PALS Bradycardia With a Pulse 2

Question 1

A 4-year-old has a heart rate of 68 bpm with poor perfusion. After ensuring airway and oxygenation, what is the next intervention if the child remains symptomatic?

Accepted Answer

Give epinephrine 0.01 mg/kg IV/IO

Answer

If bradycardia with poor perfusion persists despite adequate oxygenation, epinephrine is the drug of choice in PALS.

Question 2

Which ECG finding is most commonly associated with symptomatic bradycardia in pediatric patients requiring PALS intervention?

Accepted Answer

Complete (third-degree) heart block

Answer

Complete (third-degree) heart block causes complete dissociation between atria and ventricles, producing severe bradycardia requiring intervention.

Question 3

A 7-year-old with known congenital heart disease presents with HR 48 bpm, altered consciousness, and hypotension. Oxygen has been applied. What should be done NEXT?

Accepted Answer

Administer atropine 0.02 mg/kg IV

Answer

Atropine is the first-line drug for symptomatic bradycardia with a pulse when the rhythm is vagally mediated or AV block is suspected.

Question 4

What is the minimum single dose of atropine recommended in PALS to avoid paradoxical bradycardia?

Accepted Answer

0.02 mg/kg with a minimum of 0.1 mg

Answer

PALS recommends atropine 0.02 mg/kg with a minimum single dose of 0.1 mg to avoid paradoxical bradycardia from very small doses.

Question 5

During management of a bradycardic infant, the team achieves IV access. Atropine has been given twice without improvement. What is the next pharmacologic step?

Accepted Answer

Administer epinephrine infusion

Answer

If atropine fails to correct symptomatic bradycardia, epinephrine infusion (0.01–1 mcg/kg/min) is the next pharmacologic agent in PALS.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Bradycardia With a Pulse 2