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Pals Heartcode 2025
Where can you check a pulse on an infant and child?
- ANS>infant - brachial child - femoral What are signs of increased respiratory effort that can lead to fatigue and respiratory failure? Select all that apply nasal flaring unlabored breathing apnea seesaw respirations retractions head bobbing - ANS>nasal flaring seesaw respirations retractions head bobbing Determine the respiratory rate by counting the number of times the chest rises in _____ seconds and multiplying by _____. - ANS> 2
Tachypnea is often the first sign of respiratory ______ in infants - ANS>distress Hypotension fro children 1 to 10 years of age is a systolic blood pressure of less than 40mmHg + 2 x age in years 50mmHg + 2 x age in years 60mmHg + 2 x age in years 70mmHg + 2 x age in years - ANS>70mmHg + 2 x age in years What sequence is used when care for a seriously ill or injured child to help determine the best treatment or intervention? The __________ ___________ ____________ sequence - ANS>Evaluate Identify Intervene Automated blood pressure cuffs may provide _________ ________ readings when the child is in shock. - ANS>inaccurately high The primary assessment included the ABCDE approach. What does it assess? - ANS>Airway, breathing, circulation, disability, exposure
What is the preferred technique for infant compressions when there are 2 or more rescuers present? - ANS>2 thumb-encircling hands technique If pupils to not _________ in response to light consider increased _____________ pressure - ANS>Constrict intracranial pressure If ________ is not identified and treated immediately, it can result in ________ injury - ANS>hypoglycemia brain What are the 4 indicators of the AVPU scale that are used to determine responsiveness? - ANS>Alert Responds to pain Unresponsive Responds to voice If the child does not respond to voice, assess the child's response to ______ - ANS>pain What should you look for when exposing the child? - ANS>Bruising purpura bleeding
What does the mnemonic SAMPLE stand for? - ANS>Signs & symptoms allergies medications PMH last meal events leading to illness/injury What should be included in the history when asking about medications?
- ANS>OTC medications current prescribed medications Which component of SAMPLE assesses immunization status? - ANS>PMH What are some examples of diagnostic assessments? - ANS>ABG VBG Hemoglobin Concentration
How can the CPR coach improve CPR quality in a resuscitation event? - ANS>coach to midrange targets Which high performance team member has the responsibility for assigning roles (positions)? - ANS>team leader What element of team dynamics describes when a team member needs to correct actions? - ANS>constructive intervention Which of the following describe how to communicate? - ANS>closedloop communications clear messaging Which resuscitation strategy will result in an improved chest compression fraction? - ANS>hovering over the chest during compression pauses What is one way to increase chest compression fraction during a code? - ANS>Charging the defibrillator 15 seconds before a rhythm check A chest compression fraction of at least ____ is recommended, and a goal of ____ is often achievable with good teamwork - ANS>60% 80%
What is chest compression fraction? - ANS>proportion of time that compressions are performed For an unwitnessed cardiac arrest, what should you do after determining unresponsiveness and there is no breathing or pulse? - ANS>perform high-quality CPR for 2 mins What is the definition of oxygen saturation? - ANS>the amount of oxygen bound to hemoglobin Children develop hypoxemia and tissue hypoxia more quickly than adults because of their? - ANS>higher metabolic rate In infants and toddlers, the young and epiglottis, relative to those of an adult are ________ - ANS>large How can normal spontaneous breathing be characterized? - ANS>quiet unlabored inspiration Increased WOB can be associated with ________ airway resistance and/or ________ lung compliance. - ANS>increased decreased
why may excessive ventilation during CPR be harmful? - ANS>- it increases intrathoracic pressure
- it impedes venous return What should you do if you cannot achieve effective ventilation with a bag-mask device? - ANS>reposition the airway verify the mask size How are effective oxygenation and ventilation assessed?
