PALS Managing Respiratory Emergencies 3

Question 1

A 4-year-old is found unresponsive with agonal respirations and no pulse. After 2 minutes of CPR, the cardiac monitor shows a narrow complex tachycardia at 210 bpm with a palpable pulse. What is this rhythm?

Accepted Answer

Supraventricular tachycardia (SVT)

Answer

SVT at rates typically >220 bpm in infants or >180 bpm in children, with a narrow complex and sudden onset, is differentiated from sinus tachycardia by its extreme rate and lack of rate variability.

Question 2

A 7-year-old with epiglottitis requires airway management. Which approach is safest?

Accepted Answer

Allow the child to remain calm and transport to OR for controlled intubation

Answer

Epiglottitis management prioritizes keeping the child calm and performing intubation in a controlled OR setting with ENT backup to avoid sudden complete obstruction.

Question 3

A 10-month-old presents with a 2-day history of cough, wheeze, and low-grade fever. Examination shows prolonged expiration and diffuse crackles. What is the most likely diagnosis?

Accepted Answer

Bronchiolitis

Answer

Bronchiolitis, most commonly caused by RSV, typically affects infants under 2 years with wheeze, prolonged expiration, and crackles following an upper respiratory prodrome.

Question 4

Correct ETT depth (cm at the lip) for oral intubation in a child can be estimated by which formula?

Accepted Answer

Age/4 + 10

Answer

The formula (Age/4 + 10) estimates oral ETT insertion depth at the lip in centimeters for pediatric patients.

Question 5

A 5-year-old is intubated for respiratory failure. Post-intubation chest X-ray shows only right lung inflation. What is the most likely cause?

Accepted Answer

Right mainstem intubation

Answer

Right mainstem bronchus intubation is common due to its less acute angle, resulting in right-only lung inflation and absent left breath sounds.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Managing Respiratory Emergencies 3