APLS 6ed

Question 1

What does the PACE acronym stand for?

Answer 1

P - Probe
A - Alert
C - Challenge
E - Emergency

Question 2

Give an example of probing phrase

Answer 2

… I think this child might be…

OR

… Have you noticed this child looks cyanosed?

Question 3

Give an example of how to phrase an alert.

Answer 3

… I am concerned

… I am very worried that

Question 4

Give an example of a challenge.

Answer 4

… (look direct in the eyes)… I need you to listen to me now

OR

… You must listen to me now… I think X is going wrong and we need to do Y

Question 5

What would you say to take over in an emergency?

Answer 5

… This situation is critical, you are overlooking X, please move out of the way, I am going to do Y

Question 6

How might you encourage situational awareness amongst colleagues - ask a level 1 question.

Answer 6

What do you think is going on here?

Question 7

How might you encourage situational awareness amongst colleagues - ask a level 2 question.

Answer 7

So what does that mean?

Why is that happening?

Question 8

How might you encourage situational awareness amongst colleagues - ask a level 3 question.

Answer 8

Now what do we need to do?
What are the next step?
What is our plan?

Question 9

What is level 1 situational awareness?

Answer 9

Observing and acknowledging that something is happening.

Question 10

What is level 2 situational awareness?

Answer 10

How do we interpret and understand what is happening

Question 11

What is level 3 situational awareness?

Answer 11

Making a decision and planned action based on this reflection and understanding.

Question 12

What is confirmation bias?

Answer 12

Favouring information inputs that confirm your preconceptions or hypotheses.

Question 13

What is the mechanism of infant grunting?

Answer 13

Expiration against a closed glottis.

Generates PEEP

Helps to hold stiff lungs open longer for gas exchange/prevents end expiration collapse of small airways.

Question 14

Using a look, listen, feel, measure structure - describe how you would assess the airway and breathing (combined assessment)

Answer 14

Look: Colour - Pallor, Cyanosis

Effort of breathing - Accessory muscle use, nasal flaring, head bobbing, gasping

Listen: Stridor, gurgling, wheeze, cough, grunting, silent chest

Feel: Trachea central, chest expansion symmetrical, percussion note

Measure: RR/oxygen saturations/blood gas +PC02 if available.

Question 15

Give 3 instances where there may not be an appropriate compensatory increase in respiratory effort.

Answer 15

1. Fatigue
2. CNS depression - no central drive
3. Neuromuscular disease

Question 16

List 3 conditions which may result in cerebral depression.

Answer 16

1. Raised ICP
2. Poisoning
3. Encephalopathy (metabolic/renal/liver/autoimmune)

Question 17

Patient oxygen saturations are less than 70% - what happens to the 02 monitor?

Answer 17

Less accurate reading

Question 18

List 4 other features that interfere with efficacy of the 02 monitor.

Answer 18

1. Cold/vasoconstriction
2. Motion
3. Excess ambient light
4. Carboxyhaemoglobin

Question 19

At what saturation threshold does cyanosis become physically visible?

Answer 19

<70%

Question 20

What other physical condition might hide the presence of cyanosis?

Answer 20

Anaemia