PALS High-Quality Pediatric BLS 5 — Questions and Answers
Question 1: A child receives high-quality CPR for 2 minutes. The AED analyzes and advises 'no shock.' What is the NEXT step?
- Check for a pulse and observe for 30 seconds
- Immediately resume CPR for another 2 minutes (Correct answer)
- Give 2 rescue breaths before resuming compressions
- Administer epinephrine before resuming CPR
Correct answer: Immediately resume CPR for another 2 minutes
If the AED advises no shock, immediately resume CPR beginning with compressions to minimize interruptions to perfusion.
Question 2: Which of the following is a sign that CPR compressions are adequate during pediatric resuscitation?
- Pupillary dilation
- Palpable pulse with each compression (Correct answer)
- Absence of cyanosis within 1 minute
- Spontaneous eye opening
Correct answer: Palpable pulse with each compression
A palpable pulse (often femoral or carotid) synchronized with each compression confirms that adequate forward flow is being generated.
Question 3: In pediatric BLS, 'push hard and push fast' refers to which specific targets?
- Depth ≥ 1/3 AP diameter; rate 80–100/min
- Depth ≥ 2 inches; rate at least 100/min
- Depth ≥ 1/3 AP diameter; rate 100–120/min (Correct answer)
- Depth ≥ 1 inch; rate 120–140/min
Correct answer: Depth ≥ 1/3 AP diameter; rate 100–120/min
High-quality pediatric CPR requires compressing at least 1/3 the AP chest diameter at a rate of 100–120 compressions per minute.
Question 4: A rescuer is providing bag-mask ventilation to a child in cardiac arrest. Which mask size selection principle applies?
- Always use adult size for children over 2 years
- The mask should cover the mouth only to minimize dead space
- The mask should cover the mouth and nose with an airtight seal (Correct answer)
- Use the smallest available mask to reduce tidal volume
Correct answer: The mask should cover the mouth and nose with an airtight seal
The correctly sized mask covers both the mouth and nose completely, allowing an airtight seal for effective ventilation.
Question 5: Why is it important to avoid excessive ventilation during pediatric CPR even when a bag-mask is available?
- It wastes rescuer time that should be spent on compressions
- It raises intrathoracic pressure, decreasing cardiac output and coronary perfusion (Correct answer)
- It causes bronchospasm in pediatric patients
- It accelerates metabolic acidosis
Correct answer: It raises intrathoracic pressure, decreasing cardiac output and coronary perfusion
Over-ventilation raises intrathoracic pressure, impeding venous return and severely reducing cardiac output during CPR.
Question 6: During a pediatric resuscitation, a team member notices the compressor is leaning on the chest between compressions. The BEST action is to:
- Pause CPR and instruct the compressor before resuming
- Rotate the compressor immediately at the next 2-minute interval
- Verbally coach the compressor to release pressure without stopping CPR (Correct answer)
- Switch to the two thumb-encircling technique to compensate
Correct answer: Verbally coach the compressor to release pressure without stopping CPR
The best approach is to verbally coach the compressor in real time without interrupting CPR, preserving compression fraction.
Question 7: What is the recommended pediatric defibrillation dose for a FIRST shock in a child with a shockable rhythm?
- 1 J/kg
- 2 J/kg (Correct answer)
- 4 J/kg
- 200 J (fixed)
Correct answer: 2 J/kg
The initial defibrillation dose for children is 2 J/kg; subsequent shocks may be increased to 4 J/kg or higher.
PALS High-Quality Pediatric BLS 5
A child receives high-quality CPR for 2 minutes.
The AED analyzes and advises 'no shock.' What is the NEXT step?