AHA PALS precourse assessment
- Answer-SVT converting to sinus rhythm after adenosine administration
- Answer-Sinus bradycardia
- Answer-Sinus bradycardia - version 2
- Answer-Normal sinus rhythm
- Answer-Asystole
- Answer-Wide complex tachycardia
- Answer-Wide complex tachycardia - version 2
- Answer-Torsades de pointes
- Answer-Supraventricular tachycardia
- Answer-VF with successful defib and resumption of organized rhythm
- Answer-Pulseless electrical activity
- Answer-Ventricular fibrillation
- Answer-Sinus tachycardia
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV -
Answer-A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. The infant's respiratory rate is 40 breaths per minute, and central pulses are rapid and weak.
The infant has good bilateral breath sounds, cool extremities, and a capillary refill time of more than 5
seconds. The infant's blood pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.65 mmol/L). You
administer 100% oxygen via face mask and start an IV. Which treatment is most appropriate for this
infant?
Albuterol (duh) - Answer-A 9yo boy is agitated and leaning forward on the bed in obvious respiratory
distress. The patient is speaking in short phrases and tells you that he has asthma but does not carry an
inhaler. He has nasal flaring, severe suprasternal and intercostal retractions, and decreased air
movement with prolonged expiratory time and wheezing. You administer 100% oxygen by a
nonrebreathing mask. His spO2 is 92%. Which med do you prepare to give to this patient?
Rapid bolus of 20ml/kg of isotonic crystalloid - Answer-Paramedics are called to the home of a 1yo child.
Their initial assessment reveals a child who responds only to painful stimuli and has irregular breathing,
faint central pulses, bruises over the abdomen, abdominal distention, and cyanosis. Bag-mask ventilation
with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses cannot be palpated, and
central pulses are barely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is
started. Upon arrival to the emergency department, the child is intubated and ventilated with 100%
oxygen, and IV access is established. The heart rate is now 150/min with weak central pulses but no
distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided next?
, Epinephrine - Answer-You are called to help treat an infant with severe symptomatic bradycardia (heart
rate 66/min) associated with respiratory distress. The bradycardia persists despite establishment of an
effective airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you
should administer?
Routine administration is not indicated during cardiac arrest - Answer-Which statement is correct about
the use of calcium chloride in pediatric patients?
It is the least desirable route of administration - Answer-Which statement is correct about endotracheal
drug administration during resuscitative efforts for pediatric patients?
Humidified oxygen as tolerated - Answer-Initial impression of a 2yo girl shows her to be alert with mild
breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high-pitched
inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her spO2 is 92% on
room air, and she has mild inspiratory intercostal retractions. Lung auscultation reveals transmitted upper
airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial
intervention for this child?
Amiodarone 5 mg/kg IO - Answer-You are part of a team attempting to resuscitate a child with ventricular
fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access,
so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular
fibrillation is present. You administer a 4 J/kg shock and resume CPR. Which drug and dose should be
administered next?
Nonrebreathing face mask - Answer-Which oxygen delivery system most reliably delivers a high (90% or
greater) concentration of inspired oxygen to a 7yo child?
Epinephrine stimulates spontaneous contractions when asystole is present - Answer-Which statement is
correct about the effects of epinephrine during attempted resuscitation?
Epinephrine 0.01 mg/kg IV/IO - Answer-A 10mo infant boy is brought to the emergency department. Your
initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses.
One team member begins ventilation with a bag-mask device with 100% oxygen. A second team member
attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to establish
IV/IO access. The patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure
is 58/38 mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot
be palpated. Chest compressions are started and IO access is obtained. Which medication do you
anticipate will be given next?
Identify and treat reversible causes - Answer-A 7yo boy is found unresponsive, apneic, and pulseless.
CPR is ongoing. The child is intubated, and vascular access is established. The ECG monitor shows an
organized rhythm with a heart rate of 45/min, but a pulse check reveals no palpable pulses. High quality
CPR is resumed, and an initial IV dose of epinephrine is administered. Which intervention should you
perform next?
Lidocaine 1 mg/kg IV - Answer-You find a 10yo boy to be unresponsive. You shout for help, and after
finding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague
activates the emergency response system, brings the emergency equipment, and places the child on a
cardiac monitor/defibrillator, which reveals the rhythm shown here. You attempt defibrillation at 2 J/kg and
give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt
defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine
0.01 mg/kg. If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR,
you will administer another shock. Which drug and dose should be administered next?
