PALS Cardiac Arrest 5

Question 1

Which post-cardiac arrest intervention is recommended to prevent secondary brain injury in a comatose child after ROSC?

Accepted Answer

Targeted temperature management (normothermia 36-37.5°C or mild hypothermia 32-34°C)

Answer

Targeted temperature management (TTM) — either normothermia or mild hypothermia — is recommended post-ROSC in comatose pediatric patients.

Question 2

A 3-year-old is found unresponsive and pulseless. After 2 minutes of CPR, the monitor shows a shockable rhythm. What is the correct sequence?

Accepted Answer

Shock → immediately resume CPR for 2 min → rhythm check

Answer

After delivering a shock, immediately resume CPR for 2 minutes before the next rhythm check to maximize perfusion.

Question 3

Which of the following describes the correct hand placement for two-finger chest compressions in an infant?

Accepted Answer

Just below the nipple line, center of chest (lower half of sternum)

Answer

For infant single-rescuer CPR, place two fingers just below the nipple line on the center of the chest (lower half of sternum).

Question 4

During CPR, a child's EtCO2 remains at 5 mmHg despite what appears to be adequate compressions. What should be considered?

Accepted Answer

Improve compression quality and reassess for reversible causes

Answer

A persistently low EtCO2 (< 10 mmHg) during CPR indicates poor cardiac output; improve compressions and search for reversible causes.

Question 5

A child remains in refractory VF after 3 shocks, epinephrine, and amiodarone. What is the next recommended action?

Accepted Answer

Give a second dose of amiodarone (5 mg/kg) or lidocaine (1 mg/kg) and shock again

Answer

A repeat antiarrhythmic dose (amiodarone 5 mg/kg or lidocaine 1 mg/kg) followed by defibrillation is indicated for persistent VF.

PALS - Pediatric Advanced Life Support Practice Test