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2025 PALS Class > PALS 2025 > Flashcards

PALS 2025 Flashcards

1
Q

For inadequate air exchange:

BLS

For obese or pregnant patients? Abdominal thrusts or chest thrusts?

A

Chest thrusts

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2
Q

For inadequate air exchange:

For infants <1 year, perform ?

A

5 back blows and 5 chest thrust, MR PRN

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3
Q

Airway Obstruction:

If patient found or becomes unconscious?

A

Begin CPR

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4
Q

Airway Obstruction:

If suspected epiglottitis

A

— Place patient in sitting position

— Do not visualize the oropharynx

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5
Q

Airway Obstruction:

If patient found or becomes unconscious?

A

Begin CPR

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6
Q

Croup happens in what age range normally?

A

3 months to 3 year

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7
Q

Epiglottitis happens in what years normally?

A

2-6 years

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8
Q

Alter Neuro:

Symptomatic suspected opioid OD with what?

A

Respiratory depression (RR low for age, SPO2 <96%, or EtCO2 40 or greater mmHg)

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9
Q

What routes can we give narcan to a pediatric? Can it be repeated?

A

IN/IV/IM

Per drug chart and MR

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10
Q

Pediatrics less than what withhold narcan? (BLS Protocol)

A

<35 kg (77 lbs)

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11
Q

Symptomatic hypoglycemia with ALOC or unresponsive to oral glucose agents give what?

A
  • D10 per drug chart if BS less than 60 mg/dL (less than 45 mg/dL for neonate)
    MR if blood sugar remains below these parameters and symptomatic

If no IV, give glucagon per drug chart IM if BS is less than 60 (Pediatric) and less than 45 mg/DL (neonate)

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12
Q

What is considered low blood sugar for a pediatric vs neonate?

A

Pediatric <60 mg/dL

Neonate (birth to 30 days) <45 mg/dL

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13
Q

What is status epilepticus and what is the treatment?

A

Generalized, ongoing, and recurrent seizures without lucid interval

Versed IM per drug chart (lateral thigh)

If vascular access present
- Versed IV/IO per drug chart, MR x 1 in 10 minutes

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14
Q

Partial seizure lasting greater than 5 minutes (includes seizure time prior to arrival of prehospital provider)

Treatment?

A

Versed IN/IM/IV/IO per drug chart, MR x 1 in 10 minutes

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15
Q

Eclamptic seizure of any duration

A

Treat per Adult OB Emergencies

Versed IN/IM/IV/IO to a max dose of 5 mg (d/c if seizure stops), MR x1 in 10 minutes….Max 10mg total

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16
Q

Allergic Reaction (skin signs only)?

A

Hives, rash

Flushing

Itching

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17
Q

Allergic Reaction treatment

A

Benadryl per drug chart IV/IM

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18
Q

Suspected anaphylaxis reaction:

A
  • Respiratory (throat tightness, hoarse voice, wheezing/stridor, cough, SOB)
  • Cardiovascular (fainting, dizziness, tachycardia, low BP)
  • GI (nausea, vomiting, abdominal cramping)
  • Tissues (angioedema of eyelids, lips, tongue, face)
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19
Q

Anaphylaxis treatment

A

Epinephrine 1:1,000 (1mg/ml) per drug chart IM (lateral thigh), MR x2 q5 minutes -then-

Benadryl per drug chart IV/IM

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20
Q

Anaphylaxis:

If respiratory involvement

A

Albuterol/Levalbuterol per drug chart via nebulizer, MR

Ipratropium bromide per drug chart via nebulizer added to first dose of albuterol/levalbuterol

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21
Q

Respiratory distress with stridor at rest

A

EPI 1:1,000 per drug chart (combined with 3 mL normal saline) via nebulizer, MR x 1

No improvement after epinephrine via nebulizer x2 or
impending respiratory/airway compromise

• Epinephrine 1:1,000 per drug chart IM, MR x2 q5 min Ⓐ

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22
Q

Hypotension for age?

A

<1 month: SBP <60mmHg
1 month to 1 year: SBP <70 mmHg
1 year to 10 years (70+2 x age)
10 years and older <90 mmHg

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23
Q

If concerned about aerosolized infectious exposure, substitute with what?

