PALS High-Quality Pediatric BLS 3 — Questions and Answers
Question 1: A 4-year-old is in cardiac arrest. An AED arrives. After delivering a shock, what is the IMMEDIATE next step?
- Check for a pulse before resuming CPR
- Resume CPR immediately starting with chest compressions (Correct answer)
- Give 2 rescue breaths before compressions
- Reanalyze the rhythm before resuming CPR
Correct answer: Resume CPR immediately starting with chest compressions
After AED shock delivery, immediately resume CPR starting with chest compressions without pausing for a pulse check.
Question 2: During pediatric BLS, how long should you spend checking for a pulse before deciding to start CPR?
- 5 seconds
- No more than 10 seconds (Correct answer)
- 15 seconds
- 30 seconds
Correct answer: No more than 10 seconds
The pulse check should take no more than 10 seconds; if uncertain, begin CPR immediately.
Question 3: For a child in cardiac arrest with an advanced airway in place, what is the recommended ventilation rate?
- 1 breath every 2–3 seconds (20–30/min)
- 1 breath every 3–5 seconds (12–20/min) (Correct answer)
- 1 breath every 6 seconds (10/min)
- 1 breath every 2 seconds (30/min)
Correct answer: 1 breath every 3–5 seconds (12–20/min)
With an advanced airway, deliver 1 breath every 3–5 seconds (12–20 breaths/min) asynchronously with continuous compressions.
Question 4: What is the MOST reliable indicator of effective chest compressions during pediatric CPR?
- Visible chest rise with each compression
- Capnography showing ETCO₂ ≥ 15 mmHg (Correct answer)
- Palpable femoral pulse with each compression
- Skin color improvement within 2 minutes
Correct answer: Capnography showing ETCO₂ ≥ 15 mmHg
End-tidal CO₂ (ETCO₂) ≥ 15 mmHg on capnography is the most reliable real-time indicator of effective CPR perfusion.
Question 5: Which action causes the MOST significant interruption to chest compression fraction during pediatric resuscitation?
- Mask ventilation pauses during 30:2 cycles
- Prolonged rhythm analysis with the AED (Correct answer)
- Switching compressors every 2 minutes
- Placing an IV access line
Correct answer: Prolonged rhythm analysis with the AED
Prolonged AED rhythm analysis causes the longest single pause in compressions and most significantly reduces CCF.
Question 6: A lone rescuer finds a 7-year-old unresponsive with no breathing. The rescuer has a phone. What is the correct sequence?
- Start CPR → call 911 after 2 minutes
- Call 911 first → then start CPR
- Start CPR for 5 cycles → call 911 → continue CPR
- Call 911 on speakerphone simultaneously while beginning CPR (Correct answer)
Correct answer: Call 911 on speakerphone simultaneously while beginning CPR
A lone rescuer should activate EMS on speakerphone while simultaneously beginning CPR to minimize delay in both actions.
Question 7: Hyperventilation during pediatric BLS is harmful primarily because it:
- Increases intracranial pressure and worsens neurological outcomes
- Causes gastric distension and increases regurgitation risk
- Raises intrathoracic pressure and reduces venous return and cardiac output (Correct answer)
- Depletes the rescuer's energy more rapidly
Correct answer: Raises intrathoracic pressure and reduces venous return and cardiac output
Excessive ventilation increases intrathoracic pressure, which impedes venous return and dramatically reduces cardiac output during CPR.
PALS High-Quality Pediatric BLS 3
A 4-year-old is in cardiac arrest.
An AED arrives.
After delivering a shock, what is the IMMEDIATE next step?