes cyanotic, asystolic, or is in respiratory arrest, and early initiation of CPR correlates with a significant mortality benefit.
- Fluid status is an important consideration in pediatric management, and there is insufficient evidence to support choosing balanced versus unbalanced crystalloid fluids.
- First-line vasopressors for cold and warm shock in children are norepinephrine and epinephrine, respectively, with dopamine as the second line in both cases.
- Medication dosing for children is weight-based, with variability in the route of administration and specific considerations for neonates.
- Defibrillation is recommended in pulseless ventricular tachycardia and ventricular fibrillation, with amiodarone and lidocaine as suitable anti-arrhythmic choices.
- Prostacyclin or inhaled nitric oxide can benefit pediatric patients with pulmonary hypertension or right-sided heart failure.
- Suffocation from household objects and foreign body ingestion are common causes of pediatric decompensation, requiring specific approaches for airway management and potential specialist care.
- Common resuscitative medications such as sodium bicarbonate and calcium should not be given empirically, as they have been associated with a higher mortality rate.
- While stabilization can be performed at most facilities, definitive treatment or long-term care for pediatric patients is usually restricted to larger or child-specific centers.
Test your knowledge of the latest Pediatric and Neonatal Resuscitation Guidelines 2020 with this quiz. Explore key differences in anatomy, causes of cardiac arrest, medication dosing, and management strategies for pediatric and neonatal resuscitation. Stay updated on best practices for resuscitating pediatric patients in various clinical scenarios.
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