A

MDI

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24
Q

Severe anaphylaxis or inadequate response to treatment

A

Fluid bolus IV/IO per drug chart MR to maintain adequate perfusion

Push-dose epinephrine 1:100,000 (0.01 mcg/ML) per drug chart IV/IO, MR q3min, titrate to adequate perfusion or improvement in status.

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25
NG/OG tube in CPR?
Yes; PRN
26
Minimize interruption of compressions no longer then what when checking EKG?
<5 seconds
27
Compression rate for child CPR?
100-120/minute
28
Ventilation rate (compression-to-ventilation ratio) Neonate Pediatric
Neonate: 20-30/min (3:1) Ped: 10-12/min (15:2) or, continuous compressions are an acceptable alternative for Pediatrics
29
Can we use the metronome (hockey puck) for Ped CPR?
Yes
30
Unstable Bradycardia (defines) Infant Child Initial BLS treatment?
- ventilate with BVM for 30 seconds Infant (<9 years) with HR <60 bpm Child (9-14 years) with HR <40 bpm
31
Unstable bradycardia After trying to ventilate for 30 seconds and no change whatsoever, what’s the treatment (ALS)?
Epi 1:10,000 per drug chart IV/IO, MR x2 q3-5 minutes. MR q3-5 minutes BHO After 3 doses of epinephrine - Atrophine per drug chart IV/IO, MR x 1 in 5 minutes Versed per drug chart IV/IO PRN pre-pacing BHO Consider cardiac pacing, BHO
32
SVT Definition Infant/Child Child
Infant/Child <4 years with HR 220 or greater BPM -or- Child 4 years or greater with HR 180 or greater
33
SVT Stable Treatment
12 lead to verify Consider VSM Fluid bolus per drug chart IV/IO Adenosine per drug chart rapid IV/IO, followed with 20 ml NS rapid IV/IO, MRx2
34
SVT Unstable (Define and Treatment)
ALOC Pallor, mottling, or cyanosis Diaphoresis Delayed cap refill Difference in peripheral vs central pulses Treatment: 12 lead Consider versed per drug chart IV/IO pre-cardioversion Synchcardioversion per drug chart. MR BHPO
35
V-Tach Stable treatment
Fluid boluses per drug chart IV/IO to maintain SBP appropriate for age Amiodarone per drug chart BHPO -or- Lidocaine per drug chart BHPO
36
V-Tach Unstable
Consider versed per drug chart IV/IO pre-cardioversion Synch cardioversion per drug chart, MR BHPO After successful cardioversion — check BP. If hypotensive for age and rales not present, fluid bolus per drug chart IV/IO, MR — Obtain 12-Lead EKG
37
V-Fib/Pulseless VT
CPR Defibrillate per drug chart as soon as monitor available/charged Defibrillate per drug q2 min while VF/VT persists Epinephrine 1:10,000 per drug chart IV/IO q3-5 minutes
38
Persistent VF/VT after 3 defibrillation attempts
Amiodarone per drug chart IV/IO, MR x 2 -or- Lidocaine per drug chart IV/IO, MR x 1 q5 minutes
39
PEA/Asystole
CPR Epi 1:10,000 per drug chart IV/IO q3-5 min
40
PEA/Asystole Suspected Hyperkalemia
Calcium per drug chart IV/IO, MR x 1 in 5 minutes for continued EKG findings consistent with hyperkalemia Sodium Bicarbonate per drug chart IV/IO Continuous albuterol/levalbuterol per drug chart via nebulizer
41
PEA/Asystole Suspected hypovolemia
Fluid bolus per drug chart IV/IO, MR x 2
42
PEA/Asystole Prolonged asystole/PEA
After 20 minutes or greater, contact BH physician for direction
43
PEA/Asystole Suspected poisoning/OD
For suspected tricyclic antidepressant, beta blocker, or calcium channel blocker overdoses, consider treatment per Poisoning/OD
44
PEA/Asystole What medication is not authorized in a cardiac arrest?
Narcan
45
ROSC If BP is low
Fluid bolus if no rales IV/IO, MR If unresponsive to fluid boluses, push-dose epinephrine 1:100,000 (0.01 mg/mL) per drug chart IV/IO, MR q3 min, titrate to adequate perfusion
46
What is the ideal EtCO2 to achieve in ROSC?
40
47
Reported/witnessed AICD firing how many times?
2 or more
48
What’s the treatment for reported/witnessed AICD firing?
Amiodarone per drug chart, MR BHPO Lidocaine per drug chart, MR BHPO
