Pediatric Advanced Life Support Exam Questions With
Correct Answers.
Why is survival rate of pediatric arrest in hospitals so much better than
outside of them - accurate answers-In the hospital they have patient history
and can give better care vs. out of hospital where there is a lot of guessing and
a slower response
Why is gaining airway access in peds harder than adults? How do they
consume oxygen in comparison to adults? - accurate answers-Larger tongue
compared to rest of mouth,
angled vocal cords,
Narrow and compliant sublottic airway that is easily obstructed and provides
more resistance
limited O2 reserve.
Kids consume oxygen faster and cannot compensate due to a fixed tidal
volume - they run out of O2 faster
What is a problem when dosing meds in PALS - accurate answers-Weight is
required to dose the fluids and meds and often times this weight is unknown
What are our options to determine peds dosing weights - accurate answers-
appearance (inaccurate), percentile/growth chart (impractical), length (easy)
How is ped weight determined based on length in PALS - accurate answers-
Broselow tape is stretched and depending on where feet are you estimate the
weight
Why is placing IV catheters more difficult in peds - accurate answers-small
vein diameter, subcutaneous baby fat, anxiety (fighting off professional)
What are some additional challenges in peds emergencies - accurate answers-
critically ill (hypotension, vasoconstriction), untrained staff, lack peds size
catheter, less sites for access
, what IV access sites should be avoided in peds - accurate answers-those that
interrupt compressions/ventilation
How long do we try to get IV access in PALS - accurate answers-90 seconds or
3 attempts
what is the second route of admin for PALS? What is special about this route? -
accurate answers-Intraosseous in promixal tibia or distal femur then use to
give fluids, drugs and blood and follow with saline flush to get drug into
circulation
What is the last option for Route of admin in PALS - accurate answers-
endotracheal
What meds are given endotracheal in peds - accurate answers-LEAN:
lidocaine, E, atropine, naloxone
How should the endotracheal meds be dosed in PALS, particularly E? -
accurate answers-2-2.5x recommended, except E is 0.1mg/kg
How do we dilute endotracheal meds in PALS - accurate answers-dilute in >/=
5 mL NS followed by 5 manual ventilations
How are peds HR compared to adults - accurate answers-higher - usually sit
around 100-150 depending on age (younger is higher)
Is BP higher or lower in peds? What is considered hypotension? - accurate
answers-lower - hypotension is typically <70
Why is family presence a pain in peds - accurate answers-They can be present
for PALS because its believed to improve outcomes, but it can be disruptive
What is the usual cause of cardiac arrest in peds - accurate answers-usually
result of progressive respiratory failure or shock (asphyxial arrest)
Why is respiratory distress more common in peds? What is the oxygen
demand in infants? - accurate answers-They have a higher metabolic rate so
their O2 demand/kg is higher. in infants its 6-8ml/kg/min vs. 4 in adults so
Correct Answers.
Why is survival rate of pediatric arrest in hospitals so much better than
outside of them - accurate answers-In the hospital they have patient history
and can give better care vs. out of hospital where there is a lot of guessing and
a slower response
Why is gaining airway access in peds harder than adults? How do they
consume oxygen in comparison to adults? - accurate answers-Larger tongue
compared to rest of mouth,
angled vocal cords,
Narrow and compliant sublottic airway that is easily obstructed and provides
more resistance
limited O2 reserve.
Kids consume oxygen faster and cannot compensate due to a fixed tidal
volume - they run out of O2 faster
What is a problem when dosing meds in PALS - accurate answers-Weight is
required to dose the fluids and meds and often times this weight is unknown
What are our options to determine peds dosing weights - accurate answers-
appearance (inaccurate), percentile/growth chart (impractical), length (easy)
How is ped weight determined based on length in PALS - accurate answers-
Broselow tape is stretched and depending on where feet are you estimate the
weight
Why is placing IV catheters more difficult in peds - accurate answers-small
vein diameter, subcutaneous baby fat, anxiety (fighting off professional)
What are some additional challenges in peds emergencies - accurate answers-
critically ill (hypotension, vasoconstriction), untrained staff, lack peds size
catheter, less sites for access
, what IV access sites should be avoided in peds - accurate answers-those that
interrupt compressions/ventilation
How long do we try to get IV access in PALS - accurate answers-90 seconds or
3 attempts
what is the second route of admin for PALS? What is special about this route? -
accurate answers-Intraosseous in promixal tibia or distal femur then use to
give fluids, drugs and blood and follow with saline flush to get drug into
circulation
What is the last option for Route of admin in PALS - accurate answers-
endotracheal
What meds are given endotracheal in peds - accurate answers-LEAN:
lidocaine, E, atropine, naloxone
How should the endotracheal meds be dosed in PALS, particularly E? -
accurate answers-2-2.5x recommended, except E is 0.1mg/kg
How do we dilute endotracheal meds in PALS - accurate answers-dilute in >/=
5 mL NS followed by 5 manual ventilations
How are peds HR compared to adults - accurate answers-higher - usually sit
around 100-150 depending on age (younger is higher)
Is BP higher or lower in peds? What is considered hypotension? - accurate
answers-lower - hypotension is typically <70
Why is family presence a pain in peds - accurate answers-They can be present
for PALS because its believed to improve outcomes, but it can be disruptive
What is the usual cause of cardiac arrest in peds - accurate answers-usually
result of progressive respiratory failure or shock (asphyxial arrest)
Why is respiratory distress more common in peds? What is the oxygen
demand in infants? - accurate answers-They have a higher metabolic rate so
their O2 demand/kg is higher. in infants its 6-8ml/kg/min vs. 4 in adults so
