PALS

Question 1

CPR should be started when the HR is ____ bpm with cardiopulmonary compromise despite adequate oxygenation and ventilation

Answer 1

< 60

Question 2

If child does not have normal breathing and no pulse is felt the next step is to:

Answer 2

Start CPR

Question 3

Under what two situations should CPR be started?

Answer 3

1. Child is not breathing and no pulse is felt
2. Child is not breathing and HR is < 60 bpm despite adequate oxygenation and ventilation

Question 4

What are the two shockable rhythms?

Answer 4

Pulseless ventricular tachycardia (VTach)
Ventricular fibrillation (vFib)

Question 5

Pulseless VTach (is/is not) a shockable rhythm

Answer 5

Is

Question 6

Ventricular fibrillation (is/is not) a shockable rhythm

Answer 6

Is

Question 7

Pulseless electrical activity (PEA) (is/is not) a shockable rhythm

Answer 7

Is not

Question 8

Asystole (is/is not) a shockable rhythm

Answer 8

Is not

Question 9

Next step if a non-shockable rhythm is present:

Answer 9

CPR for 2 min

Question 10

How often can epinephrine be given in a code situation?

Answer 10

Every 3-5 minutes

Question 11

What are two other medications that can be used in cardiac arrest if no response to epinephrine?

Answer 11

Amiodarone
Lidocaine

Question 12

What is the IV/IO dose and concentration of epinephrine for cardiac arrest?

Answer 12

0.01 mg/kg (0.1 mg/mL) to max of 1 mg

Question 13

What is the IV/IO dose of amiodarone for cardiac arrest?

Answer 13

5 mg/kg (max 300 mg) for max 3 doses
- 150 mg max for subsequent doses

Question 14

What is the IV/IO dose of lidocaine for cardiac arrest?

Answer 14

1 mg/kg

Question 15

Shock energy for defibrillation: first shock

Answer 15

2 J/kg

Question 16

Shock energy for defibrillation: second shock

Answer 16

4 J/kg

Question 17

Shock energy for defibrillation: 3rd shock and beyond

Answer 17

4+ J/kg to max 10 J/kg

Question 18

What is the appropriate depth of compression for high-quality CPR?

Answer 18

1/3rd AP diameter

Question 19

How fast should compressions be done in high-quality CPR?

Answer 19

100-120 per min

Question 20

Ratio of compressions to breaths when 1 rescuer is present:

Answer 20

30:2 (compressions:breaths)

Question 21

Ratio of compressions to breaths when 2 rescuers are present (child is pre-pubertal):

Answer 21

15:2 (compressions:breaths)

Question 22

Ratio of compressions to breaths when 2 rescuers are present (child is post-pubertal):

Answer 22

30:2 (compressions:breaths)

Question 23

Ratio of compressions to breaths when an advanced airway is present:

Answer 23

Continuous compressions, breath given every 2-3 seconds

Question 24

Formula for estimating uncuffed ET tube size:

Answer 24

(age in years/4) + 4

Question 25

Formula for estimating cuffed ET tube size:

Answer 25

(age in years/4) + 3.5

Question 26

Reversible causes of cardiac arrest: H's (6)

Answer 26

Hypoxia Hypovolemia Hydrogen ions (acidosis) Hypoglycemia Hypo/hyperkalemia Hypothermia

Question 27

Reversible causes of cardiac arrest: T's (4)

Answer 27

Tension pneumothorax Thrombosis (pulmonary or coronary) Tamponade Toxins

Question 28

What drug (and dose(s)) is used to treat SVT?

Answer 28

Adenosine - First dose: 0.1 mg/kg IV/IO push with rapid flush (max 6 mg) - Second dose (if needed): 0.2 mg/kg IV/IO push with rapid flush (max 12 mg)

Question 29

What drug is used to treat asthma, anaphylaxis (bronchospasm), and hyperkalemia?

Answer 29

Albuterol

Question 30

What drug is used to treat SVT, Vtach (with or without pulses), and Vfib?

Answer 30

Amiodarone

Question 31

What drug is used to treat symptomatic bradycardia?

Answer 31

Atropine

Question 32

What drug is used to treat organophosphate toxicity?

Answer 32

Atropine

Question 33

Calcium chloride 10% and calcium gluconate should be given (rapidly/slowly) when treating hypocalcemia, hypermagnesemia, hyperkalemia, or calcium channel blocker toxicity

Answer 33

Slowly

Question 34

What dose of dexamethasone is recommended for treatment of croup and asthma?

Answer 34

0.6 mg/kg PO/IM/IO (max 16 mg)

Question 35

What dose of dextrose is recommended for IV/IO treatment of hypoglycemia?

Answer 35

0.5-1 g/kg - D25W to 2-4 mL/kg - D5W to 5-10 mL/kg

Question 36

What is the IM dose and concentration of epinephrine for treatment of anaphylaxis?

Answer 36

0.01 mg/kg (1 mg/mL concentration) to max dose of 0.3 mg

Question 37

Dose of epinephrine for treatment of anaphylaxis with IM auto injector: (child 30+ kg)

Answer 37

0.3 mg

Question 38

Dose of epinephrine for treatment of anaphylaxis with IM auto injector: (child 10-30 kg)

Answer 38

0.15 mg

Question 39

What is the ET tube dose and concentration of epinephrine for cardiac arrest?

Answer 39

0.1 mg/kg (1 mg/mL concentration)

Question 40

Recommended dose of hydrocortisone for treatment of adrenal insufficiency:

Answer 40

2 mg/kg IV (max 100 mg)

Question 41

What medication is used for treatment of Torsades de Pointes?

Answer 41

Magnesium sulfate

Question 42

What two medications may be used for treatment of bradycardia (< 60 with cardiopulmonary compromise)?

Answer 42

Epinephrine Atropine (if increased vagal tone or primary AV block)

Question 43

Infant rate for sinus tachycardia typically < ____ bpm

Answer 43

220

Question 44

Child rate for sinus tachycardia typically < ____ bpm

Answer 44

180

Question 45

Next best step in management of stable narrow complex tachycardia:

Answer 45

Vagal maneuvers Adenosine if vagal maneuvers unsuccessful

Question 46

Next best step in management of unstable narrow complex tachycardia:

Answer 46

Synchronized cardioversion - Can trial adenosine if IV/IO access ALREADY established

Question 47

Next best step in management of stable wide complex tachycardia:

Answer 47

Adenosine if rhythm is regular and QRS is monomorphic - Otherwise consult cardiology

Question 48

Next best step in management of unstable wide complex tachycardia:

Answer 48

Synchronized cardioversion

Question 49

Dose(s) for synchronized cardioversion:

Answer 49

First dose: 0.5-1 J/kg Second dose: 2 J/kg