AHA Pediatric Advanced Life Support Exam questions answered correctly

AHA Pediatric Advanced Life Support Exam questions answered correctly During bag-mask ventilation, how should you hold the mask to make an effective seal between the child's face and the mask? - ANSWERS*Position your fingers using the E-C clamp technique* Age of infants - ANSWERS1 yo (excluding the newly born) Age of children - ANSWERSfrom 1 year of age to puberty To perform a pulse check in an infant, palpate a - ANSWERSbrachial pulse - if you don't definitely feel a pulse within 10 seconds, starts CPR, beginning with chest compressions To perform a pulse check in a child, palpate a - ANSWERScarotid or femoral pulse - if you don't definitely feel a pulse within 10 seconds, starts CPR, beginning with chest compressions Compression depth in infants - ANSWERSat least 1/3 the AP diameter of the chest or about 1 1/2 inches (4 cm) If a head or neck injury is suspected, use what to open the airway? - ANSWERSjaw-thrust maneuver - if jaw thrust does not open the airway, use the head tilt-chin lift The primary assessment (primary survey) uses a hands-on ABCDE approach and includes assessment of the patient's vital signs .. what does ABCDE stand for? - ANSWERSAirway Breathing Circulation Disability Exposure During PALS, determine the respiratory rate by ... - ANSWERScounting the number of times the chest rises in 30 seconds and multiply by 2 Rectractions accompanied by stridor or inspiratory snoring suggest - ANSWERSupper airway obstruction - seesaw respirations also usually indicated upper airway obstruction + may also be observed in severe lower airway obstruction Rectractions accompanied by expiratory wheezing suggest - ANSWERSmarked lower airway obstruction (asthma or bronchiolitis), causing obstruction during both inspiration and expiration Cause of seesaw breathing in most kids with neuromuscular dz is - ANSWERSweakness of abdominal and chest wall muscles - caused by strong contraction of diaphragm that dominates weaker abdominal and chest wall muscles - result = retraction of chest and expansion of abdomen during inspiration Normal tidal volume - ANSWERSappx 5-7 mL/kg of body weight throughout life - difficult to measure unless child is mechanically ventilated -- clinical assessment is important Auscultation of air movement is critical. In a child, listen for the intensity of breath sounds and quality of air movement in the following areas: - ANSWERSAnterior: mid-chest (just to the left and right of sternum) Lateral: under the armpits (best location for evaluating air movement into lower parts of lungs) Posterior: both sides of back Most common cause of bradycardia in children - ANSWERShypoxia - if child with bradycardia has signs of poor perfusion (decreased responsiveness, weak peripheral pulses, cool mottled skin), immediately support ventilation with bag and mask and administer supplementary O2 - be prepared to start chest compressions if heart rate remains less than 60/min with signs of poor perfusion despite adequate oxygenation and ventilation Heart rate that warrants further assessment and may be a serious condition in kids - ANSWERSHR 180/min in infant or toddler and 160/min in child older than 2 yo Normal capillary refill time - ANSWERS2 seconds or less Children with septic shock may have warm skin and extremities with very rapid (less than 2 seconds) capillary refill time, often called - ANSWERSflash capillary refill When perfusion deteriorates in children and O2 delivery to tissues becomes inadequate, what are typically affected first? - ANSWERShands and feet - they may become coo, pale, dusky, or mottled You respond to a child or an infant that is found down. What is the next action after determining unresponsiveness? - ANSWERS*Tell a bystander to call 911.* - Early activation is key. - Send any available bystander to call 911. Many pediatric cardiac arrest situations are the result of a respiratory problem, and immediate intervention can be life-saving. Which of the following describes the brachial pulse location? - ANSWERS*Upper arm - inside* - The brachial pulse is located in the upper arm. What is a simple mnemonic for aid in the assessment of mental status? - ANSWERS*AVPU* - AVPU (alert, voice, pain, unresponsive) is a simple assessment tool to assess for adequate brain perfusion. Adenosine dosage of SVT in PALS for children - ANSWERSAdenosine is effective for the treatment of SVT. - The first dose is 0.1 mg/kg up to a maximum of 6 mg. - The second dose is 0.2 mg/kg up to a maximum of 12 mg. A child has an advanced airway in place during cardiac arrest. How frequently should ventilations be given? - ANSWERS*Every six seconds* - The latest AHA guidelines recommend one ventilation every six seconds, or 10 per minute, when an advanced airway is in place. In small children, a rescue breath should be given: - ANSWERS*over one second* - Rescue breaths and ventilations should be delivered over one second, regardless of the patient's age. What is the normal range of heart rates for an 8-year-old child? - ANSWERS*60-140 per minute* An elevated respiratory rate is a sign of early respiratory compromise. In late stages or overt respiratory failure, the respiratory rate is - ANSWERSlow or barely detectable. The 8-year-old child you are treating has a palpable pulse and a heart rate of 200. You look at the monitor and see a rapid rhythm with narrow QRS complexes. There are no discernible P waves on the monitor. The rhythm is probably: - ANSWERS*superventricular tachycardia* - The absence of P waves rules out a sinus rhythm, even sinus tachycardia. Ventricular tachycardia creates a wide QRS complex. You are doing CPR on a child with symptomatic bradycardia. An intravenous line is in place. What is the first drug of choice for the patient? - ANSWERS*Epinephrine* - If oxygenation and ventilation fail to correct symptomatic bradycardia in a child, epinephrine should be given. - While atropine is the recommended initial treatment choice for symptomatic bradycardia in adults, in children it is a secondary choice. - Atropine is the initial treatment in children with AV block due to primary bradycardia, however.