Cv: Test 2: 4. Ryan : Pediatric Ekg Interpretation And Resuscitation

Front 1

What is the intrinsic heart rate of the SA node for newborns-3 years?

3 years to teen?

Back 1

newborn: 95-100

teen: 55-120

Front 2

What is the intrinsic heart rate of the AV node for newborns-3 years?

3 years to teen?

Back 2

newborn: 45-85

teen: 35-65

Front 3

When you are a baby, what is your electrical axis?

*******

Back 3

Right axis predominance

Right axis deviation

Front 4

what T-waves are ok to be inverted?

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Back 4

V1-V3

Front 5

What is the intrinsic heart rate of the purkinje fibers for newborns-3 years?

3 years to teen?

Back 5

baby: 35-55

teen: 25-45

Front 6

what are the intervals like for a baby compared to an adult?

Back 6

they are shorter

Front 7

what are the rates like for a baby compared to an adult?

Back 7

faster in baby

Front 8

how often will you see Premature Ventricular Contractions (PVC) in kids?

Back 8

Seen in 5-10 % normal children

Front 9

if a patient has a Premature Ventricular Contractions (PVC) what else might you see 10% of the time

Back 9

10 % will have MVP

Front 10

what must you do if your patient has PVC, syncope, or idiopathic seizures?

Back 10

MUST have an ECG and QTc measurement

Front 11

if you have a PVC (premature ventricular contraction), what must you rule out

******

Back 11

HCM (hypertrophic cardiac myopathy)
Long QTc syndrome
RV Dysplasia

Front 12

If you don’t see p-waves, can the rhythm be sinus?

Back 12

99% NO!

Front 13

what is a second-degree AV block

Back 13

2 P waves per QRS

Front 14

what is a 3rd-degree AV block

Back 14

3 P waves per QRS

Front 15

Longer than normal PR & QRS intervals can mean _____

Back 15

a slowing of conduction

Front 16

what is a common finding in athletes (false positive)? why

Back 16

LVH

they are tall and skinny, so the electrical signal can pump through the chest wall like it aint no thang, making it look like LVH

Front 17

in an athlete, if you see nonspecific ST-T wave changes what should you do?

Back 17

sit back and chill...its normal

Front 18

are Q waves normal in kids?

Back 18

yeppers... unless its more than 2-3mm in more than one lead

Front 19

what is the resting heart rate of an athlete like compared to another person?

Back 19

its lower

Front 20

CO=

Back 20

SV x HR

Front 21

what is the most common arrhythmia seen in kids?

Back 21

sinus arrhythmia

Variation of heart rate which normally occurs with respiration
Increases with inspiration
Slows with expiration
Mediated by vagus nerve

Front 22

what is a sinus tachy in kids? (RR, rate, p wave, QRS)

Back 22

normal RR

Rate: >100 bpm (usually 100-160)

P-wave: normal and upright, one p for every QRS

QRS: < 0.12 sec and constant

Front 23

when is sinus tachy a problem?

Back 23

when they have it during sleep or at rest

can be indicative of:
Congestive Heart Failure
Fever
Thyrotoxicosis
Myocardial disease
Shock

Front 24

what usually causes QRS changes in kids? is this normally pathological?

Back 24

Usually in kids, it’s a post-operative phenomenon

not normally pathological

Front 25

for supraventricular tachycardia in kids please give the RR, rate, p-wave, and QRS findings

Back 25

Regularity: Regular
Rate: 150-250 bpm
P-wave: atrial p-wave, different than the sinus p-wave, often lost in the preceding t-wave
QRS: < 0.12 sec

Front 26

at what age does a supraventricular tachycardia become an issue?

Back 26

if you have one less than age 4, then its fine... but when you get older then it becomes a problem

Front 27

what is a treatment technique for supraventricular tachy in infants?

Back 27

Diving reflex (ice)
Glove filled with ice over entire face for up to 20 sec
Apnea is an essential part of reflex so entire face should be covered
Rarely - a severe bradycardia can result
Always record rhythm strip before, during and after

Front 28

if you give someone adeonsine, what will this do?

Back 28

slow the sinus HR and cause a transient AV block

Front 29

If you have a child who is unstable, flopping on the ground, and non-responsive to adenosine or ice, what should you do?

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Back 29

shock em! synchronized electrical cardioversion

Front 30

do you sedate a kid to do a Synchronized Electrical Cardioversion?

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Back 30

NO

if they are unstable to start with, you don't want to waste time

Front 31

how many Joules do you use in Synchronized Electrical Cardioversion?

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Back 31

0.25 J/kg to 1.0 J/kg

Front 32

Do you ever give a child IV verapamil?

Back 32

NOOOOOOOOOOOO

never a Ca2+ blocker

Front 33

What are the characteristics of WPW

Back 33

Short PR interval (<.12 in adults and children over 10; <.08 to .1 in infants/kids)

prolonged QRS interval due to delta wave

AV connection via bundle of kent

Front 34

What are 2 drugs you can use to treat WPW? which is the treatment of choice

Back 34

Digoxin

Propranolol---DRUG OF CHOICE

Front 35

what will be the effect of using a CCB in WPW?

****

Back 35

DEATH

Front 36

What is the top cause of an infant’s heart rate drop?

Back 36

Apnea

Front 37

When looking at a 3rd degree heart block, is there association between atrial or ventricular beats?

Back 37

NO

Front 38

what is the most common cause of congenital heart block?

Back 38

SLE

Front 39

what is unique about a junctional bradycardia?

Back 39

P waves will be inverted; can fall before, during, or after QRS complex

Front 40

if a patient is unstable, what do you do?

Back 40

SHOCK THEM

Front 41

what energy do you use with a defibrillator ?

Back 41

Energy Settings
Initial: 2 J/kg
Repeat: 4 J/kg

Front 42

what are the lethal rhythms? (4)

Back 42

V fib

V tach

asystole

PEA

Front 43

if you have an abnormal rhythm what must you obtain

Back 43

a 12 lead EKG

Front 44

if a patient has an abnormal rhythm what is key to remember?

Back 44

Treat the patient…not the Rhythm!