EPALS 85 Updated Actual Exam
Question and Answer 2026/2027 |
Grade A+ Updated
• Paediatric airway differences -✓✓- airway proportionately narrower
- head larger so flexes on the neck and can cause partial obstruction
- small mouth but large tongue
- preferential nasal breather up to 6 months
- higher larynx (creates sharp angle)
• Paediatric breathing differences -✓✓- small resting lung volume so low o2
reserve
- relies on diaphragm more than muscles
• Paediatric circulation differences -✓✓Circulating vol newborn = 80 ml/ kg
Decreases to around 60-70ml/kg in adulthood
MAP more accurate than systolic BP
• Strider -✓✓upper airway narrowing or obstruction, loud-high pitched breath
sound
• Wheezing -✓✓A high-pitched, whistling breath sound that is most prominent on
expiration, and which suggests an obstruction or narrowing of the lower airways;
occurs in asthma and bronchiolitis.
• grunting -✓✓An "uh" sound heard during exhalation; reflects the child's attempt
to keep the alveoli open; a sign of increased work of breathing.
• 5 categories of shock -✓✓- Hypovolemic
- Cardiogenic
- Distributive
- Obstructive
- Dissociative
• distributive shock -✓✓Inadequate distribution of blood, flow insufficient for the
demand of the tissues. Eg - anaphylaxis, sepsis
, • Obstructive shock -✓✓Shock that occurs when there is a block to blood flow in
the heart or great vessels, causing an insufficient blood supply to the body's tissues.
Eg cardiac tamponade, tension pneumothorax
• Dissociative shock -✓✓Something that does not allow O2 to reach the cells. Eg:
CO posioning and anaemia
• Cardiac output -✓✓heart rate x stroke volume
• Central pulse points -✓✓Carotid, femoral and brachial
COMPARE THESE WITH PERIPHERAL (RADIAL)
• How much fluid can be lost before hypotension occurs -✓✓40%
• Inadequate renal perfusion -✓✓< 2ml/kg/hr in infants
< 1ml/kg/hr in children older than 1
• Max flow rate for nasal cannula -✓✓4L/min
• When to use a supraglottic airway device -✓✓If BMV unsuccessful and is an
alternative to intubation
Only to be used if child unconscious
• When to ventilate -✓✓Apnea: patient lacks power/muscle to breathe at all
Hypoventilation: patient moving inadequate volume, CO2 retention
Impending ventilatory failure: working so hard that hypoventilation/apnea is
inevitable
Infective BMV
Need for protection of airway from aspiration of gastric contents
• Choice of tracheal tube -✓✓Preterm neonates - 2.5-3mm uncuffed
Question and Answer 2026/2027 |
Grade A+ Updated
• Paediatric airway differences -✓✓- airway proportionately narrower
- head larger so flexes on the neck and can cause partial obstruction
- small mouth but large tongue
- preferential nasal breather up to 6 months
- higher larynx (creates sharp angle)
• Paediatric breathing differences -✓✓- small resting lung volume so low o2
reserve
- relies on diaphragm more than muscles
• Paediatric circulation differences -✓✓Circulating vol newborn = 80 ml/ kg
Decreases to around 60-70ml/kg in adulthood
MAP more accurate than systolic BP
• Strider -✓✓upper airway narrowing or obstruction, loud-high pitched breath
sound
• Wheezing -✓✓A high-pitched, whistling breath sound that is most prominent on
expiration, and which suggests an obstruction or narrowing of the lower airways;
occurs in asthma and bronchiolitis.
• grunting -✓✓An "uh" sound heard during exhalation; reflects the child's attempt
to keep the alveoli open; a sign of increased work of breathing.
• 5 categories of shock -✓✓- Hypovolemic
- Cardiogenic
- Distributive
- Obstructive
- Dissociative
• distributive shock -✓✓Inadequate distribution of blood, flow insufficient for the
demand of the tissues. Eg - anaphylaxis, sepsis
, • Obstructive shock -✓✓Shock that occurs when there is a block to blood flow in
the heart or great vessels, causing an insufficient blood supply to the body's tissues.
Eg cardiac tamponade, tension pneumothorax
• Dissociative shock -✓✓Something that does not allow O2 to reach the cells. Eg:
CO posioning and anaemia
• Cardiac output -✓✓heart rate x stroke volume
• Central pulse points -✓✓Carotid, femoral and brachial
COMPARE THESE WITH PERIPHERAL (RADIAL)
• How much fluid can be lost before hypotension occurs -✓✓40%
• Inadequate renal perfusion -✓✓< 2ml/kg/hr in infants
< 1ml/kg/hr in children older than 1
• Max flow rate for nasal cannula -✓✓4L/min
• When to use a supraglottic airway device -✓✓If BMV unsuccessful and is an
alternative to intubation
Only to be used if child unconscious
• When to ventilate -✓✓Apnea: patient lacks power/muscle to breathe at all
Hypoventilation: patient moving inadequate volume, CO2 retention
Impending ventilatory failure: working so hard that hypoventilation/apnea is
inevitable
Infective BMV
Need for protection of airway from aspiration of gastric contents
• Choice of tracheal tube -✓✓Preterm neonates - 2.5-3mm uncuffed
