Wed3November0844PM 10

You are called to assist with the resuscitation of a 5-year-old child who has had a cardiac arrest. The ECG monitor shows pulseless electrical activity.

During the resuscitation which of the following statements is the most appropriate?

(Please select 1 option)

The dose of intravenous adrenaline is 180 mcg Correct

For a shockable rhythm in manual mode use 36 joules of energy

The size of defibrillator pad should be 4.5 cm

The rate of chest compressions should be 120-140 per minute

Once the child has been intubated, ventilate at a rate of two breaths per 15 chest compressions

Explanation

One first has to calculate the approximate weight of the child. There are a number of formulae that can be used. The advanced paediatric life support formula is acceptable:

Weight = (Age + 4) × 2

A 5-year-old child will weigh approximately 18 kg.

The appropriate dose of intravenous or intraosseous adrenaline is 10 mcg/kg (0.1 ml/kg of 1 in 10 000 adrenaline) = 180 mcg.

The appropriate energy level to be delivered is 4 J/kg is 72 joules.

The appropriate size of pad for this patient is 8 -12 cm in size. A pad size of 4.5 cm is appropriate for an infant.

In infants and small children the pads might be best placed anteriorly and posterior aspects of the chest to allow adequate separation.

If ventilating with a bag and mask ventilate, give two breaths per 15 chest compressions. However if intubated and uninterrupted chest compressions are being applied then a ventilation rate of approximately 10-20 breaths per minute should be given.

The appropriate rate of chest compressions is 100 -120 per minute, the same as an adult.

Reference:

Resuscitation Council (UK). Paediatric Advanced Life Support.

Answer Statistics

1

60%

2

6%

3

8%

4

18%

5

11%

Times answered: 281