PALS 2025 Heartcode Questions with Complete Solutions Rated A+

What is the priority in initially managing arrhythmias? - The initial management of both stable and unstable arrhythmias are identical to the treatment for any critically-ill child. Begin with the support of the airway, breathing, and circulation and treating the underlying cause of the arrhythmia. What are the causes of secondary bradycardia? - Hypoxia, hypotension, hypothermia, acidosis, drugs. What are the causes of primary bradycardia? - Congenital or acquired heart conditions. What are the ECG characteristics of bradycardia? - P wave and QRS may be unrelated. Heart rate slow for age. QRS may be narrow or wide. In what patients would asymptomatic bradycardia not be problematic? - A well-conditioned athlete. A healthy child who is sleeping. Define bradycardia. - A heart rate that is: - slow for normal range - activity - clinical condition What is the leading cause of symptomatic bradycardia? - Tissue hypoxia. What is the dose for epinephrine? - Epinephrine every 3-5 mins - 0.01 mg/kg IV - 0.1 mg/kg ETT In what conditions is atropine preferred over epinephrine as 1st choice treatment of symptomatic bradycardia? - When the bradycardia is due to: - excessive vagal tone - cholinergic drug toxicity, e.g. organophosphates - complete AV block (primary bradycardia) What is the dose for atropine? - Atropine 0.02 mg/kg IV What clinical findings may be present in a child with tachyarrhythmia? - Syncope, light-headedness, palpitations. If bradycardia persists after initial treatment, and HR 60 /min, what is the next step? - Begin CPR. Where can tachyarrhythmias originate? - In the atria or ventricles. What sinus tachycardia usually develop? - The body needs increased cardiac output. What are the characteristics of atrial flutter? - - Atrial rate 300 /min or higher - Venticular rate often slower - Can occur in congenital heart disease - A narrow-complex tachyarrhythmia What is the initial treatment of bradycardia with cardiopulmonary compromise? - Provide BVM ventilation, with 100% oxygen. How is tachycardia defined? - A heart rate that is fast for the child's age. What are characteristics of ventricular tachycardia? - The rapid rate may - deteriorate into pulseless VT or VFib - compromise ventricular filling It is a wide QRS generated within the ventricles