PEARS Cardiac Arrest Care — Questions and Answers

Question 1: During pediatric CPR, what is the recommended compression-to-ventilation ratio for a single rescuer?

15:2
30:2 (Correct answer)
5:1
10:2

Correct answer: 30:2

A single rescuer uses a 30:2 compression-to-ventilation ratio for pediatric CPR regardless of age.

Question 2: A 7-year-old is in cardiac arrest. Two rescuers are present. What compression-to-ventilation ratio should they use?

30:2
15:2 (Correct answer)
10:1
20:2

Correct answer: 15:2

Two rescuers performing CPR on a child use a 15:2 compression-to-ventilation ratio to optimize oxygenation.

Question 3: Which rhythm is most commonly associated with pediatric cardiac arrest?

Ventricular fibrillation
Asystole or pulseless electrical activity (Correct answer)
Atrial fibrillation
Supraventricular tachycardia

Correct answer: Asystole or pulseless electrical activity

Pediatric cardiac arrest is most often caused by respiratory failure leading to asystole or PEA, not a primary cardiac event.

Question 4: When performing chest compressions on an infant, what is the preferred two-rescuer technique?

Two-finger technique on the sternum
Heel-of-hand technique
Two thumb-encircling hands technique (Correct answer)
One-hand compression technique

Correct answer: Two thumb-encircling hands technique

The two thumb-encircling hands technique is preferred for two-rescuer infant CPR because it generates higher coronary perfusion pressure.

Question 5: What is the recommended compression depth for a 4-year-old child during CPR?

At least 1 inch (2.5 cm)
At least 2 inches (5 cm)
At least 1.5 inches (4 cm) (Correct answer)
At least 2.5 inches (6 cm)

Correct answer: At least 1.5 inches (4 cm)

For children, compress the chest at least one-third the anterior-posterior depth, approximately 2 inches (5 cm), but the guideline target is at least 2 inches.

Question 6: After achieving return of spontaneous circulation (ROSC) in a pediatric patient, what is a key post-resuscitation priority?

Immediately begin oral feeding
Avoid oxygen supplementation
Prevent hyperthermia and hypoglycemia (Correct answer)
Discontinue IV access

Correct answer: Prevent hyperthermia and hypoglycemia

Post-ROSC care includes avoiding hyperthermia, preventing hypoglycemia, and maintaining adequate perfusion to prevent secondary brain injury.

Question 7: Which of the following represents an H that should be considered as a reversible cause during pediatric cardiac arrest?

Hypertension
Hyperkalemia (Correct answer)
Hypernatremia
Hypercalcemia

Correct answer: Hyperkalemia

Hyperkalemia is one of the Hs in the Hs and Ts framework for identifying reversible causes of cardiac arrest.

Question 8: When is it appropriate to use an automated external defibrillator (AED) on an infant under 1 year of age?

AEDs should never be used on infants
AEDs can be used with pediatric pads if a manual defibrillator is unavailable (Correct answer)
AEDs are the preferred device for infants
Only adult pads should be used on infants

Correct answer: AEDs can be used with pediatric pads if a manual defibrillator is unavailable

An AED with pediatric dose-attenuating pads may be used on infants when a manual defibrillator is not available.

Question 9: What does PEA stand for in the context of cardiac arrest?

Pulmonary Edema Assessment
Pulseless Electrical Activity (Correct answer)
Post-Event Analysis
Peripheral Electrolyte Abnormality

Correct answer: Pulseless Electrical Activity

PEA (Pulseless Electrical Activity) describes organized cardiac electrical activity on the monitor without a palpable pulse.

Question 10: A 10-year-old is found unresponsive with no pulse. The cardiac monitor shows a fine disorganized waveform. What is the next step?

Begin CPR and give epinephrine
Deliver a defibrillation shock immediately (Correct answer)
Perform synchronized cardioversion
Give adenosine IV push

Correct answer: Deliver a defibrillation shock immediately

Ventricular fibrillation is a shockable rhythm; deliver defibrillation as soon as possible while CPR continues.

Question 11: Which of the following best describes the recommended rate of chest compressions during pediatric CPR?

60-80 compressions per minute
80-100 compressions per minute
100-120 compressions per minute (Correct answer)
120-140 compressions per minute

Correct answer: 100-120 compressions per minute

High-quality CPR requires compressions at a rate of 100-120 per minute for both adults and children.

