PALS HEARTCODE 2 ASSESSMENT SCRIPT
2026 VERIFIED ANSWERS COMPREHENSIVE
REVIEW
◉ What is the most appropriate method of delivering rapid fluid
boluses to this patient?
Answer: A syringe and 3-way stopcock
◉ After the first fluid bolus is administered, the child is reassessed
and her vital signs are HR 167, BP 58/44 mm Hg, RR 56/min and
SpO2 92%. Her skin is still cool and pale and she is still lethargic and
weak.
What should be the next intervention?
Answer: Deliver a second fluid bolus of 20 mL/kg and reassess
◉ When should vasoactive therapy be considered be considered in
managing distributive shock?
Answer: If the child remains hypotensive and poorly perfused
despite rapid bolus fluid administration
◉ How does the clinical presentation of distributive shock compare
with hypovolemic shock?
,Answer: Distributive shock has more variable presentation than that
of hypovolemic shock
◉ For general shock management, administer an isotonic crytalloid
bolus of __ mL/kg over __ to __ minutes
Answer: For general shock management, administer an isotonic
crytalloid bolus of 20 mL/kg over 5 to 20 minutes
◉ What signs distinguish anaphylactic shock from other types of
shock?
Answer: -Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
◉ in a child with anaphylactic shock, what is the most appropriate
initial treatment?
Answer: IM epinephrine
◉ How soon after exposure do symptoms typically occur in
anaphylactic shock?
Answer: Seconds to minutes
◉ What should you evaluate to recognize septic shock?
, Answer: -Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
◉ When should antibiotics be administered in septic shock?
Answer: Within the first hour
◉ What are the initial assessment findings for septic shock?
Answer: -Fever
-Hypothermia
-Normal, elevated or decreased WBC
◉ For septic shock, how soon should fluid resuscitation begin?
Answer: Within 10 to 15 minutes after recognizing shock
◉ What is the recommendation for fluid bolus of isotonic
crystalloids in cardiogenic shock?
Answer: 5 to 10 mL/kg over 10 to 20 minutes
◉ What is the focus of the initial management of distributive shock?
2026 VERIFIED ANSWERS COMPREHENSIVE
REVIEW
◉ What is the most appropriate method of delivering rapid fluid
boluses to this patient?
Answer: A syringe and 3-way stopcock
◉ After the first fluid bolus is administered, the child is reassessed
and her vital signs are HR 167, BP 58/44 mm Hg, RR 56/min and
SpO2 92%. Her skin is still cool and pale and she is still lethargic and
weak.
What should be the next intervention?
Answer: Deliver a second fluid bolus of 20 mL/kg and reassess
◉ When should vasoactive therapy be considered be considered in
managing distributive shock?
Answer: If the child remains hypotensive and poorly perfused
despite rapid bolus fluid administration
◉ How does the clinical presentation of distributive shock compare
with hypovolemic shock?
,Answer: Distributive shock has more variable presentation than that
of hypovolemic shock
◉ For general shock management, administer an isotonic crytalloid
bolus of __ mL/kg over __ to __ minutes
Answer: For general shock management, administer an isotonic
crytalloid bolus of 20 mL/kg over 5 to 20 minutes
◉ What signs distinguish anaphylactic shock from other types of
shock?
Answer: -Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
◉ in a child with anaphylactic shock, what is the most appropriate
initial treatment?
Answer: IM epinephrine
◉ How soon after exposure do symptoms typically occur in
anaphylactic shock?
Answer: Seconds to minutes
◉ What should you evaluate to recognize septic shock?
, Answer: -Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
◉ When should antibiotics be administered in septic shock?
Answer: Within the first hour
◉ What are the initial assessment findings for septic shock?
Answer: -Fever
-Hypothermia
-Normal, elevated or decreased WBC
◉ For septic shock, how soon should fluid resuscitation begin?
Answer: Within 10 to 15 minutes after recognizing shock
◉ What is the recommendation for fluid bolus of isotonic
crystalloids in cardiogenic shock?
Answer: 5 to 10 mL/kg over 10 to 20 minutes
◉ What is the focus of the initial management of distributive shock?
