PALS- Practical Application
A 1-year-vintage boy is brought to the emergency department for evaluation of poor feeding,
irritability, and sweating. The toddler is lethargic but arousable. He has labored respiration, very
rapid pulses, and a dusky color. His respiration fee is 68/min, heart charge three hundred/min,
and blood strain 70/forty five mm Hg. He has vulnerable brachial pulses and absent radial
pulses, a capillary replenish of 6 seconds, SpO2 eighty five% in room air, and properly bilateral
breath sounds. You administer excessive-glide oxygen and vicinity the child on a cardiac
monitor and spot the rhythm shown right here. The baby has no history of congenital heart
disease. IV get admission to has been established. Which remedy is maximum appropriate for
this child?
A) Consult with pediatric cardiology
B) Administer isotonic crystalloid fluid of 20 mL/kg
C) Administer adenosine zero.1 mg/kg IV rapid push
D) Perform immediate defibrillation - ANS-C) Administer adenosine 0.1 mg/kg IV fast push
A 10-month-vintage toddler boy is introduced to the emergency branch. Your initial assessment
exhibits a torpid, pale infant with gradual respirations and sluggish, susceptible valuable pulses.
One group member starts offevolved air flow with a bag-masks device with 100% oxygen. A 2d
team member attaches the display/defibrillator and obtains vital symptoms whilst a 3rd crew
member attempts to set up IV/IO get entry to. The patient's heart charge is 38/min with the
rhythm shown here. The toddler's blood pressure is 58/38 mm Hg, and capillary replenish is 4
seconds. His primary pulses stay weak, and distal pulses can't be palpated. Chest
compressions are started and IO access is received. Which remedy do you anticipate might be
given next?
A) Atropine 0.02 mg/kg IV/IO
B) Epinephrine 0.01 mg/kg IV/IO
C) Adenosine 0.1 mg/kg fast IV/IO
D) Epinephrine 0.1 mg/kg IV/IO - ANS-B) Epinephrine 0.01 mg/kg IV/IO
A 3-year-vintage boy presents with more than one-system trauma. The baby was an
unrestrained passenger in a excessive-speed motor automobile crash. On primary evaluation,
he's unresponsive to voice or painful stimulation. His respiratory fee is five/min, coronary heart
, rate and pulses are 170/min, systolic blood strain is 60 mm Hg, capillary refill is five seconds,
and SpO2 is seventy five% on room air. Which action should you take first?
A) While a colleague presents spinal movement restrict, open the airway with a jaw thrust and
offer bag-masks ventilation
B) Establish instant vascular get right of entry to
C) Perform instantaneous endotracheal intubation
D) Provide a hundred% oxygen by means of simple masks - ANS-A) While a colleague presents
spinal movement restrict, open the airway with a jaw thrust and provide bag-masks air flow
A three-yr-old unresponsive, apneic toddler is brought to the emergency branch. EMS personnel
file that the kid became unresponsive as they arrived on the health facility. The child is receiving
CPR with bag-masks ventilation. The rhythm proven right here is on the cardiac display. A
biphasic guide defibrillator is gift. You speedy use the duration from head to heel of the child on
a colour-coded length-based totally resuscitation tape to estimate the approximate weight as 15
kg. Which remedy is maximum suitable for this infant right now?
A) Attempt defibrillation at 30 J, after which resume CPR, beginning with compressions
B) Attempt defibrillation at 10 J, and then resume CPR, starting with compressions
C) Attempt defibrillation at 30 J, and then open the airway and test for a pulse
D) Establish IV/IO and administer epinephrine 0.01 mg/kg IV/IO - ANS-A) Attempt defibrillation
at 30 J, after which resume CPR, starting with compressions
A 4-year-vintage boy is in pulseless arrest inside the pediatric in depth care unit. High-best CPR
is in development. You quickly review his chart and discover that his baseline-corrected QT c
language on a 12-lead ECG is prolonged. The reveal indicates recurrent episodes of the rhythm
proven here. The affected person has acquired 1 dose of epinephrine zero.01 mg/kg, but the
rhythm shown here keeps. If this rhythm persists at the next rhythm test, which medication
would be maximum suitable to administer at that time?
