1. Which is NOT a contraindication to IO access?
a) Fracture at the site
b) Overlying infection at the site
c) Previous attempt at the site
d) Fused growth plate at the site
2. Which of the following drugs can NOT be administered via the endotracheal route?
3. What level of EtCO2 generally indicates inadequate compressions during CPR?
a) <5 mmHg
b) <10-15 mmHg
c) <20 mmHg
d) <30 mmHgl
ANSWERS & EXPLANATIONS
1. D. Fused growth plates are not a contraindication to IO access. IO access should not be attempted in the setting of a fracture of the bone, those with fragile bones (ie osteogenesis imperfecta), if there is an overlying infection at the site, or if there has been a previous attempt at the same site. IO access can be used in all age groups; thus, fusion of growth plates does not preclude its use.
2. D. Amiodarone cannot be given via the endotracheal route. Lipid soluble medications such as lidocaine, epinephrine, atropine, naloxone (LEAN) and vasopressin can be given via the endotracheal route.
3. B An ETCO2 <10-15 mmHg indicates poor cardiac output with not much blood reaching the lungs. Hence, the quality of compressions may need to be improved. An ETCO2 of >35-40 during CPR generally coincides with return of spontaneous circulation (ROSC)