PALS Tachycardia 3

Question 1

A 10-year-old presents with a wide-complex tachycardia at 180 bpm with hemodynamic stability. Which drug is preferred when the rhythm is uncertain?

Accepted Answer

Adenosine 0.1 mg/kg rapid IV

Answer

Adenosine is preferred for stable wide-complex tachycardia of uncertain origin because it is safe if the rhythm is SVT with aberrancy and has a short half-life.

Question 2

Which medication is CONTRAINDICATED in pediatric SVT management?

Accepted Answer

Verapamil in infants <1 year

Answer

Verapamil is contraindicated in infants under 1 year because it can cause severe hypotension, bradycardia, and cardiac arrest in this age group.

Question 3

A 3-year-old with a history of congenital heart disease develops a wide-complex tachycardia at 190 bpm with signs of shock. What is the first action?

Accepted Answer

Prepare for synchronized cardioversion

Answer

Unstable wide-complex tachycardia with shock requires immediate synchronized cardioversion regardless of rhythm identification.

Question 4

What is the recommended adenosine dose for the SECOND administration in a child with SVT?

Accepted Answer

0.2 mg/kg

Answer

If the first dose of adenosine (0.1 mg/kg) is ineffective, the second dose is doubled to 0.2 mg/kg (maximum 12 mg).

Question 5

During SVT cardioversion in an awake child, which consideration is most important?

Accepted Answer

Ensure sedation and analgesia before delivery

Answer

If the clinical situation allows time, sedation and analgesia should be provided before elective synchronized cardioversion in a conscious child.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Tachycardia 3