PALS version A

You are caring for a child who was resuscitated after a drowning event. The child is intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2 detected. The heart rate is slow and the monitor shows sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable and the central pulses are weak. Intravenous access has been established. The core temperature is 37.3oC. Based on the PALS bradycardia algorithm, which of the following should be provided first? Epinephrine IV Transcutaneous pacing Atropine IV Dobutamine IV infusion Correct Answer-Epinephrine IV You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate = 220/min). The child is lethargic. The skin is pale and cool with delayed capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to provide without delay? Place cold packs on the distal upper and lower extremities Ask the child to blow through a small straw Exert light pressure on the eyes bilaterally Provide synchronized cardioversion at 0.5 to 1 J/kg Correct Answer-Provide synchronized cardioversion at 0.5 to 1 J/kg You are initiating treatment for a child with septic shock and hypotension. While administering high-flow oxygen you determine that the child's respirations are adequate and SpO2 is 100%. You have just established vascular access and obtained blood samples. Which of the following is the next most appropriate therapy to support systemic perfusion? Administer repeated fluid boluses of isotonic colloid Administer repeated fluid boluses of isotonic crystalloid Begin immediate dopamine infusion Begin immediate dobutamine infusion Correct Answer-Administer repeated fluid boluses of isotonic crystalloid You are treating an 8-year-old with ventricular tachycardia with pulses and adequate perfusion. You attempted synchronized cardioversion without success. While seeking expert consultation, it would be most appropriate to: Administer a loading dose of milrinone Consider possible metabolic and toxicologic causes Initiate overdrive pacing transcutaneously Deliver an unsynchronized shock Correct Answer-Consider possible metabolic and toxicologic causes