PALS Pediatric Tachycardia with Poor Perfusion

Pediatric Tachycardia with Poor Perfusion

A 7-year-old child presents to the emergency department with a heart rate of 210 bpm, narrow QRS complexes, and poor perfusion. The child is pale, diaphoretic, and lethargic, with a weak pulse and delayed capillary refill. The child is experiencing signs of hypotension and poor perfusion, indicating the need for urgent intervention.

What tachycardia presents with a narrow QRS and rapid rate in children?

A 7-year-old presents with a heart rate of 210 bpm, narrow QRS complexes, and poor perfusion. What is the most likely diagnosis?

Ventricular tachycardia.

Atrial fibrillation.

Sinus tachycardia.

Supraventricular tachycardia (SVT).

What non-invasive technique is often effective in stable SVT?

The child is diagnosed with SVT and is stable. What is the first-line treatment?

Start epinephrine infusion.

Provide synchronized cardioversion.

Attempt vagal maneuvers.

Administer adenosine 0.1 mg/kg IV.

What is the medication of choice for stable SVT unresponsive to vagal maneuvers?

Vagal maneuvers are unsuccessful. What is the next step in treating this child with stable SVT?

Administer atropine 0.02 mg/kg IV.

Provide synchronized cardioversion.

Administer amiodarone 5 mg/kg IV.

Administer adenosine 0.1 mg/kg IV.

What intervention terminates SVT quickly in unstable patients?

The child becomes unstable with altered mental status and weak pulses. What is the immediate next step?

Administer another dose of adenosine.

Perform synchronized cardioversion.

Start a norepinephrine infusion.

Provide unsynchronized defibrillation.

What energy dose is used to safely cardiovert a child?

What energy dose is recommended for synchronized cardioversion in children?

1-2 J/kg, no escalation.

0.5-1 J/kg, increase to 2 J/kg if needed.

4 J/kg.

10 J/kg.

What medication is used for stable wide-complex tachycardia?

A 9-year-old presents with a wide-complex tachycardia and is stable. What is the most appropriate initial treatment?

Administer adenosine 0.1 mg/kg IV.

Provide synchronized cardioversion.

Start epinephrine infusion.

Administer amiodarone 5 mg/kg IV over 20-60 minutes.

What is the treatment of choice for unstable tachycardia?

The child’s wide-complex tachycardia becomes unstable with signs of poor perfusion. What is the next immediate step?

Start chest compressions.

Administer amiodarone.

Perform synchronized cardioversion.

Perform unsynchronized defibrillation.

What rhythm is commonly caused by dehydration and resolves with treatment of the underlying condition?

A 6-year-old with tachycardia has a heart rate of 180 bpm and signs of dehydration. What is the most likely rhythm?

Ventricular tachycardia.

Atrial fibrillation.

Sinus tachycardia.

Supraventricular tachycardia (SVT).

What is the standard bolus volume for pediatric fluid resuscitation?

What is the recommended fluid bolus for a child with sinus tachycardia due to dehydration?

20 mL/kg of dextrose 5% in water (D5W).

10 mL/kg of isotonic crystalloid.

30 mL/kg of isotonic crystalloid.

20 mL/kg of isotonic crystalloid.

What ensures the tachycardia does not recur?

After treatment, the child’s rhythm resolves, and they stabilize. What is an important step in preventing recurrence?

Administer maintenance fluids only.

Treat the underlying cause, such as dehydration.

Prescribe long-term antiarrhythmic medication.

Perform a 24-hour Holter monitor test.

Your score is

The average score is 0%

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