PALS CERTIFICATION COURSE
QUESTIONS AND ANSWERS GRADED
A+
j Which topics are included in the PALS course ? - PALS includes the following:
(1) Overview of assessment
(2) Recognition and management of respiratory distress and failure
(3) Recognition and management of shock
(4) Recognition and management of cardiac arrhythmias
(5) Recognition and management of cardiac arrest
(6) Postresuscitation management of patients with pulmonary and cardiac arrest
(7) Review of pharmacology
What should be the primary focus of the clinician on prevention of cardiopulmonary failure - The
clinician should primarily focus on prevention of cardiopulmonary failure through early recognition and
management of respiratory distress, respiratory failure, and shock that can lead to cardiac arrest from
hypoxia, acidosis, and ischemia.
What is the main cause of cardiac arrests in children? - In infants and children, most cardiac arrests result
from progressive respiratory failure and/or shock, thus one of the aims of PALS rapid assessment model
is to prevent progression to cardiac arrest.
What is the pediatric assessment triangle? - Brief visual and auditory observation of child's overall (1)
appearance, (2) work of breathing, (3) circulation
What are the components of the primary assessment? What signs should the clinician look for? - The
clinician should in rapid sequence assess:
(1) Airway (patent, patent with maneuvers/adjuncts, partially or completely obstructed)
(2) Breathing (respiratory rate, effort, tidal volume, lung sounds, pulse oximetry)
(3) Circulation (skin color and temperature, heart rate and rhythm, blood pressure, peripheral and
central pulses, capillary refill time)
(4) Disability: (a)AVPU pediatric response scale: Alert, Voice, Pain, Unresponsive; (b) Pupillary response
to light
(c) Presence of hypoglycemia (rapid bedside glucose or response to empiric administration of dextrose)
(d) Glasgow Coma Scale
, What are the components of the secondary assessment? For what should the clinician look for during
the secondary assessment? - This portion of the evaluation includes a thorough head to toe physical
examination, as well as a focused medical history that consists of the "SAMPLE" history:
(S) Signs and Symptoms
(A) Allergies
(M) Medications
(P) Past medical history
(L) Last meal
(E) Events leading to current illness
What are the components of the tertiary assessment? - Injury and infection are common causes of life-
threatening illness in children. Thus, for this stage, ancillary studies are frequently directed towards
identifying the extent of trauma or an infectious focus.
There are many causes of acute respiratory compromise in children. The clinician should strive to
categorize respiratory distress or failure into one or more of the following: - (1) Upper airway obstruction
(eg, croup, epiglottitis)
(2) Lower airway obstruction (eg, bronchiolitis, status asthmaticus)
(3) Lung tissue (parenchymal) disease (eg, bronchopneumonia)
(4) Disordered control of breathing (eg, seizure, coma, muscle weakness)
What is the focus of initial management - The main focus of initial management is to support airway,
breathing, and circulation
How can the clinician support the airway? - (1) Provide 100 percent inspired oxygen
(2) Allow child to assume position of comfort or manually open airway
(3) Clear airway (suction)
(4) Insert an airway adjunct if consciousness is impaired (eg, nasopharyngeal airway or, if gag reflex
absent, oropharyngeal airway)
How can the clinician support breathing? - For supporting breathing, the clinician should:
(1) Assist ventilation manually in patients not responding to basic airway maneuvers or with inadequate
or ineffective respiratory effort
(2) Monitor oxygenation by pulse oximetry
(3) Monitor ventilation by end-tidal carbon dioxide (EtCO2) if available
(4) Administer medications as needed (eg, albuterol, epinephrine)
QUESTIONS AND ANSWERS GRADED
A+
j Which topics are included in the PALS course ? - PALS includes the following:
(1) Overview of assessment
(2) Recognition and management of respiratory distress and failure
(3) Recognition and management of shock
(4) Recognition and management of cardiac arrhythmias
(5) Recognition and management of cardiac arrest
(6) Postresuscitation management of patients with pulmonary and cardiac arrest
(7) Review of pharmacology
What should be the primary focus of the clinician on prevention of cardiopulmonary failure - The
clinician should primarily focus on prevention of cardiopulmonary failure through early recognition and
management of respiratory distress, respiratory failure, and shock that can lead to cardiac arrest from
hypoxia, acidosis, and ischemia.
What is the main cause of cardiac arrests in children? - In infants and children, most cardiac arrests result
from progressive respiratory failure and/or shock, thus one of the aims of PALS rapid assessment model
is to prevent progression to cardiac arrest.
What is the pediatric assessment triangle? - Brief visual and auditory observation of child's overall (1)
appearance, (2) work of breathing, (3) circulation
What are the components of the primary assessment? What signs should the clinician look for? - The
clinician should in rapid sequence assess:
(1) Airway (patent, patent with maneuvers/adjuncts, partially or completely obstructed)
(2) Breathing (respiratory rate, effort, tidal volume, lung sounds, pulse oximetry)
(3) Circulation (skin color and temperature, heart rate and rhythm, blood pressure, peripheral and
central pulses, capillary refill time)
(4) Disability: (a)AVPU pediatric response scale: Alert, Voice, Pain, Unresponsive; (b) Pupillary response
to light
(c) Presence of hypoglycemia (rapid bedside glucose or response to empiric administration of dextrose)
(d) Glasgow Coma Scale
, What are the components of the secondary assessment? For what should the clinician look for during
the secondary assessment? - This portion of the evaluation includes a thorough head to toe physical
examination, as well as a focused medical history that consists of the "SAMPLE" history:
(S) Signs and Symptoms
(A) Allergies
(M) Medications
(P) Past medical history
(L) Last meal
(E) Events leading to current illness
What are the components of the tertiary assessment? - Injury and infection are common causes of life-
threatening illness in children. Thus, for this stage, ancillary studies are frequently directed towards
identifying the extent of trauma or an infectious focus.
There are many causes of acute respiratory compromise in children. The clinician should strive to
categorize respiratory distress or failure into one or more of the following: - (1) Upper airway obstruction
(eg, croup, epiglottitis)
(2) Lower airway obstruction (eg, bronchiolitis, status asthmaticus)
(3) Lung tissue (parenchymal) disease (eg, bronchopneumonia)
(4) Disordered control of breathing (eg, seizure, coma, muscle weakness)
What is the focus of initial management - The main focus of initial management is to support airway,
breathing, and circulation
How can the clinician support the airway? - (1) Provide 100 percent inspired oxygen
(2) Allow child to assume position of comfort or manually open airway
(3) Clear airway (suction)
(4) Insert an airway adjunct if consciousness is impaired (eg, nasopharyngeal airway or, if gag reflex
absent, oropharyngeal airway)
How can the clinician support breathing? - For supporting breathing, the clinician should:
(1) Assist ventilation manually in patients not responding to basic airway maneuvers or with inadequate
or ineffective respiratory effort
(2) Monitor oxygenation by pulse oximetry
(3) Monitor ventilation by end-tidal carbon dioxide (EtCO2) if available
(4) Administer medications as needed (eg, albuterol, epinephrine)
