PALS Post-Cardiac Arrest Care 4

Question 1

A post-arrest child on TTM develops shivering. Why is shivering problematic in this setting?

Accepted Answer

It raises core temperature and counteracts cooling

Answer

Shivering generates heat, which raises core temperature and undermines the cooling goals of TTM.

Question 2

Which of the following is an appropriate management target for post-arrest oxygen delivery in pediatric patients?

Accepted Answer

SpO2 of 94–99%

Answer

Targeting SpO2 94–99% avoids both hypoxia and hyperoxia, both of which worsen outcomes after cardiac arrest.

Question 3

What is the primary concern when giving high-dose IV fluids immediately after ROSC in a child?

Accepted Answer

Myocardial dysfunction may worsen with volume overload

Answer

Post-arrest myocardial dysfunction is common; excessive fluid boluses can worsen cardiac output in a stunned heart.

Question 4

A child 48 hours post-cardiac arrest has a fixed, dilated pupil. How should this finding be interpreted in the context of TTM?

Accepted Answer

Pupillary findings during TTM are unreliable and must be interpreted cautiously

Answer

TTM and sedating medications can alter pupillary responses, making neurological prognostication unreliable until at least 72 hours after rewarming.

Question 5

Which ECG finding post-ROSC should prompt urgent evaluation for a reversible cardiac cause of arrest?

Accepted Answer

ST-segment elevation

Answer

ST-segment elevation post-ROSC may indicate acute coronary syndrome or myocarditis requiring immediate cardiac evaluation and possible intervention.

PALS - Pediatric Advanced Life Support Practice Test