Page 1 of 71
EPALS PREP EXAM | {LATEST 2026/ 2027
UPDATE} COMPLETE ACTUAL AND AUTHENTIC
EXAM | BRAND NEW!
What is the most common cause of cardiorespiratory arrest
Respiratory failure resulting in hypoxia and acidosis
what is an important drug to be immediately available in intubation
Atropine
Examples of appropriate resuscitation crystalloids
0.9% sodium chloride
Ringer's lactate (lactate buffered solution)
Hartmann's solution (lactate buffered solution)
Plasma-lyte (acetate and gluconate buffered solution)
Management of obstructed tracheostomy
,Page 2 of 71
- Suctioning the tube. If a suction catheter cannot be passed, the
tracheostomy tube should be removed immediately and replaced.
- If a clean tube is not available, ventilation via BMV a t the
tracheostomy stoma site should be done until the tube is cleaned and
replaced. Can give BMV at mouth if upper airway is patent and whilst
tracheal stoma is occluded
- In an emergency situation, tracheal intubation via the tracheostomy
with a classical endotracheal tube may be needed
Threshold for needle cricothyroidotomy
8 years old
Information that can be gained from ETCO2 monitoring
Tube placement most reliable method of TT placement, but presence
of CO2 trace does not exclude endobronchial intubation
Quality of CPR More effective chest compressions, greater the cardiac
output, which delivers CO2 to the lungs, where it is exhaled,
generating a higher end tidal Concentration
ROSC there will be an immediate, sustained increase in ETCO2, this
may be the first indicator o ROSC and often precedes a palpable pulse
Guide to the rate of ventilation hyperventilation is common during
resuscitation ad should be avoided. End tidal CO2 can help avoid this.
,Page 3 of 71
When to expect ETCO2 (end tidal CO2) trace
The presence of an ETCO2 trace after 4-6 ventilated breaths indicates
that the TT is in the tracheobronchial tree, both in the presence of a
perfusing rhythm and during cardiorespiratory arrest.
Cardiorespiratory arrest cause in children
Hypoxic
Most common cardiac arrhythmia
Bradycardia, deteriorating into asystole
Collapsed child, breathing normally
Consider turning the child onto their side, into a recovery position, or
maintain an open airway with a head tilt and chin lift or jaw thrust.
Call for help.
Continuously check for normal breathing.
, Page 4 of 71
Collapsed child, absent breathing
Give 5 initial rescue breaths
can use expired air ventilation but only for 16-17% of oxygen
If difficult to see chest rise, open mouth and remove visible
obstruction, do not perform blind finger sweep
If signs of life after rescue breaths, continue ventilations - 12-30 per
min
only 1 rescuer
If one rescuer, call for help immediately after 5 iniitial rescue breaths.
Proceed to next step whilst waiting for answer. If no phone is
available, perform 1 min of CPR before leaving the child.
No signs of life after rescue breaths in infant NOT NEONATE
Start CPR at 30:2 rate of 100-120 per min.
Depth of chest compressions
EPALS PREP EXAM | {LATEST 2026/ 2027
UPDATE} COMPLETE ACTUAL AND AUTHENTIC
EXAM | BRAND NEW!
What is the most common cause of cardiorespiratory arrest
Respiratory failure resulting in hypoxia and acidosis
what is an important drug to be immediately available in intubation
Atropine
Examples of appropriate resuscitation crystalloids
0.9% sodium chloride
Ringer's lactate (lactate buffered solution)
Hartmann's solution (lactate buffered solution)
Plasma-lyte (acetate and gluconate buffered solution)
Management of obstructed tracheostomy
,Page 2 of 71
- Suctioning the tube. If a suction catheter cannot be passed, the
tracheostomy tube should be removed immediately and replaced.
- If a clean tube is not available, ventilation via BMV a t the
tracheostomy stoma site should be done until the tube is cleaned and
replaced. Can give BMV at mouth if upper airway is patent and whilst
tracheal stoma is occluded
- In an emergency situation, tracheal intubation via the tracheostomy
with a classical endotracheal tube may be needed
Threshold for needle cricothyroidotomy
8 years old
Information that can be gained from ETCO2 monitoring
Tube placement most reliable method of TT placement, but presence
of CO2 trace does not exclude endobronchial intubation
Quality of CPR More effective chest compressions, greater the cardiac
output, which delivers CO2 to the lungs, where it is exhaled,
generating a higher end tidal Concentration
ROSC there will be an immediate, sustained increase in ETCO2, this
may be the first indicator o ROSC and often precedes a palpable pulse
Guide to the rate of ventilation hyperventilation is common during
resuscitation ad should be avoided. End tidal CO2 can help avoid this.
,Page 3 of 71
When to expect ETCO2 (end tidal CO2) trace
The presence of an ETCO2 trace after 4-6 ventilated breaths indicates
that the TT is in the tracheobronchial tree, both in the presence of a
perfusing rhythm and during cardiorespiratory arrest.
Cardiorespiratory arrest cause in children
Hypoxic
Most common cardiac arrhythmia
Bradycardia, deteriorating into asystole
Collapsed child, breathing normally
Consider turning the child onto their side, into a recovery position, or
maintain an open airway with a head tilt and chin lift or jaw thrust.
Call for help.
Continuously check for normal breathing.
, Page 4 of 71
Collapsed child, absent breathing
Give 5 initial rescue breaths
can use expired air ventilation but only for 16-17% of oxygen
If difficult to see chest rise, open mouth and remove visible
obstruction, do not perform blind finger sweep
If signs of life after rescue breaths, continue ventilations - 12-30 per
min
only 1 rescuer
If one rescuer, call for help immediately after 5 iniitial rescue breaths.
Proceed to next step whilst waiting for answer. If no phone is
available, perform 1 min of CPR before leaving the child.
No signs of life after rescue breaths in infant NOT NEONATE
Start CPR at 30:2 rate of 100-120 per min.
Depth of chest compressions
