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

VF is characterized by chaotic, disorganized electrical activity with no discernible P waves or QRS complexes on ECG.

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

SVT typically presents with rates >220 bpm in infants or >180 bpm in children, narrow QRS complexes, and absent or retrograde P waves.

Question 3

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

Accepted Answer

Asystole or pulseless electrical activity (PEA)

Answer

Asystole and PEA are the most common arrest rhythms in children, unlike adults where VF is more common.

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

Complete AV block shows no association between P waves and QRS complexes, with the atria and ventricles beating independently.

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

PEA is defined as organized electrical activity on the cardiac monitor without a detectable pulse.

PALS - Pediatric Advanced Life Support Practice Test