Pals Algorithms

Question 1

How far should chest compressions go with infants?

Answer 1

1/3 diameter of chest

Question 2

What is the one and two rescuer CPR compressions to ventilations ratio?

Answer 2

One = 30:2
Two = 15:2

Question 3

What is the dose of energy in J/kg for defibrillation doses in children? Second and subsequent doses? Max one time dose?

Answer 3

First = 2 j/kg
Second = 4
Max = 10

Question 4

What is the dose of epi in PALS cardiac arrest?

Answer 4

0.01 mg/kg (or 0.1 mL/kg of 0.1 mg/mL dose)

Question 5

What is the ET dose of epi in pals?

Answer 5

0.1 mg/kg (1 mL/kg of 0.1 mg/mL concentration)

Question 6

What is the dose of amiodarone for children?

Answer 6

5 mg /kg given over 20 minutes

Question 7

What is the bolus and maintenance dose of lidocaine for PALS?

Answer 7

Bolus = 1 mg/kg
Maintenance = 20-50 mcg/kg

Question 8

What is the rate of ventilation for PALS with an ET tube?

Answer 8

once every 6 seconds

Question 9

What are the 5 Hs?

Answer 9

Hypoxia
Hypovolemia
H+ ions
Hypoglycemia
Hypokalemia

Question 10

What are the 5 Ts?

Answer 10

• tPTX
• Tamponade
• Toxins
• Thrombosis pulmonary
• Thrombosis cardiac

Question 11

What is the formula for cuffed and uncuffed ET tube sizes in kids?

Answer 11

Cuffed = (age in year /4)+4
Uncuffed = (age in year/4) +3.5

Question 12

What is the first thing to do when you see a child is distress?

Answer 12

Assess ABCs, check for pulse

Question 13

Under what HR should compressions begin for bradycardia in a pediatric patient?

Answer 13

60 if s/sx of hypotension, AMS, shock

Question 14

What is the dose of atropine for pediatric bradycardia? How many times can this be repeated? What is the min and max dose?

Answer 14

• 0.02 mg/kg, may repeat once.
• min dose is 0.1 mg
• Max dose is 0.5 mg

Question 15

What is the dose of epi for peds bradycardia?

Answer 15

0.01 mg/kg or 0.1 mL/kg of 0.1 mg/mL solution

Question 16

What is the first and second dose of adenosine for SVT in pediatrics?

Answer 16

1 = 0.1 mg/kg bolus
2 = 0.2 mg/kg bolus

Question 17

What is the dose of amiodarone for pediatrics? Over what time should this be given over?

Answer 17

5 mg/kg over 20-60 minutes

Question 18

What is the dose of procainamide for PALS? Over how long should this be given?

Answer 18

15 mg/kg over 30-60 minutes

Question 19

What is the maintenance fluid requirements of infants under 10 kg (in mL/kg/hr)?

Answer 19

4 mL/kg per hour

Question 20

What is the formula for maintenance fluids in children?

Answer 20

4 mL/kg/hr for first 10 kg
2 mL//kg/hr for next 10 kg
1 mL/kg/hr for each additional kg thereafter

Question 21

What must you differentiate between in a child with a narrow complex tachycardia?

Answer 21

SVT vs ST

Question 22

What is the second line treatment for SVT in children if adenosine is ineffective?

Answer 22

Shock

Question 23

What is the first and second dose of electricity for synchronized cardioversion in children?

Answer 23

1 j/kg, then 2 j/kg

Question 24

What are the four major signs of shock according to the PALS algorithm?

Answer 24

• AMS
• Tachycardia
• Hypotension
• Decreased perfusion
• Hypothermia

Question 25

What is the drug of choice for treating hypotension kids in septic shock with warm extremities? Cold?

Answer 25

``` Warm = norepi Cold = epi ```

Question 26

What two major procedural interventions are needed for kids with septic shock unresponsive to fluids?

Answer 26

Central line and art line

Question 27

What is the goal ScvO2 in treating septic shock in children?

Answer 27

Over 70%

Question 28

What is the treatment for kids in septic shock with ScvO2 less than 70% and cold extremities (hint: there are two options depending on situation)

Answer 28

If BP low, add norepi | If BP adequate, add milrinone or vasodilator therapy

Question 29

What is the treatment for a child in septic shock with an ScvO2 over 70%, but with continued poor perfusion and warm extremities despite norepi administration?

Answer 29

Give IVFs, Norepi, and additional vasopressors