PALS - Red Cross - Cardiac Arrest and Post-Cardiac Arrest Care [Pre-Assessment] 2021

A child in cardiac arrest presents with the ECG rhythm seen in the following image, but a central pulse cannot be palpated. The provider correctly identifies this as which rhythm? - answer-Pulseless ventricular tachycardia (pVT) A healthcare provider suspects that hyperkalemia may be the cause of the patient's cardiac arrest. Which should the provider order to confirm hyperkalemia? - answer-Serum electrolyte panel A patient admitted to the pediatric emergency department is in cardiac arrest. The rhythm on the defibrillator monitor is ventricular fibrillation (VF). Which energy dose should the team leader order to administer an initial shock? - answer-2 J/kg A patient has received 2 minutes of high-quality CPR for asystole with no response. Which medication should the team leader order? - answer-Administer epinephrine 0.01 mg/kg After achievement of return of spontaneous circulation (ROSC), an indwelling arterial catheter is placed in the patient and connected to the cardiac monitor. Which finding should the provider report to the team leader given its association with poor outcomes after cardiac arrest? - answer-Hypotension After completing a focused physical examination, the provider suspects that a seizure may have caused cardiac arrest in an assigned patient. Which diagnostic test will the provider likely order? - answer-Electroencephalogram During a resuscitative event of a child in cardiac arrest, the team leader orders amiodarone to be administered. The medication team member determines which dose to be correct? - answer-5 mg/kg IV/IO During a resuscitative event, the PALS team notes a change in cardiac rhythm on the defibrillator monitor. The monitor team member assesses for a central pulse, but notes that no pulse is present. The PALS team correctly identifies this as which rhythm? - answer-Pulseless electrical activity (PEA) Ensuring an adequate mean arterial pressure (MAP) post-cardiac arrest is critical to optimizing which factor? - answer-Cerebral perfusion In children and infants, cardiac arrest most often arises from which complication? - answer-Respiratory failure The healthcare provider notes that an infant receiving post-cardiac arrest care has an increase in temperature. The provider understands treatment should be initiated if the temperature rises at least which amount above normal? - answer-1 degree increase The healthcare provider understands that an ischemia/reperfusion response during post-cardiac arrest syndrome (PCAS) is similar to which kind of shock? - answer-Septic The PALS team is actively attempting to resuscitate a 9-kg infant in cardiac arrest. The team leader instructs the monitor team member to administer a second defibrillation. How many joules should the team member administer? - answer-36 joules: 1. Activate emergency medical services, call a pediatric "code blue", obtain AED or defibrillator 2. Is the rhythm shockable? Rhythm IS shockable (ventricular fibrillation or unstable ventricular tachycardia) 1. Administer shock at 2 Joules/kg 2. Administer high-quality CPR for 2 minutes 3. Check rhythm If not shockable, move to asystole/PEA rhythm protocol If shockable, continue 4. Administer shock at 4 Joules/kg 5. Administer epinephrine 0.01 mg/kg IV or 0.1 mg/kg per ETT every 3-5 minutes 6. Administer high-quality CPR for 2 minutes 7. Check rhythm If not shockable, move to asystole/PEA rhythm protocol If shockable, continue 8. Administer shock at >4 Joules/kg 9. Administer amiodarone 5 mg/kg IV (repeat 2 times if needed) or lidocaine 1 mg/kg IV 10. Administer high-quality CPR for 2 minutes 11. Check rhythm If not shockable, move to asystole/PEA rhythm protocol If shockable, repeat steps 8-11 Rhythm IS NOT shockable (asystole or pulseless electrical activity) 1. Administer high-quality CPR for 2 minutes 2. Administer epinephrine 0.01 mg/kg IV or 0.1 mg/kg per ETT every 3-5 minutes 3. Check rhythm If shockable, move to VF/VT rhythm protocol If not shockable, continue 4. Administer high-quality CPR for 2 minutes 5. Check rhythm If shockable, move to VF/VT rhythm protocol If not shockable, continue 6. Administer amiodarone 5 mg/kg IV (repeat 2 times if needed) 7. Administer high-quality CPR for 2 minutes 8. Check rhythm If shockable, move to shockable rhythm protocol If not shockable, continue CPR and medications The PALS team leader correctly alternates the chest compressor role after which duration? - answer-Every 2 minutes The pediatric intensive care team is caring for a child post-cardiac arrest. During which assessment should the need for an advanced airway be determined? - answer-Primary What are the components of post-cardiac arrest syndrome (PCAS)? - answer-1. Myocardial dysfunction 2. Systemic response to ischemia/reperfusion 3. Brain injury