PALS 2025 Heartcode EXAM 2025 Q&A
What is the priority in initially managing arrhythmias? - ANSWER>>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? - ANSWER>>Hypoxia,
hypotension, hypothermia, acidosis, drugs.
What are the causes of primary bradycardia? - ANSWER>>Congenital or
acquired heart conditions.
What are the ECG characteristics of bradycardia? - ANSWER>>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? -
ANSWER>>A well-conditioned athlete.
A healthy child who is sleeping.
Define bradycardia. - ANSWER>>A heart rate that is:
- slow for normal range
- activity
- clinical condition
What is the leading cause of symptomatic bradycardia? -
ANSWER>>Tissue hypoxia.
What is the dose for epinephrine? - ANSWER>>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? - ANSWER>>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? - ANSWER>>Atropine 0.02 mg/kg IV
What clinical findings may be present in a child with tachyarrhythmia? -
ANSWER>>Syncope, light-headedness, palpitations.
If bradycardia persists after initial treatment, and HR < 60 /min, what is the
next step? - ANSWER>>Begin CPR.
Where can tachyarrhythmias originate? - ANSWER>>In the atria or
ventricles.
What sinus tachycardia usually develop? - ANSWER>>The body needs
increased cardiac output.
What are the characteristics of atrial flutter? - ANSWER>>- Atrial rate 300
/min or higher
- Venticular rate often slower
- Can occur in congenital heart disease
- A narrow-complex tachyarrhythmia
What is the initial treatment of bradycardia with cardiopulmonary
compromise? - ANSWER>>Provide BVM ventilation, with 100% oxygen.
How is tachycardia defined? - ANSWER>>A heart rate that is fast for the
child's age.
What are characteristics of ventricular tachycardia? - ANSWER>>The rapid
rate may
- deteriorate into pulseless VT or VFib
What is the priority in initially managing arrhythmias? - ANSWER>>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? - ANSWER>>Hypoxia,
hypotension, hypothermia, acidosis, drugs.
What are the causes of primary bradycardia? - ANSWER>>Congenital or
acquired heart conditions.
What are the ECG characteristics of bradycardia? - ANSWER>>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? -
ANSWER>>A well-conditioned athlete.
A healthy child who is sleeping.
Define bradycardia. - ANSWER>>A heart rate that is:
- slow for normal range
- activity
- clinical condition
What is the leading cause of symptomatic bradycardia? -
ANSWER>>Tissue hypoxia.
What is the dose for epinephrine? - ANSWER>>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? - ANSWER>>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? - ANSWER>>Atropine 0.02 mg/kg IV
What clinical findings may be present in a child with tachyarrhythmia? -
ANSWER>>Syncope, light-headedness, palpitations.
If bradycardia persists after initial treatment, and HR < 60 /min, what is the
next step? - ANSWER>>Begin CPR.
Where can tachyarrhythmias originate? - ANSWER>>In the atria or
ventricles.
What sinus tachycardia usually develop? - ANSWER>>The body needs
increased cardiac output.
What are the characteristics of atrial flutter? - ANSWER>>- Atrial rate 300
/min or higher
- Venticular rate often slower
- Can occur in congenital heart disease
- A narrow-complex tachyarrhythmia
What is the initial treatment of bradycardia with cardiopulmonary
compromise? - ANSWER>>Provide BVM ventilation, with 100% oxygen.
How is tachycardia defined? - ANSWER>>A heart rate that is fast for the
child's age.
What are characteristics of ventricular tachycardia? - ANSWER>>The rapid
rate may
- deteriorate into pulseless VT or VFib
