PALS MC Pediatric Drowning Incident with Cardiac Arrest

Pediatric Drowning Incident with Cardiac Arrest

A 5-year-old child is pulled from a swimming pool, unresponsive and apneic. Bystanders report that the child had been submerged for approximately 2-3 minutes before being rescued. The child is cyanotic and has absent respirations with no pulse. The child’s condition appears critical, and it is unclear if there are any additional injuries.

What action addresses the most immediate threat in drowning?

A 5-year-old is pulled from a swimming pool unresponsive and apneic. What is your first priority?

Assess for signs of trauma.

Start chest compressions.

Dry the child to prevent hypothermia.

Open the airway and provide rescue breaths.

What intervention supports oxygenation in respiratory arrest?

The child remains apneic but has a pulse. What is the next step in management?

Administer epinephrine 0.01 mg/kg IV/IO.

Prepare for synchronized cardioversion.

Begin chest compressions.

Continue rescue breaths at 1 breath every 3-5 seconds.

What action is first-line in cardiac arrest?

The child loses their pulse despite effective rescue breathing. What is your next step?

Administer sodium bicarbonate.

Perform unsynchronized defibrillation.

Start high-quality CPR immediately.

Administer atropine 0.02 mg/kg IV/IO.

What medication increases heart rate and contractility in PEA?

The child's rhythm is pulseless electrical activity (PEA). What is the next recommended medication?

Administer amiodarone 5 mg/kg IV/IO.

Administer epinephrine 0.01 mg/kg IV/IO.

Administer atropine 0.02 mg/kg IV/IO.

Administer magnesium sulfate 25-50 mg/kg IV/IO.

What warming techniques are safe and effective for moderate hypothermia?

The child is hypothermic with a core temperature of 30°C (86°F). What is the best approach to rewarming?

Rapidly warm the child with a hot bath.

Perform only passive rewarming, such as removing wet clothes.

Start extracorporeal membrane oxygenation (ECMO).

Use active external rewarming techniques, such as warm blankets and heat packs.

What intervention protects the brain after ROSC?

After ROSC, the child remains unresponsive. What is the next priority?

Administer atropine 0.02 mg/kg IV.

Administer a rapid fluid bolus.

Initiate targeted temperature management (TTM).

Perform immediate defibrillation.

What is a common and reversible cause of bradycardia?

During post-ROSC care, the child develops bradycardia. What is the first step in managing this?

Administer atropine 0.02 mg/kg IV/IO.

Begin chest compressions.

Administer epinephrine 0.01 mg/kg IV/IO.

Ensure adequate oxygenation and ventilation.

What fluid strategy minimizes risks in neurologically unstable children?

What is a key consideration when administering fluids during post-ROSC care?

Provide rapid boluses regardless of clinical status.

Avoid overhydration to prevent cerebral edema.

Use hypertonic saline for all fluid resuscitation.

Avoid fluids entirely to prevent overload.

What factor directly correlates with hypoxic brain injury in drowning?

The child’s family asks about long-term outcomes. What factor most strongly predicts neurologic recovery?

Initial blood glucose level.

Duration of submersion.

Heart rate on admission.

Core temperature on presentation.

What approach targets the root cause of ongoing oxygenation issues?

After ROSC, the child has persistent hypoxemia despite adequate ventilation. What is the next step?

Administer a higher dose of epinephrine.

Assess for underlying causes such as aspiration or pneumothorax.

Perform chest compressions.

Initiate ECMO immediately.

Your score is

The average score is 0%

PALS Course