DCAS Paediatric Emergencies (PALS) 3

Question 1

Status epilepticus in a child is defined as a seizure lasting longer than:

Accepted Answer

5 minutes, or two seizures without a return to baseline consciousness between them

Answer

Status epilepticus is defined as a seizure lasting ≥5 minutes (or recurrent seizures without full recovery between), requiring active pharmacological intervention to prevent neurological injury.

Question 2

First-line medication for status epilepticus in the pre-hospital setting is:

Accepted Answer

Benzodiazepines — midazolam IM/buccal/intranasal, or diazepam rectal

Answer

Benzodiazepines are first-line for status epilepticus; midazolam (IM, buccal, or intranasal) is preferred pre-hospital as it does not require IV access; diazepam (rectal or IV) is an alternative.

Question 3

Bronchiolitis in infants is most commonly caused by:

Accepted Answer

Respiratory Syncytial Virus (RSV)

Answer

RSV is responsible for the majority of bronchiolitis cases in infants, causing lower respiratory tract inflammation, wheeze, and hyperinflation; the disease peaks in winter and can cause severe respiratory failure in young infants.

Question 4

The management of a conscious infant (under 1 year) with a foreign body causing complete airway obstruction includes:

Accepted Answer

5 back blows followed by 5 chest thrusts — repeated until the object is dislodged or infant becomes unconscious

Answer

The Heimlich manoeuvre (abdominal thrusts) is NOT used in infants — it risks abdominal organ injury; instead, alternating cycles of 5 back blows and 5 chest thrusts are used to dislodge the foreign body.

Question 5

Signs of decompensated shock in a paediatric patient include:

Accepted Answer

Hypotension, altered mental status, and mottled/cold extremities — late and ominous signs

Answer

Children compensate remarkably well — hypotension is a late and ominous sign indicating decompensation; earlier signs (tachycardia, prolonged CRT, cool extremities) indicate compensated shock and should trigger intervention.

DCAS Practice Test

DCAS Practice Test

DCAS Paediatric Emergencies (PALS) 3