49
Suspected tricyclic antidepressant OD with cardiac effects (hypotension, heart block, or widened QRS)
Sodium Bicarbonate per drug chart IV
50
Suspected Beta blocker or calcium channel blocker OD?
Contact Poison Control Center and Base Hospital
51
What age is IV Tylenol contraindicated?
Less that 2 years old
52
What pain medications can be given to a child?
Tylenol (if 2 years or greater) Fentanyl
53
Ketamine age restriction?
Less than 15
54
When do you have to get a BHPO for pain medication?
Isolated head injury Acute onset severe headache Drug/ETOH intoxication Suspected active labor Major Trauma with GCS <15
55
What type of pain are we giving Tylenol?
For mild pain (1-3) -or- Moderate pain (4-6)
56
How is Tylenol mixed up and given?
Tylenol per drug chart in 100mL of NS over 15 minutes
57
For moderate pain to severe pain What is the kilogram weight?
<10 kg fentanyl IV/IN per drug chart, MR BHO 10 kg or more, fentanyl IV/IN per drug chart, MR
58
What age can we give zofran?
6 months and older ODT/IV/IM
59
Pediatric mode on zoll monitor allows for what?
- changes alarm settings - NIBP (non-invasive blood pressure) inflation pressure and inflation volume - Initial energy selection
60
What age does the 12-lead not give accurate readings?
Less than 18 years of age
61
Snapshot on the zoll will record what?
14 seconds before and after (total of 28 seconds) *****snapshot again if rhythm changes
62
Pad placement for pediatrics?
- always place anterior/posterior (red to bed) placement - not touching each other - Pediatric pads 0-8 years old and/or <55lbs or 25kg - Can use adult pads on pediatrics (don’t let them touch) ****no Ped pads on adults
63
LBRT should be measured how?
Top of the head to non-flexed of foot
64
On-scene medication verification for paramedics?
With another paramedic first. If not, can use another EMT (Captain or firefighters)
65
Pediatric Assessment Triangle tool used for general impression is called what?
TICLS - Tone - Interactiveness - Consolability - Look or Gaze - Speech or Cry
66
Stridor: Inspiratory stridor indicates what? Expiratory stridor indicates what?
- upper airway - lower airway
67
PEEP valve contradictions
CPR Hypotension for age Possible pnuemothorax
68
Can the PEEP valve be used on pediatrics?
Yes; 5-10 cmH2O (max is 10)
69
Peep valve increase by how much?
2-3 cmH2O ****closely monitor response and vital sign changes
70
Pediatric drug charts: How many paramedics to confirm? Can a paramedic use an EMT to confirm?
(2) paramedics if possible EMT may be allowed to verify if needed
71
Pediatric drug chart: What do you draw up? MG or ML?
ML
72
CPRs: What must be done for the 2-minute checks?
Pulse-rhythm-airway-Lucas
73
When should the Lucas be applied?
During a cardiac arrest at the 2” marker (if first-responder and transport unit at scene)
74
Where do we send 12-lead “STEMI” to?
The STEMI receiving facility
75
Pediatrics Respiratory distress with stridor at rest
Epi 1:1,000 per drug chart (combined with 3ml normal saline) via nebulizer, MR x 1
76
Pediatric Respiratory distress with stridor at rest No improvement after epinephrine via nebulizer x2 or impending respiratory/airway compromise
Epi 1:1,000 per drug chart IM, MR x2 q5 minutes
77
Dialysis catheters contains what?
Heparin and must be aspirated prior to infusion
78
Hemodialysis patients: Late changes
P wave disappears QRS widens V-Fib and Asystole follows
79
Hemodialysis Patient What color are the ports on the “VAS CATHS”
Red and Blue ****either may be accessed in an emergency
80
Intubated patients with agitation and potential for airway compromise
Versed 2-5mg IM/IN/IV, MRx1 in 5-10 minute
81
What hospital do we transport to if we get ROSC (regardless of 12-Lead outcome)?
Closest STEMI Center

2025 PALS Class (1 decks)

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