ACLS Practice Questions   ACLS PALS

The best answer is: true

The AED can be used as effectively in pediatrics as in adults. In the small child (1-8 years old), pediatric patches are recommended. However, if not available, use the adult patches. AED’s are not recommended for children under 1 year of age.

The best answer is: assisted (augmented) ventilation (bag/valve or mechanical ventilation device)

If adequate minute ventilation cannot be maintained by a patient, the only treatment is to support and augment the patient minute ventilation using positive pressure devices such as the bag/valve and mechanical ventilator.

The best answer is: true

Manufacturers supply pediatric chest patches that better fit the smaller chest. In an extreme emergency, if only larger adult patches are available, place the patch in an anterior/posterior* position, making certain there is no contact between the two electrodes.

*Place one patch on the front of the chest, over the heart, left of the sternum if possible. Place the second patch at the cardiac level on the rear chest.

The best answer is: (1,2,4)

The recommended initial dose of adenosine in pediatrics is 0.1 mg/kg. Once a child is 60 kg or greater, the adult recommendation is an initial dose of 6 mg. If unsuccessful, the initial dose can be doubled. Because adenosine has a rapid alpha half-life, it must be delivered rapidly to the right side of the heart. An IV close to the central circulation (usually antecubital) and pushing the adenosine bolus rapidly with a 20-30 ml bolus of IV fluid is the recommended method. 

The best answer is: false

Because most pediatric patients have intact underlying physiology, they typically possess dramatic abilities to compensate for acute changes. Intense vasoconstriction is a common response to severe hypovolemia. Thus, these young patients may have serious intra-vascular volume loss, and through their ability to compensate, have a “normal” blood pressure. That is why assessing all physiologic parameters should be used to confirm shock. Capillary refill is not affected by compensation, thus, is a valuable measurement. Children with acceptable perfusion will usually have 1 second or less capillary refill time. Rapid breathing (tachypnea) is a common response to tissue hypoxia brought about by shock. Differentiating a primary pulmonary dysfunction causing tachypnea vs. compensatory tachypnea is best done by assessing work of breathing. Patients with pulmonary dysfunction almost always have an increased work of breathing. Patients with compensatory tachypnea do not.