PALS Pediatric Arrhythmia Recognition 2

Question 1

A 6-month-old infant has a heart rate of 240 bpm with poor perfusion and no P waves visible on ECG. What is the most appropriate initial treatment if IV access is unavailable?

Accepted Answer

Synchronized cardioversion at 0.5–1 J/kg

Answer

Unstable SVT without IV/IO access is treated with synchronized cardioversion starting at 0.5–1 J/kg.

Question 2

Which ECG finding distinguishes sinus tachycardia from SVT in an infant?

Accepted Answer

Presence of visible P waves with a rate that varies with activity

Answer

Sinus tachycardia has identifiable P waves and rate variability with stimulation, whereas SVT is typically fixed and lacks visible P waves.

Question 3

A child is found in cardiac arrest with a shockable rhythm. What is the correct initial defibrillation dose in PALS?

Accepted Answer

2 J/kg

Answer

PALS guidelines recommend an initial defibrillation dose of 2 J/kg for VF or pVT, increasing to 4 J/kg for subsequent shocks.

Question 4

Which of the following is a non-shockable cardiac arrest rhythm?

Accepted Answer

Asystole

Answer

Asystole is a non-shockable rhythm; treatment focuses on high-quality CPR and epinephrine rather than defibrillation.

Question 5

A wide-complex tachycardia at 180 bpm with a pulse is seen in a child with mild symptoms. What should be done first to differentiate VT from SVT with aberrancy?

Accepted Answer

Obtain a 12-lead ECG and assess clinical history

Answer

A 12-lead ECG combined with clinical context helps differentiate VT from SVT with aberrant conduction before pharmacologic intervention.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Pediatric Arrhythmia Recognition 2