DCAS Paediatric Emergencies (PALS) 2 — Questions and Answers
Question 1: In paediatric CPR, the compression-to-ventilation ratio for a single rescuer is:
- 30:2 (same as adults) (Correct answer)
- 15:2 (two rescuers: 15:2; single rescuer: 30:2)
- 5:1
- Continuous compressions without ventilation
Correct answer: 30:2 (same as adults)
A single rescuer uses 30:2; two rescuers (PALS guideline) use 15:2 for children over 1 year, allowing more frequent ventilations given the respiratory cause of most paediatric arrests.
Question 2: Correct paediatric chest compression depth is:
- At least one-third of the chest anteroposterior diameter (approximately 4cm in infants, 5cm in children) (Correct answer)
- 1cm for all paediatric patients
- Same as adults regardless of age
- Half the chest depth
Correct answer: At least one-third of the chest anteroposterior diameter (approximately 4cm in infants, 5cm in children)
Compressions should be at least one-third the AP chest diameter — approximately 4cm in infants and 5cm in older children — generating adequate cardiac output without causing thoracic injury.
Question 3: For infants in cardiac arrest when two rescuers are present, compressions are performed using:
- Two-thumb encircling technique (thumbs on lower sternum, hands encircling the chest) (Correct answer)
- Two-finger technique on the lower sternum
- One-hand technique using palm
- Heel of hand as in adult CPR
Correct answer: Two-thumb encircling technique (thumbs on lower sternum, hands encircling the chest)
The two-thumb encircling technique is the preferred method for two rescuers: thumbs on the lower sternum with fingers encircling the chest, generating higher pressures and better coronary perfusion than the two-finger method.
Question 4: Febrile seizures in children are most commonly associated with:
- Rapid temperature rise in children aged 6 months to 5 years with a benign, self-limiting course (Correct answer)
- Meningitis in all cases
- Epilepsy as a permanent diagnosis
- Hypoglycaemia as the primary cause
Correct answer: Rapid temperature rise in children aged 6 months to 5 years with a benign, self-limiting course
Simple febrile seizures occur with rapid temperature elevation in young children (peak 18 months-3 years), are typically brief (<15 minutes), generalised, and resolve spontaneously without indicating epilepsy or meningitis.
Question 5: The Broselow tape is used in paediatric emergencies to:
- Estimate weight-based drug doses and equipment sizes from the child's length (Correct answer)
- Measure blood pressure in small children
- Assess developmental milestones
- Diagnose long bone fractures
Correct answer: Estimate weight-based drug doses and equipment sizes from the child's length
The Broselow tape correlates the child's length (measured from head to heel) with estimated weight and pre-calculated drug doses and equipment sizes (ETT, blade, IV catheter size), enabling rapid safe paediatric drug administration.
Question 6: Paediatric patients in respiratory distress assume which characteristic position?
- Tripod position (leaning forward, hands on knees, neck extended) to maximise airway patency (Correct answer)
- Supine position with head extended
- Curled fetal position
- Seated with head between knees
Correct answer: Tripod position (leaning forward, hands on knees, neck extended) to maximise airway patency
Children (and adults) in respiratory distress instinctively adopt the tripod position — leaning forward, supporting weight on arms, extending the neck — to maximise airway diameter and use accessory muscles effectively.
DCAS Paediatric Emergencies (PALS) 2
In paediatric CPR, the compression-to-ventilation ratio for a single rescuer is: