Focus on fully understanding the "Key Points", not memorizing sample questions.
1. What are the 5 initial steps in neonatal resuscitation? Provide warmth by placing uncovered baby under a radiant warmer to keep temperature between 36.5-37.5 degrees C. Dry with warm towel, discard and use fresh towel. Stimulate by gently rubbing the baby, trunk, or extremities. Position in “sniffing position” with a rolled towel under shoulders to open the airway. Clear secretions from the mouth, then nose as needed. (NRP 8th edition pgs. 35, 40, 42-43, 77)
2. Why should you place the pulse oximeter sensor on the newborns right hand or wrist? “Blood in the right arm is referred to as “pre-ductal” and has similar oxygen saturation as the blood perfusing the heart and brain. The left side may receive poorly oxygenated venous blood that bypassed the lungs, showing a lower oxygen saturation.” (NRP 8th edition pg. 46)
3. How do you achieve a “sniffing position” in the child > 2 years of age? Place padding under the occiput in children > 2 years of age. Infants and younger children may need padding under the shoulders. Avoid hyperextending the neck since this may obstruct the airway. (PALS pg. 147)
4. How do you insert an oropharyngeal airway (OPA) in a child? Depress the tongue with a tongue blade and insert the OPA directly into the oropharynx. (PALS pg. 154)
5. Why are cuffed endotracheal tubes preferred in pediatric resuscitation? Intubation with cuffed endotracheal tubes improves successful ventilation and the accuracy of capnography and decreases the risk of aspiration and need for reintubation. (PALS pg. 9)
6. Why is it essential to insert a gastric tube immediately post endotracheal intubation? Bag-mask ventilation causes gastric distension. Gastric distention may impair ventilation by impeding downward movement of the diaphragm. (ENPC pg. 49 and PALS pg. 152)
7. In a pediatric patient with hypotensive hypovolemic shock, how should you administer the 20 mL/kg fluid bolus? Infuse the fluid bolus within 5 to 10 minutes using the pull-push method with a three-way stopcock. (ENPC pg. 50 and PALS pg. 198)
8. What is the suggested fluid bolus for septic shock in children? 10 mL/kg to 20 mL/kg of isotonic crystalloid solution (up to 40-60 mL/kg total) for septic shock. Administer epinephrine or norepinephrine for fluid-refractory septic shock. (PALS pgs. 9, 213, 214)
9. In hemorrhagic shock, what is the recommended volume of packed red blood cells and other blood products? The recommended volume is 10 mL/kg per bolus in children. (PALS pg. 202)
10. When is sodium bicarbonate indicated in a pediatric cardiac arrest? Sodium bicarbonate is indicated in cardiac arrest due to hyperkalemia or tricyclic antidepressant (TCA) overdose. (PALS pg. 87)
11. Why is prostaglandin E1 (PGE1) administered for ductal-dependent lesions? Prostaglandin E1 can restore ductal patency. (PALS pg. 220)
12. What disorders may cause torsades de pointes? Long QT syndrome, hypomagnesemia, hypokalemia, and tricyclic antidepressant toxicity. (PALS pg. 241)
13. When is atropine sulfate preferred over epinephrine in the treatment of pediatric bradycardia? Atropine is preferred for bradycardia caused by increased vagal tone, cholinergic drug (organophosphate pesticides) toxicity, or complete AV block. (PALS pg. 247)
14. What chelating agent is used in iron ingestion? Deferoxamine.
15. What is the hallmark symptom of diphtheria? Thick gray coating in throat.
16. A rash with a “honey-colored crust” is suggestive of what infection? Impetigo.
17. A “rose-colored” rash is suggestive of what infection? Roseola
18. Scarlet fever (scarlatina) has a “sandpaper texture” rash. What is a complication of scarlet fever? Rheumatic fever.
19. How does JumpStart differ from START disaster triage? Administer 5 positive-pressure breaths.
20. Why is forensic evidence NOT stored in plastic? It will mold and degrade DNA.
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