Pediatric Emergencies
Domain focus
The Pediatric Emergencies domain tests the pediatric assessment triangle, weight-based resuscitation, respiratory distress, dehydration, and sepsis. Doses and equipment sizes are high-yield.
Core rules
- Pediatric assessment triangle: appearance, work of breathing, circulation.
- Two-rescuer CPR: 15:2; single rescuer: 30:2. Depth one-third AP chest.
- Epinephrine 0.01 mg/kg IV/IO every 3–5 min; defibrillation 2 J/kg, then 4 J/kg.
- Fluid bolus 20 mL/kg isotonic crystalloid for shock, reassess.
- Status epilepticus: benzodiazepine by weight; check glucose.
- Fever in a young infant: full sepsis evaluation; do not miss meningitis.
- Use length-based tape or weight-based dosing.
Worked example
A 10-kg child has a generalized seizure lasting 8 minutes. Give midazolam 0.2 mg/kg IM (2 mg) or lorazepam 0.1 mg/kg IV (1 mg); check glucose. If seizure continues, repeat benzodiazepine once, then load levetiracetam 20–40 mg/kg. Reasoning: weight-based dosing and airway/glucose check come before second-line drugs.
Traps
Adult doses, missing hypoglycemia, and attributing lethargy to postictal state without rechecking glucose are dangerous. Do not use adult-sized equipment; do not delay antibiotics in septic shock.