Pediatric Anesthesia Practice Quiz

1. A 6-year-old, 20-kg girl develops pulseless ventricular tachycardia after induction of anesthesia with halothane, nitrous oxide, and oxygen for a tonsillectomy. The anesthesiologist intubates the child, administers 100% oxygen, and starts chest compressions. When the defibrillator quickly arrives in the OR the defibrillator should be charged to what energy level for the initial shock?

20 joules

40 joules

60 joules

80 joules

120 joules

In pediatric patients, the initial shock energy level for defibrillation is typically lower than in adults. The recommended energy level for the initial shock in a 6-year-old girl is 2 joules/kg. Since the girl weighs 20 kg, the appropriate energy level for the initial shock would be 40 joules. This lower energy level is used to minimize the risk of complications and tissue damage in pediatric patients.

Explanation

In pediatric patients, the initial shock energy level for defibrillation is typically lower than in adults. The recommended energy level for the initial shock in a 6-year-old girl is 2 joules/kg. Since the girl weighs 20 kg, the appropriate energy level for the initial shock would be 40 joules. This lower energy level is used to minimize the risk of complications and tissue damage in pediatric patients.

2. In a 12-year-old child the length of an oral endotracheal tube (from the lips to the mid trachea) should be:

12 cm

14 cm

16 cm

18 cm

20 cm

The length of an oral endotracheal tube in a 12-year-old child should be 18 cm. This length is appropriate to reach from the lips to the mid trachea, ensuring proper placement and effective ventilation.

Explanation

The length of an oral endotracheal tube in a 12-year-old child should be 18 cm. This length is appropriate to reach from the lips to the mid trachea, ensuring proper placement and effective ventilation.

3. Overall, considering both spontaneous and controlled ventilation, the Mapleson circuit requiring the lowest fresh gas flow rates is the

A

B

C

D

The Mapleson circuit that requires the lowest fresh gas flow rates is A.

Explanation

The Mapleson circuit that requires the lowest fresh gas flow rates is A.

4. Regarding monitoring for pediatric inhalation induction:

Temperature monitoring is essential during induction.

It is unwise to upset anxious children by placing a blood pressure cuff before induction.

A baseline ECG must be obtained before induction, especially in anxious children

It is unnecessary to obtain pre-induction blood pressures in neonates, often difficult to obtain due to motion.

Placing a blood pressure cuff before induction can upset anxious children. This means that it is not recommended to use a blood pressure cuff as a monitoring tool before the induction process in pediatric patients. The explanation suggests that this action may cause distress and anxiety in children, which can be avoided to ensure a smooth and comfortable induction procedure.

Explanation

Placing a blood pressure cuff before induction can upset anxious children. This means that it is not recommended to use a blood pressure cuff as a monitoring tool before the induction process in pediatric patients. The explanation suggests that this action may cause distress and anxiety in children, which can be avoided to ensure a smooth and comfortable induction procedure.

5. What is the first sign of inhalation anesthetic induction in a child?

Disappearance of eyelash reflex

Shallow, rapid breathing

Appearance of nystagmus

The patient does not react to verbal stimuli

The appearance of nystagmus is the first sign of inhalation anesthetic induction in a child. Nystagmus refers to the involuntary rhythmic movement of the eyes, which can be a result of the effects of the anesthetic on the central nervous system. This sign indicates that the anesthetic is starting to take effect and the child is entering a state of anesthesia. The other options, such as disappearance of eyelash reflex, shallow rapid breathing, or lack of reaction to verbal stimuli, may also occur during anesthesia induction but are not specifically the first signs.

Explanation

The appearance of nystagmus is the first sign of inhalation anesthetic induction in a child. Nystagmus refers to the involuntary rhythmic movement of the eyes, which can be a result of the effects of the anesthetic on the central nervous system. This sign indicates that the anesthetic is starting to take effect and the child is entering a state of anesthesia. The other options, such as disappearance of eyelash reflex, shallow rapid breathing, or lack of reaction to verbal stimuli, may also occur during anesthesia induction but are not specifically the first signs.