PALS

Question 1

What is the recommended compression depth for CPR in infants and children?

Answer 1

• Infant: 1 1/2’’
• Child: 2’’

Question 2

What are the first two steps in a witnessed arrest for a pediatric patient?

Answer 2

1. Call 911
2. Begin CPR

Question 3

What are the first two steps in an unwitnessed arrest for a pediatric patient?

Answer 3

1. Begin CPR for 2 minutes.
2. Call 911.

Question 4

What are the assessments for pediatric breathing?

Answer 4

• Look for retractions.
• Listen for audible noises.
• Feel for appropriate tidal volume.
• Position airway appropriately.

Question 5

What is the Pediatric Assessment Triangle?

Answer 5

The three components:

• Appearance
• Work of breathing
• Circulation (color of skin)

Question 6

What is considered hypotension in children aged 1 to 12 years old?

Answer 6

< 70 mmHg + (age x 2)

Question 7

What is considered hypoglycemia in infants and children?

Blood glucose level

Answer 7

< 60 md/dL

Question 8

What is considered hypoglycemia in neonates?

Answer 8

< 45 mg/dL

Question 9

What is the amount of fluid resuscitation for cardiogenic shock?

Answer 9

10 ml/kg over 10-20 minutes

Question 10

What is the amount of fluid resuscitation for non-cardiogenic shock?

Answer 10

20 ml/kg over 10-20 minutes

Question 11

Fill in the blank:

A heart rate < 60bpm, you begin ____.

Hint: intervention

Answer 11

compressions

Question 12

How can you perform a vagal maneuver in a child with SVT?

Answer 12

1. Apply ice mixed with water to the face.
2. Have the child blow through a straw.

Question 13

What is the manual defibrillation dose?

Answer 13

• 2 J/kg
• 4 J/kg
• 6 J/kg
• 8 J/kg
• 10 J/kg

Question 14

What is the rate for pediatric compressions?

Answer 14

100-120 cpm

compressions per minute

Question 15

What is the ratio of compression:breath for 1 person pediatric CPR?

Answer 15

30:2

Question 16

What is the ratio of compression:breath for 2 person pediatric CPR?

Answer 16

15:2

Question 17

Where is the location for an infant pulse check?

Answer 17

Brachial

Question 18

Where is the location for a child pulse check?

Answer 18

Carotid or Femoral

Question 19

What technique should be used for a single rescuer infant compressions?

Answer 19

two-thumb encircling hands technique

Question 20

What technique should be used for a two-person rescuer infant compress?

Answer 20

two-thumb encircling

Question 21

Where should the defibrillation pads be positioned for both infants and children?

Answer 21

front and back

Question 22

At what age can adult defibrillation pads be used on children?

Answer 22

>8 years old

Question 23

True or false.

Grunting is a normal sign in children, and not indicative of severe respiratory distress.

Answer 23

False

Grunting requires a quick intervention.

Question 24

What is the normal urine output for an infant?

Answer 24

1.5-2 ml/kg per hour

Question 25

What is the **normal** urine output for **children**?

Answer 25

1 ml/kg per hour

Question 26

What are the steps for a **high quality CPR**?

Answer 26

* Compressions at 100-120/min * Compression depth at 1½ - 2'' * Complete chest recoil after compressions * \<10 seconds interruptions * 1 breath every 6 seconds

Question 27

What is the most **common cause** of cardiac arrest in **infants** and **children**?

Answer 27

Most pediatric arrests are secondary to **respiratory failure or shock**.

Question 28

# Dosage: Epinephrine

Answer 28

0.01 mg/kg

Question 29

# Dosage: Lidocaine ## Footnote Pulseless

Answer 29

1 mg/kg

Question 30

# Dosage: Amiodarone ## Footnote Pulseless

Answer 30

5 mg/kg, MAX 300mg

Question 31

# Dosage: Atropine

Answer 31

0.02 mg/kg

Question 32

What are the signs/symptoms of **hypoglycemia**?

Answer 32

* Poor Perfusion * Lethargy * Hypothermia * Diaphoresis * Hypotension * Irritability * Tachycardia

Question 33

How **wide** must a **QRS complex** be considered wide in a **pediatric** patient?

Answer 33

>120 ms ## Footnote Unless age-specific norms used.

Question 34

What is the **heart rate for SVT** in an **infant and child**?

Answer 34

* **Infant**: \>220 bpm * **Child**: \>180 bpm

Question 35

What is the joules dose for **Synchronized Cardioversion** in **pediatrics**?

Answer 35

0.5 J/kg - 1 J/kg ## Footnote Followed by 2j/kg

Question 36

# Dosage: Epinephrine Infusion ## Footnote Post ROSC

Answer 36

**0.1-0.3 mcg/kg** per minute

Question 37

What is the **4-2-1 rule** for maintenance fluids?

Answer 37

**D5NS/hr** * **4** ml/kg for the first 10kg * **2** ml/kg for the second 10kg * **1** ml/kg for each kg after ## Footnote Example: Patient is 18kg 4ml(10) = 40ml 8ml(2) = 16ml **D5NS = 56ml/hr**