Tachycardia With a Pulse Flashcards
7 cards from real PALS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Tachycardia With a Pulse flashcards as text
A 3-year-old presents with a heart rate of 220 bpm, poor perfusion, and altered mental status. The rhythm is narrow-complex and regular. What is the most appropriate next intervention?
Answer: Synchronized cardioversion at 1 J/kg
Unstable SVT with signs of poor perfusion requires immediate synchronized cardioversion starting at 1 J/kg.
Which ECG feature best distinguishes sinus tachycardia from SVT in a pediatric patient?
Answer: P-waves present before every QRS with a normal axis
Sinus tachycardia shows upright P-waves with a normal axis preceding each QRS, unlike SVT which often shows absent or retrograde P-waves.
A 6-year-old with SVT receives adenosine 0.1 mg/kg IV without conversion. What is the next dose of adenosine?
Answer: 0.2 mg/kg IV
If the first dose of adenosine (0.1 mg/kg) fails, the second dose is doubled to 0.2 mg/kg (max 12 mg).
In a child with wide-complex tachycardia and a pulse who is hemodynamically stable, which drug is preferred?
Answer: Amiodarone 5 mg/kg IV over 20–60 minutes
Amiodarone is the preferred antiarrhythmic for stable wide-complex tachycardia in pediatric patients per PALS guidelines.
Which scenario is MOST consistent with sinus tachycardia rather than SVT?
Answer: Heart rate that gradually decreases with fluid administration for dehydration
Sinus tachycardia has an identifiable cause (e.g., fever, dehydration) and responds to treatment of that cause, often showing gradual rate change.
When performing synchronized cardioversion for unstable SVT in a child, which energy level is used for the second attempt if the first is unsuccessful?
Answer: 2 J/kg
If the initial synchronized cardioversion at 1 J/kg fails, the second attempt uses 2 J/kg.
A child with SVT is conscious and has adequate perfusion. IV access is unavailable. What is the most appropriate initial intervention?
Answer: Vagal maneuvers such as ice water to the face
In stable SVT without IV access, vagal maneuvers (e.g., ice water facial immersion in infants) are the first-line intervention.