PALS Test Anwer Key

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PALS test answer key and terms to learn

Chest Compression depth: Infant
1.5 inch or 4 cm (1/3 AP Diameter)
Chest Compression depth: Child
2 inches or 5 cm (1/3 AP Diameter)
Maximum Compression depth: Infant
2.4 in or 6cm
Infant/children/adolescent compression rate
100-120 compressions a minute
Ratio for single rescuer
30 compressions 2 breaths
Ratio for 2 rescuer
15 compressions 2 breaths
Rate of rescue breathing
1 breath every 6-8 seconds or 8-10 breaths/min
Isotonic Crystalloids 2 examples
NS & Lactated Ringers
Fluid challenge is how much (in hypotension)?
20mL/kg (18kg gets 260 mL)
BP parameters for PALS (minimum systolic in 4 age groups)
0-1month old= min 60 systolic
1 month-1 year= min 70 systolic
1 year-10 year= min 70+(2xage) systolic
over 10 years= min 90 systolic
Atropine dose pre-intubation
Atropine 0.02 mg/kg
Med: Shock refractory VF or pulseless Tachycardia
Lidocaine or Amiodarone (used in field had better chance of survival but in hospital, either drug has same outcome)
Amiodarone dosage
5mg/kg
Epinephrine in Cardiac Arrest Indication
all pulseless arrests, hypotensive shock, anaphylaxis, asthma, croup
Targeted Temperature management post cardiac arrest
5 days of normothermia (36C-37.5C or 96.8F-99.5F)- NOT HYPOTHERMIA
Inotrope drugs (3)
Dopamine, Dobutamine, epinephrine (epi also vasopressor)
Normoxemia is what %?
94% or above oxygenation
6 roles in PALS:
team leader
airway
compressor
monitor
medication
recorder
Oxygen saturation level goals
94%-99%
Fluid bolus during post cardiac arrest care
5-10 mL/kg over 10-20 minutes
Causes of Secondary Brain Injury
Hyperthermia
Hypotension
Hypoglycemia
Hypoxia
Defibrillation Joules (initial and refractory)
2J and then if refractory 4J
Temp & timing for Permissive hypothermia post-cardiac arrest… how many days of normothermia after?
32C-34C (89.6-98.2) for 2 days followed by 3 days of normothermia
4 Spots for IO
proximal tibia
medial malleolus
distal femur
ASIS
How to evaluate alert/awake/responsive?
Appearance, Breathing, Circulation
What should always follow IO?
NS flush 5-10mL

 

 

PALS 2019 Test Questions

Q:1-Clinical signs of respiratory distress may include all of the following EXCEPT:
Mark one answer:

  • Rapid respiratory rate
  • Grunting respirations
  • Warm, pink skin
  • Diminished level of consciousness

Q:2-Late and ominous signs of respiratory failure include all of the following EXCEPT:
Mark one answer:

  • Rapid respiratory rate
  • Cyanosis
  • Bradycardia
  • Diminished level of consciousness

Q:3-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:
Mark one answer:

  • Sinus tachycardia
  • Supraventricular tachycardia
  • Sinus rhythm
  • Ventricular tachycardia

Q:4-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?
Mark one answer:

  • Atropine
  • Epinephrine
  • Sodium bicarbonate
  • Dopamine

Q:5-High-quality CPR for young children includes:
Mark one answer:

  • Compress to a depth of at least one third of the child’s chest diameter
  • Compress at a rate between 100 and 120 compressions per minute
  • Minimize interruptions to chest compressions
  • All of the above

Q:6-You are the team leader on a team resuscitating a child without a pulse or respirations. When you look at the monitor, you see a disorganized rhythm with chaotic electrical activity. This rhythm is most likely:
Mark one answer:

  • Asystole
  • PEA
  • Ventricular fibrillation
  • Ventricular tachycardia

Q:7-The goal of the PALS team in the treatment of shock is to:
Mark one answer:

  • Improve oxygen delivery
  • Prevent organ injury
  • Stop the progression to cardiopulmonary failure
  • All of the above

Q:8-When evaluating a child’s bradycardia, it is important to consider the child’s:
Mark one answer:

  • Baseline rate
  • Level of activity
  • Clinical condition
  • All of the above

Q:9-For asystole, the team should do CPR until IV or IO access is achieved. The drug of choice for asystole is:
Mark one answer:

  • Amiodarone
  • Epinephrine
  • Lidocaine
  • Atropine

Q:10-In school age children and infants, the two most common initial rhythms seen in pediatric cardiac arrest are:
Mark one answer:

  • Asystole and PEA
  • Asystole and VF
  • PEA and VF
  • Pulseless VT and VF

Tips For Passing The PALS Certification Exam

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