PALS Flashcards
You are assisting at a statewide track and field event, in a sports facility, when You witness a young teenage girl collapse while running. She is unresponsive. when you arrive at her side, Other bystanders have called for EMS support and are performing well-coordinated CPR. They report that the teen has no known health problems and is now apneic and pulseless. Which of the following therapies could you add to this teen’s resuscitation that would be most likely to improve her survival?
b. you should attach and operate an AED as soon as one can be retrieved
You have just assisted with the elective tracheal intubation of a child with respiratory failure and a perfusing rhythm. You perform a clinical assessment during assisted manual ventilation to verify proper tracheal tube position, and you want to confirm tube position with a secondary technique. Which of the following provides the most reliable, prompt secondary confirmation of correct tracheal tube placement in this child?
d. presence of exhaled CO2 after delivery of 6 positive-pressure breaths
You find an 7-year-old boy is unresponsive in his bed. You open his airway and check breathing and find that that he is not breathing at all. You deliver 2 effective rescue breaths. You now want to check for signs of circulation. Which of the following choices best describes the assessment you should perform to determine if signs of circulation are present in this child?
a. attempt to feel a carotid pulse and check for adequate breathing, coughing or movement in response to the 2 rescue breaths
You are a lone rescuer when you see your neighbor’s 13-year-old adolescent floating face-down in her home swimming pool. She is unresponsive, limp and cyanotic when you pull her from the water. You did not witness her entry into the water. Which of the following best summarizes the first steps you should perform to maximize this adolescent’s chances of survival?
a. shout for help, open her airway with a jaw thrust while keeping her cervical spine immobilized, check breathing and if she is not breathing adequately provide 2 rescue breaths
Which of the following statements about pediatric injury in the United States is true?
b. injuries are the leading cause of death in children older than 6 months
You are caring for a 7-year-old boy. The child was a pedestrian struck by a car. He is breathing spontaneously with oxygen supplementation, and he has good central pulses. He has an open mid-shaft fracture of the right femur; his right thigh is swollen and bleeding heavily. The child arrives in your medical facility with adequate ventilation and perfusion and spine immobilization. Which of the following are the best initial steps for you to take to treat the child’s leg injury?
a. apply direct pressure to the wound and continue to evaluate and support systemic perfusion, including perfusion of the leg
A 3-year-old boy presents with multiple system trauma. The child was an unrestrained passenger in a motor vehicle crash. He is unresponsive to voice or painful stimula- tion, and his right pupil is dilated and responds sluggishly to light. His respiratory rate is less than 6 breaths/min, heart rate is 170 bpm, systolic blood pressure is 60 mm Hg, and capillary refill time is 5 seconds. Which of the following most accurately summarizes the first actions you should take to support this child?
d. open the airway (jaw thrust technique) while immobilizing the cervical spine, administer positivepressure, and attempt immediate tracheal intubation
An 18-month-old submersion (near-drowning) victim is currently stable in a community hospital ED. A tracheal tube is in place with proper position confirmed. The toddler is receiving mechanical ventilation and a low-dose dopamine infusion to support blood pressure and perfusion. Which of the following options is most appropriate for transporting this child from the community hospital to a tertiary care center?
c. a pediatric critical care transport team from the receiving tertiary care center that
is 30 minutes away
You are participating in the attempted resuscitation of a 3-year-old child in pulseless ventricular tachycardia. You have attempted defibrillation 3 times without converting the VT to a perfusing rhythm. The airway is secure and ventilation is effective. Attempts at IV access have been unsuccessful but IO access has been attained. You have not been able to identify any reversible cause of the VT. After administering IO epinephrine, circulating it for 30 to 60 seconds, and unsuccessful defibrillation, what is the next therapy that will be most appropriate if the child remains in VT?
d. lidocaine 1 mg/kg IO or amiodarone 5 mg/kg IO
You are preparing to provide synchronized cardioversion for a child with supraventricular tachycardia. What is the recommended initial energy dose for synchronized cardioversion for infants and children?
b. 0.5 to 1 J/kg
A pulseless 11-month-old infant arrives in the Emergency Department in ventricular fibrillation with CPR in progress. You ensure that bag-mask ventilation with 100% oxygen is producing effective chest expansion and breath sounds bilaterally, establish an IV with a large catheter, attempt defibrillation 3 times and administer a first dose of epinephrine. The child remains in ventricular fibrillation after 30-60 seconds of CPR. Which of the following should be performed next?
b. attempt defibrillation at 4 J/kg
An unresponsive 7-month-old infant presents with cold extremities and a capillary refill time of more than 5 seconds. His heart rate is 260 bpm with weak pulses and narrow QRS complexes. IV access is established with difficulty. The infant is receiving 100% oxygen by non-rebreathing face mask, and oxygenation and ventilation are adequate. Pediatric monitor/defibrillation/pacing electrode pads are in correct position on the infant’s chest. You attempt to flush the IV line with normal saline and note that it is no longer patent. Which of the following is the most appropriate initial treatment for this infant?
d. perform immediate synchronized cardioversion
An 11-year-old skateboarder suffered multiple system trauma without obvious midface injury. He is obtunded and apneic. After bag-mask ventilation with 100% oxygen and appropriate cervical spine immobilization, which of the following is the preferred method for tracheal intubation?
b. orotracheal route
You are transporting a 6-year-old tracheally intubated patient who is receiving positive-pressure mechanical ventilation. The child begins to move his head and suddenly becomes cyanotic and bradycardic. You remove the child from the mechanical ventilator circuit and provide manual assisted ventilation with a bag via the tracheal tube. During manual ventilation with 100% oxygen, the child’s color and heart rate improve slightly and his blood pressure remains adequate. Breath sounds and chest expansion are present, but they are consistently diminished on the left side. The trachea is not deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the tracheal tube. Which of the following is the most likely cause of this child’s acute deterioration?
a. tracheal tube displacement
Which of the following is the most reliable equipment for delivering a high (90% or greater) concentration of inspired oxygen?
An infant arrives by ambulance with a history of vomiting and diarrhea. The infant is responsive only to pain. The upper airway is patent, the respiratory rate is 40/minute with good bilateral breath sounds, and 100% oxygen is being administered. She has cool extremities, weak pulses and a capillary refill time of more than 5 seconds. Her Blood pressure is 85/65 mm Hg, and glucose concentration by bedside test is 100 mg/dL. Which of the following would be the most appropriate treatment for you to provide for this infant?
c. a non-rebreathing face mask with an oxygen reservoird. administer 20 mL/kg of isotonic crystalloid over 10-20 minutes
A pale and obtunded 3-year-old child is brought to the hospital with a history of diarrhea. Respirations are 45/minute with no distress and good breath sounds bilaterally. The Heart rate is 150/minute, and the BP is 88/64 mm Hg. Capillary refill is 5 seconds, and peripheral pulses are weak. After placing the child on a 10 L/min flow of 100% oxygen and obtaining vascular access, which of the following would be the most appropriate immediate treatment for this child?
c. administer a bolus of 20 mL/kg of IV or intraosseous isotonic fluids
