PALS Pediatric Arrhythmia Recognition

Question 1

Which ECG finding is characteristic of ventricular fibrillation (VF) in a child?

Accepted Answer

Chaotic, irregular waveforms with no identifiable P waves or QRS complexes

Answer

Regular narrow-complex rhythm with rate >220 bpm

Answer

Wide-complex tachycardia with identifiable P waves

Answer

Sawtooth flutter waves at 300 bpm

Question 2

A child presents with a heart rate of 280 bpm, narrow QRS, and no discernible P waves. Which arrhythmia is most likely?

Accepted Answer

Supraventricular tachycardia (SVT)

Answer

Sinus tachycardia

Answer

Ventricular tachycardia

Answer

Third-degree heart block

Question 3

Which rhythm is most commonly associated with pulseless cardiac arrest in children?

Accepted Answer

Asystole or pulseless electrical activity (PEA)

Answer

Ventricular fibrillation

Answer

Supraventricular tachycardia

Answer

First-degree AV block

Question 4

On ECG, a child has a regular rhythm at 40 bpm with P waves that bear no relationship to QRS complexes. What is this rhythm?

Accepted Answer

Third-degree (complete) AV block

Answer

Second-degree AV block type I

Answer

First-degree AV block

Answer

Junctional escape rhythm

Question 5

A child in cardiac arrest has a rhythm showing organized electrical activity on the monitor but no pulse. What rhythm is this?

Accepted Answer

Pulseless electrical activity (PEA)

Answer

Asystole

Answer

Ventricular fibrillation

Answer

Sinus bradycardia

Question 6

Which arrhythmia in a child with a pulse is treated with adenosine as the first-line pharmacologic therapy?

Accepted Answer

Supraventricular tachycardia (SVT)

Answer

Ventricular tachycardia

Answer

Atrial flutter

Answer

Sinus tachycardia