PALS: QUESTIONS & ANSWERS
A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is
intubated, and vascular access is established. The ECG monitor shows an organized rhythm with
a HR of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is resumed, and
an initial IV dose of epinephrine is administered. Which intervention should you perform next?
✔️✔️Identify and treat reversible causes
An 8-month old infant is brought to the ER department for evaluation of severe diarrhea and
dehydration. On arrival to the ER department, the infant becomes unresponsive, apneic, and
pulseless. You shout for help and start CPR. Another provider arrives, at which point you switch
to 2-rescuer CPR. The rhythm shown is bradycardia on the cardiac monitor. The infant is
intubated and ventilated with 100% oxygen. An IO line is established, and a dose of epinephrine
is given. While continuing high-quality CPR, what do you do next? ✔️✔️Give normal saline
20 mL/kg IO rapidly
An 8-year-old child was struck by a car. He arrives in the ER department alert, anxious, and in
respiratory distress. His cervical spine is immobilized, and he is receiving a 10-L/min flow of
100% O2 by NRB face mask. His RR is 60/min, HR 150/min, systolic BP 70 mmHg, and SPO2
84%. Breath sounds are absent over the right chest but present over the left chest, and the trachea
is deviated to the left. He has weak central pulses and absent distant pulses. Which intervention
should be performed next? ✔️✔️Perform needle decompression of the right chest
, You are supervising a student who is inserting an IO needle into an infant's tibia. The student
asks you what she should look for to know that she has successfully inserted the needle into the
bone marrow cavity. What do you tell her? ✔️✔️Fluids can be administered freely without
local soft tissue swelling
You are giving chest compressions for a child in a cardiac arrest. What is the proper depth of
compressions for a child ✔️✔️Compress at least 1/3 the depth of the chest , about 2 inches
(5cm).
During bag-mask ventilation, how should you hold the mask to make an effective seal between
the child's face and the mask? ✔️✔️Position your fingers using the E-C clamp technique
A 10-month-old infant boy is brought to the emergency department. Your initial assessment
reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team
member begins ventilation with a BVM with 100% O2. A second team member attaches the
monitor/defibrillator and obtains vital signs while a third team member attempts to establish
IV/IO access. The patient's HR is 38/min with the rhythm (bradycardia) on the monitor. The
infant's BP is 58/38 mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and
distal pulses cannot be palpated. Chest compressions are started and IO access is obtained.
Which medication do you anticipate will be given next? ✔️✔️epinephrine 0.01 mg/kg IV/IO
You are caring for a 6-year old patient who is receiving positive-pressure mechanical ventilation
via ETT. The child begins to move his head and suddenly become cyanotic, and his HR
A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is
intubated, and vascular access is established. The ECG monitor shows an organized rhythm with
a HR of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is resumed, and
an initial IV dose of epinephrine is administered. Which intervention should you perform next?
✔️✔️Identify and treat reversible causes
An 8-month old infant is brought to the ER department for evaluation of severe diarrhea and
dehydration. On arrival to the ER department, the infant becomes unresponsive, apneic, and
pulseless. You shout for help and start CPR. Another provider arrives, at which point you switch
to 2-rescuer CPR. The rhythm shown is bradycardia on the cardiac monitor. The infant is
intubated and ventilated with 100% oxygen. An IO line is established, and a dose of epinephrine
is given. While continuing high-quality CPR, what do you do next? ✔️✔️Give normal saline
20 mL/kg IO rapidly
An 8-year-old child was struck by a car. He arrives in the ER department alert, anxious, and in
respiratory distress. His cervical spine is immobilized, and he is receiving a 10-L/min flow of
100% O2 by NRB face mask. His RR is 60/min, HR 150/min, systolic BP 70 mmHg, and SPO2
84%. Breath sounds are absent over the right chest but present over the left chest, and the trachea
is deviated to the left. He has weak central pulses and absent distant pulses. Which intervention
should be performed next? ✔️✔️Perform needle decompression of the right chest
, You are supervising a student who is inserting an IO needle into an infant's tibia. The student
asks you what she should look for to know that she has successfully inserted the needle into the
bone marrow cavity. What do you tell her? ✔️✔️Fluids can be administered freely without
local soft tissue swelling
You are giving chest compressions for a child in a cardiac arrest. What is the proper depth of
compressions for a child ✔️✔️Compress at least 1/3 the depth of the chest , about 2 inches
(5cm).
During bag-mask ventilation, how should you hold the mask to make an effective seal between
the child's face and the mask? ✔️✔️Position your fingers using the E-C clamp technique
A 10-month-old infant boy is brought to the emergency department. Your initial assessment
reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team
member begins ventilation with a BVM with 100% O2. A second team member attaches the
monitor/defibrillator and obtains vital signs while a third team member attempts to establish
IV/IO access. The patient's HR is 38/min with the rhythm (bradycardia) on the monitor. The
infant's BP is 58/38 mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and
distal pulses cannot be palpated. Chest compressions are started and IO access is obtained.
Which medication do you anticipate will be given next? ✔️✔️epinephrine 0.01 mg/kg IV/IO
You are caring for a 6-year old patient who is receiving positive-pressure mechanical ventilation
via ETT. The child begins to move his head and suddenly become cyanotic, and his HR