While a colleague provides spinal motion restriction, open the airway with a jaw thrust and provide bag-
mask ventilation - Answer-A 3yo boy presents with multiple-system trauma. The child was an
- Answer-SVT converting to sinus rhythm after adenosine administration
- Answer-Sinus bradycardia
- Answer-Sinus bradycardia - version 2
- Answer-Normal sinus rhythm
- Answer-Asystole
- Answer-Wide complex tachycardia
- Answer-Wide complex tachycardia - version 2
- Answer-Torsades de pointes
- Answer-Supraventricular tachycardia
- Answer-VF with successful defib and resumption of organized rhythm
- Answer-Pulseless electrical activity
- Answer-Ventricular fibrillation
- Answer-Sinus tachycardia
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV -
Answer-A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. The infant's respiratory rate is 40 breaths per minute, and central pulses are rapid and weak.
The infant has good bilateral breath sounds, cool extremities, and a capillary refill time of more than 5
seconds. The infant's blood pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.65 mmol/L). You
administer 100% oxygen via face mask and start an IV. Which treatment is most appropriate for this
infant?
Albuterol (duh) - Answer-A 9yo boy is agitated and leaning forward on the bed in obvious respiratory
distress. The patient is speaking in short phrases and tells you that he has asthma but does not carry an
inhaler. He has nasal flaring, severe suprasternal and intercostal retractions, and decreased air
movement with prolonged expiratory time and wheezing. You administer 100% oxygen by a
nonrebreathing mask. His spO2 is 92%. Which med do you prepare to give to this patient?
Rapid bolus of 20ml/kg of isotonic crystalloid - Answer-Paramedics are called to the home of a 1yo child.
Their initial assessment reveals a child who responds only to painful stimuli and has irregular breathing,
faint central pulses, bruises over the abdomen, abdominal distention, and cyanosis. Bag-mask ventilation
with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses cannot be palpated, and
central pulses are barely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is
started. Upon arrival to the emergency department, the child is intubated and ventilated with 100%
oxygen, and IV access is established. The heart rate is now 150/min with weak central pulses but no
distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided next?
, Epinephrine - Answer-You are called to help treat an infant with severe symptomatic bradycardia (heart
rate 66/min) associated with respiratory distress. The bradycardia persists despite establishment of an
effective airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you
should administer?
Routine administration is not indicated during cardiac arrest - Answer-Which statement is correct about
the use of calcium chloride in pediatric patients?
It is the least desirable route of administration - Answer-Which statement is correct about endotracheal
drug administration during resuscitative efforts for pediatric patients?
Humidified oxygen as tolerated - Answer-Initial impression of a 2yo girl shows her to be alert with mild
breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high-pitched
inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her spO2 is 92% on
room air, and she has mild inspiratory intercostal retractions. Lung auscultation reveals transmitted upper
airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial
intervention for this child?
Amiodarone 5 mg/kg IO - Answer-You are part of a team attempting to resuscitate a child with ventricular
fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access,
so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular
fibrillation is present. You administer a 4 J/kg shock and resume CPR. Which drug and dose should be
administered next?
Nonrebreathing face mask - Answer-Which oxygen delivery system most reliably delivers a high (90% or
greater) concentration of inspired oxygen to a 7yo child?
Epinephrine stimulates spontaneous contractions when asystole is present - Answer-Which statement is
correct about the effects of epinephrine during attempted resuscitation?
Epinephrine 0.01 mg/kg IV/IO - Answer-A 10mo infant boy is brought to the emergency department. Your
initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses.
One team member begins ventilation with a bag-mask device with 100% oxygen. A second team member
attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to establish
IV/IO access. The patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure
is 58/38 mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot
be palpated. Chest compressions are started and IO access is obtained. Which medication do you
anticipate will be given next?
Identify and treat reversible causes - Answer-A 7yo boy is found unresponsive, apneic, and pulseless.
CPR is ongoing. The child is intubated, and vascular access is established. The ECG monitor shows an
organized rhythm with a heart rate of 45/min, but a pulse check reveals no palpable pulses. High quality
CPR is resumed, and an initial IV dose of epinephrine is administered. Which intervention should you
perform next?
Lidocaine 1 mg/kg IV - Answer-You find a 10yo boy to be unresponsive. You shout for help, and after
finding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague
activates the emergency response system, brings the emergency equipment, and places the child on a
cardiac monitor/defibrillator, which reveals the rhythm shown here. You attempt defibrillation at 2 J/kg and
give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt
defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine
0.01 mg/kg. If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR,
you will administer another shock. Which drug and dose should be administered next?
While a colleague provides spinal motion restriction, open the airway with a jaw thrust and provide bag-
mask ventilation - Answer-A 3yo boy presents with multiple-system trauma. The child was an
