PALS - Written Test and Case Study Review Material with
complete solution
CPR Sequence
C-A-B
Circulation-Airway-Breathing
Core Case Action Order
(A,I,I)
Assess
Identify
Intervene
CBC
(Assessment part 1 aka initial assessment)
Consciousness
Breathing
Color
ABCDE
(Assessment part 2 aka primary assessment)
Airway
Breathing
Circulation
Disability
Exposure
SAMPLE
(Assessment part 3)
S/Sx
Allergies
Medications
Past medical hx
Last meal/drink
Events leading to situation
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
6 H's
(G,K,T,V,X,DRO)
1. Hypo-Glycemia
2. Hypo/hyper-Kalemia
3. Hypo-Thermia
4. Hypo-Volemia
5. Hypo-Xia
6. HyDROgen ion (acidosis)
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
5 T's
(A,E,HC,HP,O)
1. Tamponade, cardiac
2. Tension pneumothorax
, 3. Thrombosis, coronary
4. Thrombosis, pulmonary
5. Toxins
UAO: Presentation, Causes, TX
Stridor on inspiration, High pitched inspiration
(Anaphylaxis, Croup, Foreign Body)
Humid Oxygen, Neb Epi, Removal
Croup presentation Tx
O2
Racemic epinephrine (0.25mg/kg)
Humidified epi (0.5 ml/kg/3cc's NS
Core Case Resp 1: UAO (Anaphylaxis)
Open airway
Admin O2 100% non-rebreather, re-assess
AED, Vitals (cardiac rhythm = sinus tachy)
S/sx of UAO, resp distress
TX: Epi IM, Steroids, CPAP
Vascular access
Prepare for intubation
LAO: Presentation, Causes, TX
Wheezing on expiration
(Asthma, Bronchiolitis)
Neb Albuterol,
SQ Epi,
Mag Sulf,
Steroids
Core Case Resp 2: LAO (Bronchiolitis or Asthma)
Admin O2 100% non-rebreather after finishing neb tx, re-assess
AED, Vitals (cardiac rhythm = sinus tachy)
S/sx of LAO, resp distress
Suction nose
TX: Neb albuterol (2.5mg/3cc's NS), Non-invasive pos press vent (NIPPV), Steroids
Vascular access, labs, ABGs, chest X-ray
Prep for bag-mask vent, intubation
Lung Tissue Disease: Presentation, Causes, TX
Grunting, stiff lungs, increased breathing effort (I, E), tachypnea, crackles
(Pneumonia)
Antibiotics, Albuterol
Core Case Resp 3: Lung Tissue Disease (Pneumonia or Aspiration)
*Admin O2 100% non-rebreather after finishing neb tx, re-assess, titrate O2 to 94-99%
TX: Neb albuterol, antibiotics, Non-invasive vent (CPAP or NIPPV - PEEP)
Prep for bag-mask vent, intubation*
AED, Vitals (cardiac rhythm = sinus tachy)
S/sx of LTD, resp failure
Suction nasopharynx
Vascular access, labs, ABGs, chest x-ray
complete solution
CPR Sequence
C-A-B
Circulation-Airway-Breathing
Core Case Action Order
(A,I,I)
Assess
Identify
Intervene
CBC
(Assessment part 1 aka initial assessment)
Consciousness
Breathing
Color
ABCDE
(Assessment part 2 aka primary assessment)
Airway
Breathing
Circulation
Disability
Exposure
SAMPLE
(Assessment part 3)
S/Sx
Allergies
Medications
Past medical hx
Last meal/drink
Events leading to situation
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
6 H's
(G,K,T,V,X,DRO)
1. Hypo-Glycemia
2. Hypo/hyper-Kalemia
3. Hypo-Thermia
4. Hypo-Volemia
5. Hypo-Xia
6. HyDROgen ion (acidosis)
Reversible Causes of Pediatric Cardiac Arrest (H&T's)
5 T's
(A,E,HC,HP,O)
1. Tamponade, cardiac
2. Tension pneumothorax
, 3. Thrombosis, coronary
4. Thrombosis, pulmonary
5. Toxins
UAO: Presentation, Causes, TX
Stridor on inspiration, High pitched inspiration
(Anaphylaxis, Croup, Foreign Body)
Humid Oxygen, Neb Epi, Removal
Croup presentation Tx
O2
Racemic epinephrine (0.25mg/kg)
Humidified epi (0.5 ml/kg/3cc's NS
Core Case Resp 1: UAO (Anaphylaxis)
Open airway
Admin O2 100% non-rebreather, re-assess
AED, Vitals (cardiac rhythm = sinus tachy)
S/sx of UAO, resp distress
TX: Epi IM, Steroids, CPAP
Vascular access
Prepare for intubation
LAO: Presentation, Causes, TX
Wheezing on expiration
(Asthma, Bronchiolitis)
Neb Albuterol,
SQ Epi,
Mag Sulf,
Steroids
Core Case Resp 2: LAO (Bronchiolitis or Asthma)
Admin O2 100% non-rebreather after finishing neb tx, re-assess
AED, Vitals (cardiac rhythm = sinus tachy)
S/sx of LAO, resp distress
Suction nose
TX: Neb albuterol (2.5mg/3cc's NS), Non-invasive pos press vent (NIPPV), Steroids
Vascular access, labs, ABGs, chest X-ray
Prep for bag-mask vent, intubation
Lung Tissue Disease: Presentation, Causes, TX
Grunting, stiff lungs, increased breathing effort (I, E), tachypnea, crackles
(Pneumonia)
Antibiotics, Albuterol
Core Case Resp 3: Lung Tissue Disease (Pneumonia or Aspiration)
*Admin O2 100% non-rebreather after finishing neb tx, re-assess, titrate O2 to 94-99%
TX: Neb albuterol, antibiotics, Non-invasive vent (CPAP or NIPPV - PEEP)
Prep for bag-mask vent, intubation*
AED, Vitals (cardiac rhythm = sinus tachy)
S/sx of LTD, resp failure
Suction nasopharynx
Vascular access, labs, ABGs, chest x-ray
