Pediatric Cardiac Arrest in COVID-19 Patients

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Questions and Answers

What is the initial bolus dose of Lidocaine for treatment during cardiac arrest?

20 mcg/kg

50 mcg/kg

1 mg/kg (correct)

5 mg/kg

How often should Epinephrine be administered during cardiac arrest?

Every 3-5 minutes (correct)

Every 2-3 minutes

Every 10 minutes

Every 5-7 minutes

What is the maximum number of times Amiodarone can be repeated during cardiopulmonary resuscitation?

One time

Two times (correct)

Four times

Three times

What should be monitored to assess Return of Spontaneous Circulation (ROSC)?

Pulse and blood pressure Signup and view all the answers

What is the maintenance infusion rate for Lidocaine per minute after the initial bolus?

20-50 mcg/kg Signup and view all the answers

What is the recommended compression rate during CPR for pediatric patients?

100-120/min Signup and view all the answers

What is the compression-ventilation ratio for pediatric CPR if no advanced airway is established?

15:2 Signup and view all the answers

What should be done to minimize interruptions during CPR?

Limit personnel involved in the CPR process Signup and view all the answers

If a pediatric patient requires defibrillation, what is the appropriate energy for the first shock?

2 J/kg Signup and view all the answers

When should personnel be changed during chest compressions?

Every 2 minutes, or sooner if fatigued Signup and view all the answers

What is the maximum shock energy allowed for subsequent shocks during defibrillation?

10 J/kg or adult dose Signup and view all the answers

What type of mask should be used for ventilation if a bag-mask device is unavailable?

Non-breathing face mask Signup and view all the answers

What is crucial to remember about chest compressions during pediatric CPR?

Push hard (≥⅓ of anteroposterior diameter of chest) Signup and view all the answers

Which of the following is a reversible cause of shock?

Hypoglycemia Signup and view all the answers

What should be administered after 2 minutes of CPR if there is no return of spontaneous circulation?

Amiodarone or lidocaine Signup and view all the answers

Which of the following conditions is NOT listed as a reversible cause?

Respiratory distress Signup and view all the answers

If there are no signs of return of spontaneous circulation, what is the next step?

Go to 5 or 7 Signup and view all the answers

Which of the following is a potential cause of acidosis?

Hydrogen ion (acidosis) Signup and view all the answers

Which of these conditions can lead to tension pneumothorax?

Severe asthma attack Signup and view all the answers

Which of the following is NOT recommended for treatment during cardiac arrest?

Immediate administration of toxins Signup and view all the answers

What is the primary focus if return of spontaneous circulation occurs?

Go to Post–Cardiac Arrest Care Signup and view all the answers

What should be prioritized when performing advanced airway management in a resuscitation scenario?

Intubation Signup and view all the answers

What is the recommended action if intubation is delayed?

Consider using a supraglottic airway Signup and view all the answers

How often should epinephrine be administered during cardiac arrest?

Every 3-5 minutes Signup and view all the answers

What type of endotracheal tube is preferred if available during intubation?

Cuffed endotracheal tube Signup and view all the answers

What is the recommended rate of breaths once an advanced airway is in place?

1 breath every 6 seconds Signup and view all the answers

What technique can be considered to confirm and monitor endotracheal tube placement during resuscitation?

Waveform capnography Signup and view all the answers

During CPR, what should be minimized to enhance the effectiveness of airway management?

Closed-circuit disconnection Signup and view all the answers

What is the appropriate route and dose for administering epinephrine during resuscitation?

IV/IO at 0.01 mg/kg Signup and view all the answers

Study Notes

Pediatric Cardiac Arrest Algorithm for Suspected or Confirmed COVID-19 Patients

Don Personal Protective Equipment (PPE) before starting CPR
Begin CPR immediately, following standard guidelines
Prepare to intubate the patient
Use 15:2 compression-ventilation ratio
Change compressor every 2 minutes or sooner if fatigued
Shock energy for defibrillation:
- First shock: 2 J/kg
- Second shock: 4 J/kg
- Subsequent shocks: ≥ 4 J/kg, maximum 10 J/kg or adult dose
Minimize closed-circuit disconnection during advanced airway management
Use intubator with highest likelihood of first-pass success
Consider video laryngoscopy
Prefer cuffed endotracheal tube, if available
Endotracheal intubation or a supraglottic advanced airway is necessary
Use waveform capnography or capnometry to confirm and monitor ET tube placement
Give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions once an advanced airway is in place
Drug Therapy:
- Epinephrine IO/IV dose: 0.01 mg/kg (0.1 mL/kg of the 0.1 mg/mL concentration), repeat every 3-5 minutes.
- Amiodarone IO/IV dose: 5 mg/kg bolus during cardiac arrest. May repeat up to 2 times for refractory VF/pulseless VT.
- Lidocaine IO/IV dose: Initial: 1 mg/kg loading dose. Maintenance: 20-50 mcg/kg per minute infusion (repeat bolus dose if infusion initiated >15 minutes after initial bolus therapy).
Treat reversible causes if identified
Return of Spontaneous Circulation (ROSC):
- Pulse and blood pressure assessment is critical.
- Spontaneous arterial pressure waves with intra-arterial monitoring are a good indicator.
Reversible Causes:
- Hypovolemia
- Hypoxia
- Hydrogen ion (acidosis)
- Hypoglycemia
- Hypo-/hyperkalemia
- Hypothermia
- Tension pneumothorax
- Tamponade, cardiac
- Toxins
- Thrombosis, pulmonary
- Thrombosis, coronary
If no signs of ROSC, continue CPR and drug therapy
If ROSC, transition to post-cardiac arrest care.

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Description

This quiz covers the Pediatric Cardiac Arrest Algorithm specifically tailored for suspected or confirmed COVID-19 patients. It emphasizes the importance of personal protective equipment, CPR initiation, and advanced airway management techniques. Test your knowledge on handling cardiac arrest situations during the ongoing pandemic.