- ANS>oxygen saturation visible chest rise exhaled carbon dioxide How can gastric inflation impair bag mask ventilation? - ANS>It decreases lung compliance What is the most appropriate precautionary action to minimize gastric inflation during bag-mask ventilation? - ANS>Deliver each breath over 1 second Hypoxemia is defined as oxygen saturation less than _____ - ANS>94% Which is true about the difference between hypoxemia and tissue hypoxia? - ANS>Tissue hypoxia can occur with normal arterial spo
What does hyperventilation, which refers to increase alveolar ventilation result in - ANS>PaCO2 <35mmHg What happens to the arterial oxygen level in a child with severe anemia? - ANS>may increase when dissolved oxygen is increased Which is true of increased CO2 tension in the arterial blood? - ANS>it may be caused by disordered control of breathing What happens when ventilation is inadequate? - ANS>CO2 levels rise and pH falls What is a critical sign of hypercarbia? - ANS>Decreased level of consciousness What can indicate mild respiratory distress? - ANS>What can indicate mild respiratory distress? Which of the following indicates severe respiratory distress? - ANS>marked tachypnea and/or apnea
Which of the following is required to appropriately ventilate a child with a flow-inflating bag? - ANS>tidal volume needs to be delivered at the correct rate. What should be checked to ensure proper function of a bag mask system? - ANS>Oxygen Tubing is connected to the device and oxygen source Pop off valve can be closed How is the sniffing position achieved in an infant or a child? - ANS>Ensure the external ear canal is anterior to the shoulder Where may padding be needed under a child 2 years and older to maintain an patent airway? - ANS>the occiput What actions are appropriate when providing 1 person bag mask ventilation? - ANS>Perform a head tilt, insert and oral airway, and squeeze the bag until chest rise What does the E-C clamp technique include? - ANS>using the third, fourth & fifth fingers of one hand along the jaw to lift it forward using the thumb and index finger of the same hand to hold the face mask
When may a 2-person bag-max technique be preferable?
- ANS>when making a seal is difficult when there is significant airway resistance When suctioning a patient, which of the following should be monitored? - ANS>HR O saturation clinical appearance What should you do to help reduce the risk of hypoxemia during suctioning? - ANS>limit suction attempts to 10 seconds or less Under what circumstance should you use an oropharyngeal airway? - ANS>the child must me unconscious What can happen if the oropharyngeal airway is too large? - ANS>it can block the airway When measuring for an oropharyngeal airway, it should extend from the corner of the mouth to the angle of the - ANS>jaw
What are the signs of upper airway obstruction? - ANS>stridor use of accessory muscles A child presents with a barking cough, good air entry during auscultation, a pulse oximetry reading 93% on room air and retractions at rest. What are appropriate initial interventions? - ANS>consider dexamethasone administer O2 & nebulized epinepherine Which diagnosis may present with upper airway obstruction? - ANS>foreign body obstruction epiglottitis croup When may pulse oximetry be inaccurate? - ANS>the displayed heart rate does not correlate with the child's heart rate An 8 month old boy is brought to the hospital by his parents. He has a hoarse cry and barking cough. His mother says that during the night, her son had difficulty breathing, which has progressively worsened throughout the day.
The infant most likely has what type of respiratory emergency? - ANS>upper airway obstruction According to the systematic approach algorithm, what are the correct assessments to perform during the evaluation phase? - ANS>initial, primary, secondary The infant is responsive and is breathing. What is an initial measure that you can perform to maintain his airway? - ANS>Sit him up What are the components of breathing assessment? - ANS>lung and airway sounds chest expansion and air movement oxygen saturation respiratory rate respiratory effort When calculating the tube size based on the child's age, to avoid injury to the subglottic area, you should use an endotracheal tube that is: - ANS>half a size smaller than predicted for the child Which anatomical features may contribute to upper airway obstruction in infants? - ANS>large tongue large occiput
Which of the following are typical signs of lung tissue disease? - ANS>tachypnea & hypoxemia Which of the following is characterized by fluid accumulation in the alveoli and or insterstitium? - ANS>lung tissue disease Which interventions are helpful in the management of acute infectious pneumonia? - ANS>ABX therapy perform diagnostic assessments What is the first priority in managing lower airway obstruction? - ANS>restore adequate oxygenation What pulses should be assessed to monitor systemic perfusion in a child? - ANS>Peripheral and central Which of the following signs of disordered control of breathing? - ANS>variable RR decreased air movement shallow breathing What condition is characterized by signs of adequate carbon dioxide elimination and hypoxemia - ANS>lung tissue disease
Which of the following are most commonly associated with disordered control of breathing? - ANS>neuro disorders drug overdose What intervention can reduce metabolic demand in a child with pneumonia? - ANS>treat the fever What are the characteristics of shock? - ANS>decreased level of consciousness inadequate peripheral perfusion decreased end-organ perfusion Which type of respiratory problem is most likely in a child with an altered level of consciousness and variable respiratory rate? - ANS>disordered control of breathing What is the most accurate definition of shock? - ANS>inadequate tissue perfusion What should you do before suctioning a child who has upper airway obstruction? - ANS>determine the underlying cause of the obstruction
