pals

Question 1

1 mmHg = ? cmH2O

Answer 1

1.36 cmH2O

Question 2

1 cmH2O = ? mmHg

Answer 2

0.735 mmHg

Question 3

Estimate size of uncuffed ETT

Answer 3

(Age in years/4) + 4

Question 4

Estimate size of cuffed ETT

Answer 4

(Age in years/4) + 3.5

Question 5

Cardiac arrest epinephrine dosage

Answer 5

0.01 mg/kg given every 3-5 minutes

Question 6

How is amiodarone dosed during cardiac arrest?

Answer 6

5 mg/kg bolus. May repeat up to two times for refractory VF/pulseless VT.

Question 7

How far to push during cardiac arrest?

Answer 7

> =1/3 ap diameter of chest

Question 8

Bradycardia with pulse and poor perfusion–what to do?

Answer 8

• maintain patent airway; assist breathing as necessary
• oxygen
• cardiac monitor to identify rhythm; monitor blood pressure and oximetry
• IO/IV access
• 12-lead ECG if available; don’t delay therapy

Question 9

If I have pediatric bradycardia with a pulse and poor perfusion, how do I know if I have cardiopulmonary compromise?

Answer 9

Hypotension
Acutely altered mental status
Signs of shock

Question 10

Therapy for persistent bradycardia

Answer 10

• epinephrine
• atropine
• consider transthoracic pacing/transvenous pacing
• treat underlying causes

Question 11

IO/IV atropine dose for bradycardia

Answer 11

0.02 mg/kg. May repeat once. Minimum dose 0.1 mg maximum single dose 0.5 mg.

Question 12

Dose for synchronized cardio version

Answer 12

Begin with 0.5-1 J/kg
If not effective, increase to
2 J/kg
Sedate if needed, but don’t delay cardioversion

Question 13

Adenosine IO/IV dose:

Answer 13

First dose:

0.1 mg/kg rapid bolus (maximum: 6mg)

Second dose:

0.2 mg/kg rapid bolus
(maximum second dose: 12 mg)

Question 14

What do you need it before you can give amiodarone for procainamide for pediatric tachycardia?

Answer 14

Expert consultation advised

Question 15

Identify signs of shock

Answer 15

• altered mental status
• altered heart rate
• altered temperature
• altered perfusion
• hypotension–may or may not be present

Question 16

Describe altered perfusion

Answer 16

• Prolonged or “flash” capillary refill
• Cool or very warm extremities
• plethoric appearance, mottled color or pallor
• possible ecchymosis or purpura
• decreased urine output

Question 17

Septic shock patient with cold extremities, delayed capillary refill, and/or low blood pressure. What drug do you use?

Answer 17

Epinephrine

Question 18

Septic shock patient with warm extremities, “flash” capillary refill, and/or low (typically diastolic) blood pressure. What drug do you use?

Answer 18

Norepinephrine

Question 19

What are the goals of therapy in a patient shows persistent signs of septic shock?

Answer 19

• ScvO2 >=70%
• Adequate blood pressure
• Normalized heart rate
• Adequate cardiac output/index and organ perfusion

Question 20

The formulas for estimating endotracheal tube size apply to children of what ages?

Answer 20

2-10 years of age

Question 21

Lidocaine IO/IV dose

Answer 21

Initial: 1 mg/kg loading dose
Maintenance: 20-30 mcg/kg per minute infusion (repeat bolus dose if infusion initiated >15 minutes after initial bolus therapy)

Question 22

The H’s

Answer 22

• Hypovolemia
• Hypoxia
• Hydrogen ion (acidosis)
• Hypoglycemia
• Hypo-/hyperkalemia
• Hypothermia

Question 23

The T’s

Answer 23

Tension pneumothorax 
Tamponade, cardiac
Toxins
Thrombosis, pulmonary
Thrombosis, cardiac

Question 24

Three levels of tachycardia with a pulse in the algorithm.

Answer 24

Narrow complex: sinus tach
Narrow complex: SVT
Wide complex: VT with a pulse

Question 25

Three levels of treatment for SVT

Answer 25

Vagal maneuvers
Adenosine
Cardioversion

Question 26

Formula for lower limit of systolic BP kids 1-10

Answer 26

70 + (age in years x 2) mmHg