AHA PEDIATRIC ADVANCED LIFE SUPPORT EXAM 2024 ACTUAL
EXAM TEST BANK
Why is survival rate of pediatric arrest in hospitals so much better than outside of
them - ANSWER: In the hospital they have patient history and can give better care vs.
out of hospital where there is a lot of guessing and a slower response
Why is gaining airway access in peds harder than adults? How do they consume
oxygen in comparison to adults? - ANSWER: Larger tongue compared to rest of
mouth,
angled vocal cords,
Narrow and compliant sublottic airway that is easily obstructed and provides more
resistance
limited O2 reserve.
Kids consume oxygen faster and cannot compensate due to a fixed tidal volume -
they run out of O2 faster
What is a problem when dosing meds in PALS - ANSWER: Weight is required to dose
the fluids and meds and often times this weight is unknown
What are our options to determine peds dosing weights - ANSWER: appearance
(inaccurate), percentile/growth chart (impractical), length (easy)
How is ped weight determined based on length in PALS - ANSWER: Broselow tape is
stretched and depending on where feet are you estimate the weight
Why is placing IV catheters more difficult in peds - ANSWER: small vein diameter,
subcutaneous baby fat, anxiety (fighting off professional)
What are some additional challenges in peds emergencies - ANSWER: critically ill
(hypotension, vasoconstriction), untrained staff, lack peds size catheter, less sites for
access
what IV access sites should be avoided in peds - ANSWER: those that interrupt
compressions/ventilation
How long do we try to get IV access in PALS - ANSWER: 90 seconds or 3 attempts
what is the second route of admin for PALS? What is special about this route? -
ANSWER: Intraosseous in promixal tibia or distal femur then use to give fluids, drugs
and blood and follow with saline flush to get drug into circulation
, What is the last option for Route of admin in PALS - ANSWER: endotracheal
What meds are given endotracheal in peds - ANSWER: LEAN: lidocaine, E, atropine,
naloxone
How should the endotracheal meds be dosed in PALS, particularly E? - ANSWER: 2-
2.5x recommended, except E is 0.1mg/kg
How do we dilute endotracheal meds in PALS - ANSWER: dilute in >/= 5 mL NS
followed by 5 manual ventilations
How are peds HR compared to adults - ANSWER: higher - usually sit around 100-150
depending on age (younger is higher)
Is BP higher or lower in peds? What is considered hypotension? - ANSWER: lower -
hypotension is typically <70
Why is family presence a pain in peds - ANSWER: They can be present for PALS
because its believed to improve outcomes, but it can be disruptive
What is the usual cause of cardiac arrest in peds - ANSWER: usually result of
progressive respiratory failure or shock (asphyxial arrest)
Why is respiratory distress more common in peds? What is the oxygen demand in
infants? - ANSWER: They have a higher metabolic rate so their O2 demand/kg is
higher. in infants its 6-8ml/kg/min vs. 4 in adults so hypoxemia and hypoxia can
develop more rapidly and clinical deterioration may progress rapidly
Why do we care so much about identifying respiratory distress in peds? - ANSWER:
early recognition and intervention in respiratory distress prevents progression and
improves outcomes
How is respiratory failure characterized - ANSWER: inadequate ventilation,
oxygenation or both
what signs help us anticipate respiratory failure - ANSWER: increased RR, signs of
distress (increased WOB, retractions, grunting)
inadequate RR, effort, or chest excursions, AMS
Cyanosis with abnormal breathing despite supp o2
what is the primary goal in respiratory distress management - ANSWER:
support/restore adequate oxygenation and ventilation
A (clear, prepare to intube) B (ventilation, bagging, o2, pulse ox, intubate) C (HR,
rhythm, get IV access)
EXAM TEST BANK
Why is survival rate of pediatric arrest in hospitals so much better than outside of
them - ANSWER: In the hospital they have patient history and can give better care vs.
out of hospital where there is a lot of guessing and a slower response
Why is gaining airway access in peds harder than adults? How do they consume
oxygen in comparison to adults? - ANSWER: Larger tongue compared to rest of
mouth,
angled vocal cords,
Narrow and compliant sublottic airway that is easily obstructed and provides more
resistance
limited O2 reserve.
Kids consume oxygen faster and cannot compensate due to a fixed tidal volume -
they run out of O2 faster
What is a problem when dosing meds in PALS - ANSWER: Weight is required to dose
the fluids and meds and often times this weight is unknown
What are our options to determine peds dosing weights - ANSWER: appearance
(inaccurate), percentile/growth chart (impractical), length (easy)
How is ped weight determined based on length in PALS - ANSWER: Broselow tape is
stretched and depending on where feet are you estimate the weight
Why is placing IV catheters more difficult in peds - ANSWER: small vein diameter,
subcutaneous baby fat, anxiety (fighting off professional)
What are some additional challenges in peds emergencies - ANSWER: critically ill
(hypotension, vasoconstriction), untrained staff, lack peds size catheter, less sites for
access
what IV access sites should be avoided in peds - ANSWER: those that interrupt
compressions/ventilation
How long do we try to get IV access in PALS - ANSWER: 90 seconds or 3 attempts
what is the second route of admin for PALS? What is special about this route? -
ANSWER: Intraosseous in promixal tibia or distal femur then use to give fluids, drugs
and blood and follow with saline flush to get drug into circulation
, What is the last option for Route of admin in PALS - ANSWER: endotracheal
What meds are given endotracheal in peds - ANSWER: LEAN: lidocaine, E, atropine,
naloxone
How should the endotracheal meds be dosed in PALS, particularly E? - ANSWER: 2-
2.5x recommended, except E is 0.1mg/kg
How do we dilute endotracheal meds in PALS - ANSWER: dilute in >/= 5 mL NS
followed by 5 manual ventilations
How are peds HR compared to adults - ANSWER: higher - usually sit around 100-150
depending on age (younger is higher)
Is BP higher or lower in peds? What is considered hypotension? - ANSWER: lower -
hypotension is typically <70
Why is family presence a pain in peds - ANSWER: They can be present for PALS
because its believed to improve outcomes, but it can be disruptive
What is the usual cause of cardiac arrest in peds - ANSWER: usually result of
progressive respiratory failure or shock (asphyxial arrest)
Why is respiratory distress more common in peds? What is the oxygen demand in
infants? - ANSWER: They have a higher metabolic rate so their O2 demand/kg is
higher. in infants its 6-8ml/kg/min vs. 4 in adults so hypoxemia and hypoxia can
develop more rapidly and clinical deterioration may progress rapidly
Why do we care so much about identifying respiratory distress in peds? - ANSWER:
early recognition and intervention in respiratory distress prevents progression and
improves outcomes
How is respiratory failure characterized - ANSWER: inadequate ventilation,
oxygenation or both
what signs help us anticipate respiratory failure - ANSWER: increased RR, signs of
distress (increased WOB, retractions, grunting)
inadequate RR, effort, or chest excursions, AMS
Cyanosis with abnormal breathing despite supp o2
what is the primary goal in respiratory distress management - ANSWER:
support/restore adequate oxygenation and ventilation
A (clear, prepare to intube) B (ventilation, bagging, o2, pulse ox, intubate) C (HR,
rhythm, get IV access)
