PALS REVIEW QUESTIONS 2023
pulses in kiddos - ✔check brachial in infant
carotid or femoral in child
position infant - ✔external ear canal level with top of infants shoulder
PAT ABC - ✔appearance, work of breathing, and circulation
TiCLS - ✔tone, interactiveness, consolability, look/gaze, speech/cry
Primary survey - ✔Airway, Breathing, Circulation, Disability, Exposure
Tidal volume - ✔5-7 mL/kg throughout life
Tachycardia - ✔Heart rate that is greater than 180/min in an infant or toddler and
greater than 160/min in a child older than 2 years of ae warrants further assessment
and may be a serious condition.
normal cap refill - ✔2 seconds or less
cuff size - ✔40% mid upper arm circumference
50-75% of length of upper arm
bp - ✔hypotension neonate <60
1-12 months <70
1-10 yo <70+agex2
AVPU - ✔Alert (15)
Responsive to Voice (13)
Responsive to pain (8)
Unresponsive (6)
Unilaterally dilated pupils with AMS - ✔Ipsilateral (same side) uncle herniation (lateral
herniation of the temporal love, caused by increased intracranial pressure)
hypoglycemia - ✔BS <45 in newly born
BS <60 in child
capillary blood gas - ✔arterialization of the capillary bed yields pH and PaCo2
comparable to arterial blood. A CBG analysis is useful for estimating arterial
oxygenation.
Normal SVo2 - ✔70-75%, assuming arterial O2 saturation is 100%
Depth of chest compression - ✔At least 2 inches in adults
,PALS REVIEW QUESTIONS 2023
Children 1 year to puberty at least 1/3 AP diameter of chest, about 2 inches
Infants At least 1/3, 1.5 inches
PETCO2 - ✔Should be greater than 10-15 mm Hg
ROSC over 40 mm hg
What meds can be administered by ET? - ✔Lipid-soluble drugs-lidocaine, epinephrine,
atropine, and naloxone (LEAN) and vasopressin
ET dose of Epi is 10 times the IV/IO dose
ET dose of other drugs is 2-3 times the IV/IO
Technique for ET drug admin - ✔Instill the drug into the ET tube
Follow with a minimum of 5mL NS
Provide rapid positive pressure breaths after drug is instilled
Shock and VF - ✔IF shock eliminates VF, continue CPR because most have PEA or
systole after shock delivery
Wt and pads - ✔>10 kg use large adult paddles (8-13 cm)
<10 kg (<1 yr) small infant paddles (4.5 cm)
Cold? - ✔Rewarm to at least 30 degrees C
Pulm HTN - ✔Correct hypercarbia and acidosis
Bolus isotonic crystalloid
If pt receiving pulm vasodilators such as NO or prostacyclin immediately before the
arrest, be sure drug admin continues
Consider admin of inhaled NO or prostacyclin to reduce pulm vascular resistance
ECPR if instituted early during resuscitation
Single ventricle heart failure consideration - ✔Heparin admin for pts with aortopulm or
RV-pulm art shunt if shunt potency is concern
Titrate O2 to optimum puls to systemic blood flow ratio
Petco may not be reliable
Consider permissive hypoventilation or even negative pressure vent in periarrest state
to improve CO
Extracorporeal life support or extracoporeal membrane oxygenation may be considered
for pts in cardiac arrest who have undergone stage I palliation (Norwood) or Fontan-
type procedures
Tx hemorrhagic shock - ✔
phases of septic shock tx - ✔
Initial tx of septic shock - ✔
, PALS REVIEW QUESTIONS 2023
algorithm for septic shock - ✔
tx anaphylactic shock - ✔
Bradycardia with a pulse algorithm - ✔
drug table for tachy - ✔
tachycardia with adequate perfusion algorithm - ✔
tachy with pulse and poor perfusion algorithm - ✔
ROSC Respiratory Failure - ✔
ROSC algorithm - ✔
Giving fluids in ROSC - ✔
Rhythm disturbance check - ✔
Vascular access check - ✔
Upper airway check - ✔
Lower airway check - ✔
Lung tissue disease check - ✔
Disordered control of breathing check - ✔
Hypovolemic shock check - ✔
Obstructive shock check - ✔
Distributive shock check - ✔
Cardiogenic shock check - ✔
SVT check - ✔
Bradycardia check - ✔
pulses in kiddos - ✔check brachial in infant
carotid or femoral in child
position infant - ✔external ear canal level with top of infants shoulder
PAT ABC - ✔appearance, work of breathing, and circulation
TiCLS - ✔tone, interactiveness, consolability, look/gaze, speech/cry
Primary survey - ✔Airway, Breathing, Circulation, Disability, Exposure
Tidal volume - ✔5-7 mL/kg throughout life
Tachycardia - ✔Heart rate that is greater than 180/min in an infant or toddler and
greater than 160/min in a child older than 2 years of ae warrants further assessment
and may be a serious condition.
