ACLS PALS

Question 1

BLS Compressions depth adult

Answer 1

At least 2 inches

Question 2

BLS Compression rate adult

Answer 2

100-120 compressions per minute

Question 3

Treatment for stable SVT

Answer 3

Adenosine 6-12-12

Rapid push with NS flush

Question 4

SVT EKG characteristic

Answer 4

Narrow complex tachycardia

No p waves

Question 5

Narrow complex tachycardia
No p waves
dx?

Answer 5

SVT
Tx if stable: Adenosine 6-12-12
Tx if unstable: immediate synchronized cardioversion

Question 6

Treatment for unstable SVT

Answer 6

Immediate synchronized cardioversion

Question 7

In BBB, look for R-R’ only in these leads

Answer 7

V1, V2, V5, V6

Question 8

Widened QRS is >

Answer 8

0.12 seconds (120 ms)

Question 9

Persistent unstable bradycardia steps

Answer 9

1. Atropine
2. If 1 doesn’t work, epinephrine or dopamine or transcutaneous
   After, transvenous pacing

Question 10

Atropine IV doses for bradycardia

Answer 10

1st dose 0.5 mg bolus
Repeat every 3-5 min
Up to 3 mg

Question 11

Dose for dopamine IV infusion for bradycardia

Answer 11

2-10 mcg/kg per minute

Question 12

Dose for epinephrine IV infusion for bradycardia

Answer 12

2-10 mcg per minute

Question 13

Unshockable rhythms

Answer 13

PEA

Asystole

Question 14

Shockable rhythms

Answer 14

VF

VT

Question 15

Dose of synchronized cardioversion for narrow regular tachycardia

Answer 15

50-100 J

Question 16

Dose of synchronized cardioversion for narrow irregular tachycardia

Answer 16

120-200 J biphasic or

200 J monophasic

Question 17

Dose of synchronized cardioversion for wide regular tachycardia

Answer 17

100 J

Question 18

Dose of cardioversion for wide irregular tachycardia

Answer 18

Defibrillation dose unsynchronized

Question 19

Persistent tachycardia causing instability, next step:

Answer 19

Synchronized cardioversion

Question 20

Persistent stable tachycardia, next step in management

Answer 20

Is QRS wide?

Question 21

Stable, wide QRS tachycardia chemical cardioversion options

Answer 21

Adenosine if regular and monomorphic;
Procainamide
Amiodarone
Sotalol

Question 22

Sotalol dose for stable wide QRS tachycardia

Answer 22

100 mg (1.5 mg/kg) over 5 minutes. Do not use in prolonged QT

Question 23

Amiodarone dose for stable wide QRS tachycardia

Answer 23

1st dose: 150 mg over 10 minutes; repeat as needed in VT returns
Maintenance infusion 1mg/min for first 6 hours

Question 24

Procainamide dose for stable wide QRS tachycardia

Answer 24

20-50 mg/min until: arrhythmia is suppressed, hypotension ensues, QRS duration increases by 50%;
Max dose 17 mg/kg
Maintenance dose 1-4mg/min
Do not use with long QT or pregnant

Question 25

Avoid procainamide if:

Answer 25

Long QT | Pregnant

Question 26

Avoid sotalol if

Answer 26

Long QT

Question 27

5H Reversible causes of cardiac arrest

Answer 27

``` Hypovolemia Hypoxia Hydrogen ion (acidosis) Hypothermia Hypo/hyperkalemia (H for hypoglycemia added in kids) ```

Question 28

5T Reversible Causes of adult cardiac arrest

Answer 28

``` Tension PTX Tamponade Toxins Thrombosis, pulmonary Thrombosis, coronary ```

Question 29

Amiodarone IV/IO dose for adult cardiac arrest

Answer 29

1st dose 300 mg bolus | 2nd dose: 150 mg bolus

Question 30

Epinephrine IV/IO dose for adult cardiac arrest

Answer 30

1 mg every 3-5 min

Question 31

Monophasic shock dose for adult cardiac arrest (VF/VT)

Answer 31

360 J

Question 32

Biphasic shock dose for adult cardiac arrest (VF/VT)

Answer 32

120-200 J | Subsequent doses can be the same or higher

Question 33

Vasopressin dose for adult cardiac arrest

Answer 33

40 units can replace first or second dose of epi

Question 34

Tx pediatric bradycardia first step

Answer 34

``` IV/IO O2 Airway EKG Vitals ```

Question 35

If HR <60 in peds with poor perfusion despite oxygenation/ventilation, next step

Answer 35

CPR

Question 36

If CPR does no improve pediatric bradycardia, next step

Answer 36

Epinephrine Atropine - for increased vagal tone or primary AV block Consider transthoracic or transvenous pacing Treat underlying causes

Question 37

Epinephrine dose in pediatric bradycardia

Answer 37

0.01 mg/kg (0.01 ml/kg of 1:10,000 [ ] ) Repeat q 3-5 min If no IV/IO access, can give in ET tube 0.1 mg/kg or 0.1 ml/kg of 1:1000

Question 38

Atropine dose in pediatric bradycardia

Answer 38

0.02 mg/kg May repeat once Maximum single dose 0.5 mg

Question 39

Adult chest compressions: breathing ratio if no advanced airway

Answer 39

30:2

Question 40

Pediatric chest compressions: breathing ratio if no advanced airway

Answer 40

15:2

Question 41

Shock energy for defibrillation in PALS

Answer 41

1st shock 2 J/kg 2nd shock 4 J/kg Subsequent shocks 4 or more J/kg Maximum 10 J/kg or adult dose

Question 42

Epinephrine dose in PALS for cardiac arrest

Answer 42

0.01 mg/kg (0.01 ml/kg of 1:10,000 [ ] ) Repeat q 3-5 min If no IV/IO access, can give in ET tube 0.1 mg/kg or 0.1 ml/kg of 1:1000

Question 43

Amiodarone bolus in PALS for cardiac arrest

Answer 43

5 mg/kg bolus | May repeat up to 2 times for refractory VF/pulseless VT

Question 44

Cutoff for wide QRS complex in kids

Answer 44

0.09s (90 ms)

Question 45

Adenosine dose for SVT in PALS

Answer 45

1st dose 0.1 mg/kg bolus (max 6 mg) 2nd dose 0.2 mg/kg (max 12 mg) 0.1-0.2-0.2 mg/kg

Question 46

Tx for SVT in PALS

Answer 46

1. Adenosine | 2. If not IV/IO access, or no response to adenosine, synchronized cardioversion

Question 47

Treatment for probable sinus tachycardia in PALS

Answer 47

Find and treat underlying cause

Question 48

Tachycardia rates in PALS

Answer 48

< 220 infant | < 180 kiddo

Question 49

Probable VT in kiddo, unstable, next step

Answer 49

Synchronized cardioversion

Question 50

Probable VT in kiddo, stable, next step

Answer 50

Consider adenosine if regular rhythm and monomorphic QRS | Followed by expert consultation, amio OR procainamide (not both)

Question 51

Synchronized cardioversion doses for PALS

Answer 51

Begin with 0.5-1 J/kg Then increase to 2 J/kg +/- sedation but do not delay cardioversion

Question 52

Amiodarone dose for PALS VT

Answer 52

5 mg/kg over 20-60 min

Question 53

Procainamide dose for PALS VT

Answer 53

15 mg/kg over 30-60 min