EPALS CERTIFICATION TEST PAPER 2026 FULL
ANSWERS GRADED A+
◍ Paediatric breathing differences. Answer: - small resting lung volume so low o2 reserve
- relies on diaphragm more than muscles
◍ Paediatric circulation differences. Answer: Circulating vol newborn = 80 ml/ kg
Decreases to around 60-70ml/kg in adulthood
MAP more accurate than systolic BP
◍ Strider. Answer: upper airway narrowing or obstruction, loud-high pitched breath sound
◍ Wheezing. Answer: A high-pitched, whistling breath sound that is most prominent on
expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in
asthma and bronchiolitis.
◍ grunting. Answer: An "uh" sound heard during exhalation; reflects the child's attempt to
keep the alveoli open; a sign of increased work of breathing.
◍ 5 categories of shock. Answer: - Hypovolemic
- Cardiogenic
- Distributive
- Obstructive
- Dissociative
◍ distributive shock. Answer: Inadequate distribution of blood, flow insufficient for the
demand of the tissues. Eg - anaphylaxis, sepsis
, ◍ Obstructive shock. Answer: Shock that occurs when there is a block to blood flow in the
heart or great vessels, causing an insufficient blood supply to the body's tissues. Eg cardiac
tamponade, tension pneumothorax
◍ Dissociative shock. Answer: Something that does not allow O2 to reach the cells. Eg: CO
posioning and anaemia
◍ Cardiac output. Answer: heart rate x stroke volume
◍ Central pulse points. Answer: Carotid, femoral and brachial
COMPARE THESE WITH PERIPHERAL (RADIAL)
◍ How much fluid can be lost before hypotension occurs. Answer: 40%
◍ Inadequate renal perfusion. Answer: < 2ml/kg/hr in infants
< 1ml/kg/hr in children older than 1
◍ Max flow rate for nasal cannula. Answer: 4L/min
◍ When to use a supraglottic airway device. Answer: If BMV unsuccessful and is an
alternative to intubation
Only to be used if child unconscious
◍ When to ventilate. Answer: Apnea: patient lacks power/muscle to breathe at all
Hypoventilation: patient moving inadequate volume, CO2 retention
Impending ventilatory failure: working so hard that hypoventilation/apnea is inevitable
ANSWERS GRADED A+
◍ Paediatric breathing differences. Answer: - small resting lung volume so low o2 reserve
- relies on diaphragm more than muscles
◍ Paediatric circulation differences. Answer: Circulating vol newborn = 80 ml/ kg
Decreases to around 60-70ml/kg in adulthood
MAP more accurate than systolic BP
◍ Strider. Answer: upper airway narrowing or obstruction, loud-high pitched breath sound
◍ Wheezing. Answer: A high-pitched, whistling breath sound that is most prominent on
expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in
asthma and bronchiolitis.
◍ grunting. Answer: An "uh" sound heard during exhalation; reflects the child's attempt to
keep the alveoli open; a sign of increased work of breathing.
◍ 5 categories of shock. Answer: - Hypovolemic
- Cardiogenic
- Distributive
- Obstructive
- Dissociative
◍ distributive shock. Answer: Inadequate distribution of blood, flow insufficient for the
demand of the tissues. Eg - anaphylaxis, sepsis
, ◍ Obstructive shock. Answer: Shock that occurs when there is a block to blood flow in the
heart or great vessels, causing an insufficient blood supply to the body's tissues. Eg cardiac
tamponade, tension pneumothorax
◍ Dissociative shock. Answer: Something that does not allow O2 to reach the cells. Eg: CO
posioning and anaemia
◍ Cardiac output. Answer: heart rate x stroke volume
◍ Central pulse points. Answer: Carotid, femoral and brachial
COMPARE THESE WITH PERIPHERAL (RADIAL)
◍ How much fluid can be lost before hypotension occurs. Answer: 40%
◍ Inadequate renal perfusion. Answer: < 2ml/kg/hr in infants
< 1ml/kg/hr in children older than 1
◍ Max flow rate for nasal cannula. Answer: 4L/min
◍ When to use a supraglottic airway device. Answer: If BMV unsuccessful and is an
alternative to intubation
Only to be used if child unconscious
◍ When to ventilate. Answer: Apnea: patient lacks power/muscle to breathe at all
Hypoventilation: patient moving inadequate volume, CO2 retention
Impending ventilatory failure: working so hard that hypoventilation/apnea is inevitable