normal cap refill - ✔2 seconds or less
cuff size - ✔40% mid upper arm circumference
50-75% of length of upper arm
bp - ✔hypotension neonate <60
1-12 months <70
1-10 yo <70+agex2
AVPU - ✔Alert (15)
Responsive to Voice (13)
Responsive to pain (8)
Unresponsive (6)
Unilaterally dilated pupils with AMS - ✔Ipsilateral (same side) uncle herniation (lateral
herniation of the temporal love, caused by increased intracranial pressure)
hypoglycemia - ✔BS <45 in newly born
BS <60 in child
capillary blood gas - ✔arterialization of the capillary bed yields pH and PaCo2
comparable to arterial blood. A CBG analysis is useful for estimating arterial
oxygenation.
Normal SVo2 - ✔70-75%, assuming arterial O2 saturation is 100%
Depth of chest compression - ✔At least 2 inches in adults
,PALS REVIEW QUESTIONS 2023
Children 1 year to puberty at least 1/3 AP diameter of chest, about 2 inches
Infants At least 1/3, 1.5 inches
PETCO2 - ✔Should be greater than 10-15 mm Hg
ROSC over 40 mm hg
What meds can be administered by ET? - ✔Lipid-soluble drugs-lidocaine, epinephrine,
atropine, and naloxone (LEAN) and vasopressin
ET dose of Epi is 10 times the IV/IO dose
ET dose of other drugs is 2-3 times the IV/IO
Technique for ET drug admin - ✔Instill the drug into the ET tube
Follow with a minimum of 5mL NS
Provide rapid positive pressure breaths after drug is instilled
Shock and VF - ✔IF shock eliminates VF, continue CPR because most have PEA or
systole after shock delivery
Wt and pads - ✔>10 kg use large adult paddles (8-13 cm)
<10 kg (<1 yr) small infant paddles (4.5 cm)
Cold? - ✔Rewarm to at least 30 degrees C
Pulm HTN - ✔Correct hypercarbia and acidosis
Bolus isotonic crystalloid
If pt receiving pulm vasodilators such as NO or prostacyclin immediately before the
arrest, be sure drug admin continues
Consider admin of inhaled NO or prostacyclin to reduce pulm vascular resistance
ECPR if instituted early during resuscitation
Single ventricle heart failure consideration - ✔Heparin admin for pts with aortopulm or
RV-pulm art shunt if shunt potency is concern
Titrate O2 to optimum puls to systemic blood flow ratio
Petco may not be reliable
Consider permissive hypoventilation or even negative pressure vent in periarrest state
to improve CO
Extracorporeal life support or extracoporeal membrane oxygenation may be considered
for pts in cardiac arrest who have undergone stage I palliation (Norwood) or Fontan-
type procedures
Tx hemorrhagic shock - ✔
phases of septic shock tx - ✔
Initial tx of septic shock - ✔
, PALS REVIEW QUESTIONS 2023
algorithm for septic shock - ✔
tx anaphylactic shock - ✔
Bradycardia with a pulse algorithm - ✔
drug table for tachy - ✔
tachycardia with adequate perfusion algorithm - ✔
tachy with pulse and poor perfusion algorithm - ✔
ROSC Respiratory Failure - ✔
ROSC algorithm - ✔
Giving fluids in ROSC - ✔
Rhythm disturbance check - ✔
Vascular access check - ✔
Upper airway check - ✔
Lower airway check - ✔
Lung tissue disease check - ✔
Disordered control of breathing check - ✔
Hypovolemic shock check - ✔
Obstructive shock check - ✔
Distributive shock check - ✔
Cardiogenic shock check - ✔
SVT check - ✔
Bradycardia check - ✔
