Cardiac Emergencies Flashcards
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Read the first 7 Cardiac Emergencies flashcards as text
A 4-year-old presents with sudden onset of HR 220 bpm, narrow QRS, and no P waves visible before each QRS on ECG. What is the most likely diagnosis?
Answer: Supraventricular tachycardia (SVT)
SVT in children typically presents with HR >200 bpm, narrow QRS, and absent or retrograde P waves.
Which medication is the first-line pharmacologic treatment for SVT in a hemodynamically stable pediatric patient when vagal maneuvers fail?
Answer: Adenosine
Adenosine is the drug of choice for SVT in stable pediatric patients, given as a rapid IV push.
A 3-week-old infant presents with pallor, poor feeding, and HR of 280 bpm. The most appropriate immediate intervention is:
Answer: Synchronized cardioversion
A hemodynamically unstable infant with SVT requires immediate synchronized cardioversion at 0.5–1 J/kg.
What is the recommended initial energy dose for synchronized cardioversion in a pediatric patient with unstable SVT?
Answer: 0.5–1 J/kg
PALS guidelines recommend 0.5–1 J/kg for the initial synchronized cardioversion, increasing to 2 J/kg if needed.
A 7-year-old with known Wolff-Parkinson-White syndrome presents in SVT. Which medication should be AVOIDED?
Answer: Verapamil
Verapamil is contraindicated in WPW because it can accelerate conduction through the accessory pathway, precipitating VF.
On a 12-lead ECG, a delta wave indicates:
Answer: Pre-excitation via an accessory pathway
A delta wave (slurred upstroke of the QRS) represents ventricular pre-excitation through an accessory pathway, characteristic of WPW.
A 10-year-old with SVT receives adenosine 0.1 mg/kg IV without conversion. What is the next appropriate step?
Answer: Repeat adenosine at 0.2 mg/kg
If the first dose of adenosine fails, the second dose is doubled to 0.2 mg/kg (max 12 mg), still given as a rapid IV push.