PALS MC Pediatric Bradycardia Leading to Cardiac Arrest

Pediatric Bradycardia Leading to Cardiac Arrest

A 6-month-old infant presents with profound lethargy and a heart rate of 50 bpm. The infant has weak central pulses and cyanosis around the lips and extremities. Their skin is cool and mottled, with signs of poor perfusion. The infant is hypotensive, and despite attempts to stimulate them, their condition rapidly deteriorates into cardiac arrest, necessitating immediate resuscitation efforts, including chest compressions and the administration of epinephrine.

Consider what typically causes bradycardia in infants and how to address it.

A 6-month-old presents with lethargy, a heart rate of 50 bpm, and poor perfusion. What is your first action?

Perform endotracheal intubation.

Provide bag-mask ventilation with 100% oxygen.

Begin chest compressions immediately.

Administer atropine 0.02 mg/kg IV/IO.

What action is taken for bradycardia unresponsive to initial interventions?

After 30 seconds of effective ventilation, the heart rate remains below 60 bpm. What is your next step?

Administer epinephrine 0.01 mg/kg IV/IO.

Continue bag-mask ventilation for another minute.

Begin chest compressions.

Place the child on a cardiac monitor.

Consider the ratio for 2-rescuer CPR without an advanced airway.

You start CPR. What is the appropriate compression-to-ventilation ratio without an advanced airway in place?

3:1

15:2

30:2

10:1

What is the first-line drug for pediatric bradycardia?

The child remains bradycardic despite chest compressions and ventilation. What is your next action?

Administer epinephrine 0.01 mg/kg IV/IO.

Increase oxygen concentration.

Administer atropine 0.02 mg/kg IV/IO.

Intubate the child immediately.

Consider the role of vagal tone in pediatric bradycardia.

After administering epinephrine, the heart rate improves but perfusion remains poor. What additional intervention should you consider?

Administer atropine 0.02 mg/kg IV/IO.

Initiate a dopamine infusion.

Administer a 20 mL/kg fluid bolus.

Perform synchronized cardioversion.

What interventions are recommended for asystole in pediatric patients?

The child’s rhythm changes to asystole. What is your immediate next action?

Defibrillate at 2 J/kg.

Intubate the child immediately.

Administer atropine.

Continue chest compressions and administer epinephrine.

What intervention corrects hypoxia in resuscitation?

During resuscitation, you identify hypoxia as the reversible cause. What action should you take?

Perform needle decompression.

Ensure effective ventilation with 100% oxygen.

Administer bicarbonate.

Administer a fluid bolus.

What is the primary goal after achieving ROSC?

ROSC is achieved. What is the next priority in post-resuscitation care?

Discontinue all resuscitation medications.

Initiate physical therapy immediately.

Optimize oxygenation and ventilation.

Administer a second dose of epinephrine.

What temperature range is ideal for minimizing neurological injury?

What is the target temperature management (TTM) strategy post-ROSC?

Maintain normothermia (36-37.5°C).

Avoid any temperature intervention.

Induce mild hypothermia (32-34°C).

Allow for mild hyperthermia.

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The average score is 0%

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