A) Epinephrine zero.1 mg/kg IV
B) Lidocaine 1 mg/kg IV
C) Adenosine 0.1 mg/kg IV
D) Magnesium sulfate 25 to 50 mg/kg IV - ANS-D) Magnesium sulfate 25 to 50 mg/kg IV
A 1-year-vintage boy is brought to the emergency department for evaluation of poor feeding,
irritability, and sweating. The toddler is lethargic but arousable. He has labored respiration, very
rapid pulses, and a dusky color. His respiration fee is 68/min, heart charge three hundred/min,
and blood strain 70/forty five mm Hg. He has vulnerable brachial pulses and absent radial
pulses, a capillary replenish of 6 seconds, SpO2 eighty five% in room air, and properly bilateral
breath sounds. You administer excessive-glide oxygen and vicinity the child on a cardiac
monitor and spot the rhythm shown right here. The baby has no history of congenital heart
disease. IV get admission to has been established. Which remedy is maximum appropriate for
this child?
A) Consult with pediatric cardiology
B) Administer isotonic crystalloid fluid of 20 mL/kg
C) Administer adenosine zero.1 mg/kg IV rapid push
D) Perform immediate defibrillation - ANS-C) Administer adenosine 0.1 mg/kg IV fast push
A 10-month-vintage toddler boy is introduced to the emergency branch. Your initial assessment
exhibits a torpid, pale infant with gradual respirations and sluggish, susceptible valuable pulses.
One group member starts offevolved air flow with a bag-masks device with 100% oxygen. A 2d
team member attaches the display/defibrillator and obtains vital symptoms whilst a 3rd crew
member attempts to set up IV/IO get entry to. The patient's heart charge is 38/min with the
rhythm shown here. The toddler's blood pressure is 58/38 mm Hg, and capillary replenish is 4
seconds. His primary pulses stay weak, and distal pulses can't be palpated. Chest
compressions are started and IO access is received. Which remedy do you anticipate might be
given next?
A) Atropine 0.02 mg/kg IV/IO
B) Epinephrine 0.01 mg/kg IV/IO
C) Adenosine 0.1 mg/kg fast IV/IO
D) Epinephrine 0.1 mg/kg IV/IO - ANS-B) Epinephrine 0.01 mg/kg IV/IO
A 3-year-vintage boy presents with more than one-system trauma. The baby was an
unrestrained passenger in a excessive-speed motor automobile crash. On primary evaluation,
he's unresponsive to voice or painful stimulation. His respiratory fee is five/min, coronary heart
, rate and pulses are 170/min, systolic blood strain is 60 mm Hg, capillary refill is five seconds,
and SpO2 is seventy five% on room air. Which action should you take first?
A) While a colleague presents spinal movement restrict, open the airway with a jaw thrust and
offer bag-masks ventilation
B) Establish instant vascular get right of entry to
C) Perform instantaneous endotracheal intubation
D) Provide a hundred% oxygen by means of simple masks - ANS-A) While a colleague presents
spinal movement restrict, open the airway with a jaw thrust and provide bag-masks air flow
A three-yr-old unresponsive, apneic toddler is brought to the emergency branch. EMS personnel
file that the kid became unresponsive as they arrived on the health facility. The child is receiving
CPR with bag-masks ventilation. The rhythm proven right here is on the cardiac display. A
biphasic guide defibrillator is gift. You speedy use the duration from head to heel of the child on
a colour-coded length-based totally resuscitation tape to estimate the approximate weight as 15
kg. Which remedy is maximum suitable for this infant right now?
A) Attempt defibrillation at 30 J, after which resume CPR, beginning with compressions
B) Attempt defibrillation at 10 J, and then resume CPR, starting with compressions
C) Attempt defibrillation at 30 J, and then open the airway and test for a pulse
D) Establish IV/IO and administer epinephrine 0.01 mg/kg IV/IO - ANS-A) Attempt defibrillation
at 30 J, after which resume CPR, starting with compressions
A 4-year-vintage boy is in pulseless arrest inside the pediatric in depth care unit. High-best CPR
is in development. You quickly review his chart and discover that his baseline-corrected QT c
language on a 12-lead ECG is prolonged. The reveal indicates recurrent episodes of the rhythm
proven here. The affected person has acquired 1 dose of epinephrine zero.01 mg/kg, but the
rhythm shown here keeps. If this rhythm persists at the next rhythm test, which medication
would be maximum suitable to administer at that time?
A) Epinephrine zero.1 mg/kg IV
B) Lidocaine 1 mg/kg IV
C) Adenosine 0.1 mg/kg IV
D) Magnesium sulfate 25 to 50 mg/kg IV - ANS-D) Magnesium sulfate 25 to 50 mg/kg IV