Question 12: After achieving ROSC in a pediatric patient, the SpO2 is 99% on 100% FiO2. What adjustment is recommended?

Maintain 100% FiO2 to prevent hypoxia
Titrate oxygen to maintain SpO2 94-99% to avoid hyperoxia (Correct answer)
Increase FiO2 above 100%
Discontinue supplemental oxygen immediately

Correct answer: Titrate oxygen to maintain SpO2 94-99% to avoid hyperoxia

Post-ROSC, titrate oxygen to maintain SpO2 between 94-99% because hyperoxia can worsen neurological injury.

Question 13: A child is in cardiac arrest due to suspected hyperkalemia. Which medication may be administered to stabilize the cardiac membrane?

Sodium bicarbonate
Calcium chloride or calcium gluconate (Correct answer)
Magnesium sulfate
Potassium chloride

Correct answer: Calcium chloride or calcium gluconate

Calcium (calcium chloride or gluconate) is given to stabilize the cardiac membrane in hyperkalemia-induced cardiac arrest.

Question 14: Why is it important to allow full chest recoil between compressions during CPR?

To prevent rib fractures
To allow the heart to refill with blood and maximize cardiac output (Correct answer)
To reduce rescuer fatigue
To improve airway positioning

Correct answer: To allow the heart to refill with blood and maximize cardiac output

Full chest recoil allows ventricular refilling between compressions, which is essential for generating effective cardiac output.

Question 15: How often should epinephrine be administered during a pediatric cardiac arrest resuscitation?

Every 1-2 minutes
Every 3-5 minutes (Correct answer)
Every 7-10 minutes
Only once during the entire resuscitation

Correct answer: Every 3-5 minutes

Epinephrine is given every 3-5 minutes during cardiac arrest to maintain its vasopressor effect.

Question 16: A child in cardiac arrest has suspected cardiac tamponade. What is the definitive emergency treatment?

Needle decompression of the chest
Pericardiocentesis to drain the pericardial fluid (Correct answer)
Immediate defibrillation
High-dose epinephrine administration

Correct answer: Pericardiocentesis to drain the pericardial fluid

Pericardiocentesis is the definitive treatment for cardiac tamponade, which is one of the Ts in the reversible causes of cardiac arrest.

Question 17: During a resuscitation attempt, the team leader should assign roles at the start. What is the primary benefit of this practice?

It speeds up medication administration only
It ensures organized, efficient resuscitation by preventing task overlap and confusion (Correct answer)
It eliminates the need for verbal communication during CPR
It allows only the team leader to make all decisions

Correct answer: It ensures organized, efficient resuscitation by preventing task overlap and confusion

Assigning clear roles prevents task overlap, ensures all critical interventions are covered, and improves resuscitation team efficiency.

Question 18: A 3-year-old is in pulseless ventricular tachycardia. After the first shock at 2 J/kg fails, what energy dose should be used for the second shock?

2 J/kg again
4 J/kg or higher (Correct answer)
10 J/kg
1 J/kg

Correct answer: 4 J/kg or higher

Subsequent defibrillation attempts use 4 J/kg or higher after the initial 2 J/kg dose fails.

Question 19: Which of the following is the preferred route for drug administration when IV access cannot be rapidly established during cardiac arrest?

Endotracheal (ET) tube
Subcutaneous injection
Intraosseous (IO) route (Correct answer)
Rectal administration

Correct answer: Intraosseous (IO) route

Intraosseous (IO) access provides rapid, reliable vascular access when IV access cannot be quickly established during cardiac arrest.

Question 20: What is the appropriate action if the rhythm check after 2 minutes of CPR reveals asystole?

Deliver a defibrillation shock
Perform synchronized cardioversion
Resume CPR immediately and continue looking for reversible causes (Correct answer)
Administer atropine and recheck in 1 minute

Correct answer: Resume CPR immediately and continue looking for reversible causes

Asystole is a non-shockable rhythm; resume CPR immediately, give epinephrine, and address reversible causes (Hs and Ts).

Question 21: In a pediatric patient who achieves ROSC, which parameter should be carefully monitored to detect hypoglycemia?

SpO2
Blood glucose level (Correct answer)
End-tidal CO2
Body temperature

Correct answer: Blood glucose level

Blood glucose must be monitored post-ROSC because hypoglycemia causes secondary brain injury and worsens neurological outcomes.

PEARS Cardiac Arrest Care

During pediatric CPR, what is the recommended compression-to-ventilation ratio for a single rescuer?

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