PALS MC Pediatric Respiratory Failure with Progression to Cardiac Arrest

Pediatric Respiratory Failure with Progression to Cardiac Arrest

A 3-year-old child presents in severe respiratory distress with nasal flaring, retractions, and grunting. The child is fatigued from labored breathing and is showing signs of hypoxia. Despite oxygen therapy, the child’s condition continues to deteriorate, with increasing bradypnea and cyanosis. Eventually, the child becomes apneic, and a pulse check reveals no signs of circulation. The child is now in cardiac arrest.

A 3-year-old presents with severe respiratory distress, including nasal flaring, retractions, and grunting. What is your initial priority?

Administer epinephrine 0.01 mg/kg IM.

Provide supplemental oxygen to maintain SpO2 >94%.

Perform endotracheal intubation.

Start bag-mask ventilation immediately.

The child’s respiratory distress worsens, and they now appear fatigued with bradypnea. What is the most appropriate next step?

Administer a fluid bolus of 20 mL/kg.

Start bag-mask ventilation (BVM).

Start high-flow nasal cannula oxygen.

Administer atropine 0.02 mg/kg.

The child is now apneic and cyanotic. You confirm no pulse. What is your next immediate step?

Provide unsynchronized defibrillation.

Start high-quality CPR.

Administer epinephrine 0.01 mg/kg IV.

Perform endotracheal intubation immediately.

What is the recommended chest compression-to-ventilation ratio for a single rescuer during CPR?

30:2

15:2

10:1

Continuous compressions with asynchronous breaths.

During CPR, the monitor shows ventricular fibrillation (VF). What is your next step?

Provide unsynchronized defibrillation at 2 J/kg.

Administer epinephrine 0.01 mg/kg IV.

Perform synchronized cardioversion.

Continue chest compressions without defibrillation.

What is the recommended dose for the first defibrillation attempt in children?

6 J/kg

2 J/kg

10 J/kg

4 J/kg

After defibrillation, the rhythm remains VF. What is the next step in management?

Administer amiodarone 5 mg/kg IV.

Switch to synchronized cardioversion.

Resume high-quality CPR and administer epinephrine 0.01 mg/kg IV.

Perform a second defibrillation immediately.

After two unsuccessful defibrillation attempts, what antiarrhythmic medication is indicated?

Administer atropine 0.02 mg/kg IV.

Administer magnesium sulfate 50 mg/kg IV.

Administer lidocaine 1 mg/kg IV.

Administer amiodarone 5 mg/kg IV.

The child achieves ROSC but remains unresponsive. What is the most important intervention post-ROSC?

Perform immediate defibrillation.

Administer another dose of amiodarone.

Administer a rapid fluid bolus of 20 mL/kg.

Initiate targeted temperature management (TTM).

Post-ROSC, the child develops persistent hypotension. What is the recommended first-line vasopressor?

Administer dopamine infusion.

Administer epinephrine infusion.

Administer norepinephrine infusion.

Administer vasopressin bolus.

Your score is

The average score is 0%

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