EPALS ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ What is the most common cause of death in neonates.
Answer: Congenital anomalies
◍ Trauma injury; Catastrophic external haemorrhage.
Answer: Perform rapid assessment to satisfy there is no hidden external
haemorrhage If identified, the area of bleeding should have direct pressure
appliedCatastrophically haemorrhage from a limb is managed with a
tourniquet being applied to a long bone above the injury
◍ Nasal cannulae.
Answer: Not suitable in children with copious nasal secretionsFlow rates to
be kept below 4L min as higher flows are irritating to the nasal passages and
do not increase oxygen delivery
◍ Indications for tracheal intubation.
Answer: - Ineffective BMV- Severe anatomical or functional upper airway
obstruction- To protect airway from aspiration of gastric contents- If high
pressures are required to maintain adequate oxygenation (eg. asthma)-
Mechanical ventilation is required- Need for bronchial or tracheal
suctioning- Instability or high probability of one of the above occurring
before or during transport
◍ Side effects of Ketamine.
Answer: Hallucinations (which can be ameliorated by benzodiazepine
administration) and hypersalivation.
◍ Paediatric circulation differences.
Answer: Circulating vol newborn = 80 ml/ kg Decreases to around
, 60-70ml/kg in adulthood MAP more accurate than systolic BP
◍ What medication to give to manage an acute presentation of cardiac
conditions.
Answer: Prostaglandin
◍ IO.
Answer: Dostęp doszpikowy
◍ Benefits of HFNC.
Answer: Increases functional residual capacityImproves mucocilliary
clearanceDelivers PEEP in hypoxic children
◍ Obstructive shock.
Answer: Circulatory failure due to obstruction of blood flow - tension
pnuemo, tamponade, constrictive pericarditis
◍ Indications for adrenaline.
Answer: Cardio respiratory arrest Brady < 60/ min with inadequate
perfusion not improving First line inotrope in fluid resistant septic shock
Anaphylaxis
◍ RR for 5 year old.
Answer: 17-30
◍ PaCO2 aim.
Answer: 4.5-6 kPa
◍ intubation technique.
Answer: Prior to intubation, the patient should be pre-oxygenated with
100% oxygen via BMV
◍ Shockable rhythms.
Answer: Ventricular Fibirlation (VF) and Pulseless Ventricular tachycardia
(PVT) 1 shock (4J/KG) CPR 2 mins. After 3 shocks give amiodarone +
adrenaline
◍ What is Hyponatremia?.
Answer: deficient sodium in the blood. <135 mmol. seizures can occur
QUESTIONS WITH ANSWERS GRADED
A+
◍ What is the most common cause of death in neonates.
Answer: Congenital anomalies
◍ Trauma injury; Catastrophic external haemorrhage.
Answer: Perform rapid assessment to satisfy there is no hidden external
haemorrhage If identified, the area of bleeding should have direct pressure
appliedCatastrophically haemorrhage from a limb is managed with a
tourniquet being applied to a long bone above the injury
◍ Nasal cannulae.
Answer: Not suitable in children with copious nasal secretionsFlow rates to
be kept below 4L min as higher flows are irritating to the nasal passages and
do not increase oxygen delivery
◍ Indications for tracheal intubation.
Answer: - Ineffective BMV- Severe anatomical or functional upper airway
obstruction- To protect airway from aspiration of gastric contents- If high
pressures are required to maintain adequate oxygenation (eg. asthma)-
Mechanical ventilation is required- Need for bronchial or tracheal
suctioning- Instability or high probability of one of the above occurring
before or during transport
◍ Side effects of Ketamine.
Answer: Hallucinations (which can be ameliorated by benzodiazepine
administration) and hypersalivation.
◍ Paediatric circulation differences.
Answer: Circulating vol newborn = 80 ml/ kg Decreases to around
, 60-70ml/kg in adulthood MAP more accurate than systolic BP
◍ What medication to give to manage an acute presentation of cardiac
conditions.
Answer: Prostaglandin
◍ IO.
Answer: Dostęp doszpikowy
◍ Benefits of HFNC.
Answer: Increases functional residual capacityImproves mucocilliary
clearanceDelivers PEEP in hypoxic children
◍ Obstructive shock.
Answer: Circulatory failure due to obstruction of blood flow - tension
pnuemo, tamponade, constrictive pericarditis
◍ Indications for adrenaline.
Answer: Cardio respiratory arrest Brady < 60/ min with inadequate
perfusion not improving First line inotrope in fluid resistant septic shock
Anaphylaxis
◍ RR for 5 year old.
Answer: 17-30
◍ PaCO2 aim.
Answer: 4.5-6 kPa
◍ intubation technique.
Answer: Prior to intubation, the patient should be pre-oxygenated with
100% oxygen via BMV
◍ Shockable rhythms.
Answer: Ventricular Fibirlation (VF) and Pulseless Ventricular tachycardia
(PVT) 1 shock (4J/KG) CPR 2 mins. After 3 shocks give amiodarone +
adrenaline
◍ What is Hyponatremia?.
Answer: deficient sodium in the blood. <135 mmol. seizures can occur
