PALS

Question 1

List normal respiratory rates by age.

Answer 1

Infant=30-60
Toddler 24-40
Preschool 22-34
School age 18-30
Teens 12-16

Question 2

What is considered an abnormal respiratory rate for children?

Answer 2

Less than 10, greater than 60,

Question 3

In the PALS algorithm, what is the first question you ask yourself when assessing a distressed child?

Answer 3

Is child unresponsive, with no breathing or only gasping.

Question 4

According to the PALS algorithm, what is the first step when a child is unresponsive or in respiratory distress? Second step?

Answer 4

Activate emergency response/shout for help.

Check for pulse.

Question 5

According to the PALS algorithm, if the child has a pulse, under what conditions would CPR be started anyway?

Answer 5

Pulse

Question 6

According to the PALS algorithm, after CPR is initiated, what guidelines should you follow?

Answer 6

The pediatric cardiac arrest algorithm.

Question 7

What are the 3 things assessed for during initial assessment?

Answer 7

LOC, breathing, color.

Question 8

What are the 3 parts to the “evaluate” portion of the evaluate-identify-intervene algorithm.

Answer 8

Primary assessment, secondary assessment, diagnostic tests.

Question 9

Describe a “primary assessment”

Answer 9

Systematic ABCDE evaluation. Includes vital signs and pulse ox.

Question 10

Describe a “secondary evaluation”

Answer 10

A focused medical history and exam.

Question 11

What is the proper way to attempt to open an obstructed airway if the child is 1 yr old?

Answer 11

If 1 yr old use abdominal thrusts only.

Question 12

What can cause tachypnea?

Answer 12

Fever, DKA, pain, sepsis, HF, anemia, congenital defects.

Question 13

What do retractions accompanied by inspiratory stridor or snoring suggest?

Answer 13

An upper airway obstruction.

Question 14

What do retractions accompanied by expiratory wheezing suggest?

Answer 14

Asthma or bronchitis.

Question 15

What is grunting usually a sign of?

Answer 15

Respiratory distress/failure due to tissue disease.

Question 16

What 5 things are assessed for circulation?

Answer 16

BP, HR/rhythm, cap refill, skin color/temp, pulses.

Question 17

What do you do when a child with bradycardia has signs of poor perfusion?

Answer 17

Bag them with O2.

Question 18

What might cause bradycardia in a child who is alert with no signs of poor perfusion?

Answer 18

Heart block, drug overdose.

Question 19

What acronym is used for peds LOC?

Answer 19

AVPU. Alert/Voice/Pain/Unresponsive

Question 20

What Glascow Coma Scores correlate to mild/moderate/severe head injury?

Answer 20

Mild=13-15. Moderate =9-12. Severe=3-8

Question 21

What does SAMPLE stand for?

Answer 21

A means of coordinating a focused assessment. Signs/Symptoms, Allergies, Medications, Past history, LAst meal, Events.

Question 22

During a resuscitation, how many team members are needed? Name the rolls performed by each.

Answer 22

6 Team leader, observer/recorder, compressor, airway, IV meds, monitor/defibrillator.

Question 23

When a pediatric Pt is in respiratory distress/failure, what are the early S/S?

Answer 23

Tachypnea,tachycardia, anxiety, increased respiratory effort, pallor, good air movement.

Question 24

When a pediatric Pt is in respiratory distress/failure, what are the late S/S?

Answer 24

Bradypnea to apnea, decreased to no effort, poor to absent air movement, bradycardia, cyanosis, lethargy/unresponsive.

Question 25

What is the Tx for mild croup?

Answer 25

Dexamethasone

Question 26

What is the Tx for moderate to severe croup?

Answer 26

O2, NPO, nebulized epi, observe 2 hours, dexamethasone, heliox.

Question 27

What is the Tx for impending respiratory failure due to croup?

Answer 27

non-rebreather O2, bag mask, dexamethasone, intubation.

Question 28

If a lower airway obstruction is present (asthma), should ventilation be slow or fast?

Answer 28

Slow, to prevent high airway pressure and its complications.

Question 29

What meds are used to treat asthma?

Answer 29

Albuterol, ipatropium, O2, steroids.