Graded A+) (2024 Update)
Which topics are included in the PALS course ? - ANSWER- 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 -
ANSWER- 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? - ANSWER- 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? - ANSWER- 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? -
ANSWER- 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? - ANSWER- 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? - ANSWER- 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: - ANSWER- (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 - ANSWER- The main focus of initial management is
to support airway, breathing, and circulation
How can the clinician support the airway? - ANSWER- (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? - ANSWER- 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