PALS 2025 HEARTCODE QUESTIONS
AND ANSWERS
k What is the priority in initially managing arrhythmias? - The initial management of both stable and
unstable arrhythmias are identical to the treatment for any critically-ill child. Begin with the support of
the airway, breathing, and circulation and treating the underlying cause of the arrhythmia.
What are the causes of secondary bradycardia? - Hypoxia, hypotension, hypothermia, acidosis, drugs.
What are the causes of primary bradycardia? - Congenital or acquired heart conditions.
What are the ECG characteristics of bradycardia? - P wave and QRS may be unrelated.
Heart rate slow for age.
QRS may be narrow or wide.
In what patients would asymptomatic bradycardia not be problematic? - A well-conditioned athlete.
A healthy child who is sleeping.
Define bradycardia. - A heart rate that is:
- slow for normal range
- activity
- clinical condition
What is the leading cause of symptomatic bradycardia? - Tissue hypoxia.
What is the dose for epinephrine? - Epinephrine every 3-5 mins
- 0.01 mg/kg IV
- 0.1 mg/kg ETT
In what conditions is atropine preferred over epinephrine as 1st choice treatment of symptomatic
bradycardia? - When the bradycardia is due to:
- excessive vagal tone
- cholinergic drug toxicity, e.g. organophosphates
- complete AV block (primary bradycardia)
What is the dose for atropine? - Atropine 0.02 mg/kg IV
What clinical findings may be present in a child with tachyarrhythmia? - Syncope, light-headedness,
palpitations.
AND ANSWERS
k What is the priority in initially managing arrhythmias? - The initial management of both stable and
unstable arrhythmias are identical to the treatment for any critically-ill child. Begin with the support of
the airway, breathing, and circulation and treating the underlying cause of the arrhythmia.
What are the causes of secondary bradycardia? - Hypoxia, hypotension, hypothermia, acidosis, drugs.
What are the causes of primary bradycardia? - Congenital or acquired heart conditions.
What are the ECG characteristics of bradycardia? - P wave and QRS may be unrelated.
Heart rate slow for age.
QRS may be narrow or wide.
In what patients would asymptomatic bradycardia not be problematic? - A well-conditioned athlete.
A healthy child who is sleeping.
Define bradycardia. - A heart rate that is:
- slow for normal range
- activity
- clinical condition
What is the leading cause of symptomatic bradycardia? - Tissue hypoxia.
What is the dose for epinephrine? - Epinephrine every 3-5 mins
- 0.01 mg/kg IV
- 0.1 mg/kg ETT
In what conditions is atropine preferred over epinephrine as 1st choice treatment of symptomatic
bradycardia? - When the bradycardia is due to:
- excessive vagal tone
- cholinergic drug toxicity, e.g. organophosphates
- complete AV block (primary bradycardia)
What is the dose for atropine? - Atropine 0.02 mg/kg IV
What clinical findings may be present in a child with tachyarrhythmia? - Syncope, light-headedness,
palpitations.
