PALS - Pediatric Advanced Life Support Post-Cardiac Arrest Care Questions and Answers

Question 1

An 8-year-old child is intubated and mechanically ventilated after achieving Return of Spontaneous Circulation (ROSC).
The initial SpO2 reading is 100% while receiving 100% FiO2.
What is the most appropriate next step regarding oxygen therapy?

Accepted Answer

Titrate FiO2 downwards to achieve a target SpO2 between 94% and 99%.

Answer

Maintain FiO2 at 100% for 24 hours to ensure maximal oxygen delivery.

Answer

Immediately perform an arterial blood gas (ABG) before making any changes.

Answer

Begin to wean from the ventilator, as 100% saturation indicates stability.

Question 2

A 5-year-old child remains comatose after ROSC from an out-of-hospital cardiac arrest. Which of the following is a primary goal of targeted temperature management (TTM) for this patient?

Accepted Answer

Actively preventing or treating fever to maintain normothermia (36°C to 37.5°C).

Answer

Inducing deep hypothermia below 32°C to minimize all metabolic activity.

Answer

Allowing the patient's temperature to fluctuate naturally.

Answer

Maintaining a slightly elevated temperature (38°C) to promote blood flow.

Question 3

A 7-year-old child achieves ROSC after a witnessed in-hospital cardiac arrest. The team is now implementing the post-cardiac arrest care plan. What is the minimum systolic blood pressure the team should target to avoid hypotension?

Accepted Answer

At least the 5th percentile for age

Answer

Greater than 100 mmHg

Answer

Between 60-70 mmHg

Answer

Equal to the child's diastolic pressure plus 40

Question 4

You are managing a comatose toddler in the PICU following a prolonged resuscitation. Continuous EEG monitoring is initiated. What is the primary rationale for this intervention in post-cardiac arrest care?

Accepted Answer

To detect and guide the treatment of subclinical seizures.

Answer

To determine the long-term neurologic prognosis within the first hour.

Answer

To assess the adequacy of cerebral perfusion pressure.

Answer

To ensure the patient is maintained at an adequate level of sedation.

Question 5

Which of the following assessments are considered essential components of the initial evaluation and management in the immediate post-ROSC period?

Accepted Answer

Obtaining a 12-lead ECG and monitoring blood glucose levels.

Answer

Lumbar puncture and prophylactic antibiotic administration.

Answer

Chest physiotherapy and initiation of enteral feeding.

Answer

Placing a central venous catheter and a pulmonary artery catheter.

Question 6

A child has been successfully resuscitated and is being managed in the post-cardiac arrest phase. The team is aiming for normocapnia. Which of the following is the most reliable method for continuous monitoring of ventilation status?

Accepted Answer

Waveform capnography

Answer

Serial chest X-rays

Answer

Pulse oximetry

Answer

Arterial blood gas analysis every 4 hours