Static Cardiology | ACLS + PALS | 100 Course-Exam Cards

[Adult ACLS 001] What should you assess before selecting a cardiac rhythm treatment?

Determine whether a pulse is present and whether the rhythm is causing poor perfusion. Assess mental status, blood pressure, chest discomfort, shock, and acute heart failure; support airway and breathing. Treat the patient, not the monitor alone. Source: Week 9 ACLS guide, initial assessment.

[Adult ACLS 002] An adult has a sinus rhythm at 38/min. Does the rate alone establish a need for atropine or pacing?

No. Sinus bradycardia is a sinus rhythm below 60/min, but treatment depends on compromised perfusion attributable to the slow rate. A well-perfused patient may need observation and evaluation of the cause. Source: Week 9 ACLS guide, bradycardia.

[Adult ACLS 003] Every P wave conducts, but the PR interval is consistently 0.24 second. What is the rhythm?

First-degree AV block: PR greater than 0.20 second with every atrial impulse conducted. Investigate the cause and assess perfusion; the PR interval alone does not require pacing. Source: Week 4 heart-block guide.

[Adult ACLS 004] The PR interval progressively lengthens, then a P wave is not followed by a QRS. What block is suggested?

Second-degree AV block, Mobitz I (Wenckebach). The characteristic pattern is progressive PR prolongation before a dropped QRS, then the cycle repeats. Source: Week 4 heart-block guide.

[Adult ACLS 005] Conducted PR intervals remain constant, but intermittent P waves lack a QRS. What block is concerning?

Mobitz II second-degree AV block, when a sufficient tracing establishes the pattern. It may progress to complete block. Prepare pacing when perfusion is compromised; do not rely on atropine to correct an infranodal block. Source: Week 4 heart-block guide.

[Adult ACLS 006] P waves march at 90/min and broad QRS complexes march at 30/min with no consistent relationship. What is the rhythm?

Third-degree (complete) AV block with a ventricular escape rhythm. Atria and ventricles are independent. Poor perfusion calls for urgent support and pacing preparation. Source: Week 4 heart-block guide.

[Adult ACLS 007] The ventricular rhythm is irregularly irregular and there are no consistent discrete P waves. What atrial rhythm is likely?

Atrial fibrillation. Assess the ventricular response, perfusion, QRS width, and possibility of pre-excitation before choosing rate-control medication or cardioversion. Source: Atrial Rhythms guide; Bledsoe Volume 2, printed p. 1101.

[Adult ACLS 008] A regular narrow tachycardia is near 150/min. Which rhythm should you deliberately look for?

Atrial flutter with 2:1 conduction. An atrial rate near 300/min conducted 2:1 produces a ventricular rate near 150/min. Look for sawtooth flutter waves, including waves hidden in QRS/T waves. Source: Bledsoe Volume 2, pp. 1100-1101; Atrial Rhythms guide.

[Adult ACLS 009] What ECG features support multifocal atrial tachycardia rather than atrial fibrillation?

An irregular tachycardia with at least three distinct P-wave morphologies in the same lead, variable PR intervals, and an isoelectric baseline between P waves. Look for and treat an underlying problem such as hypoxia. Source: Atrial Rhythms guide.

[Adult ACLS 010] What are the classic sinus-rhythm clues to a WPW pattern, and which tachycardia is especially dangerous to treat with AV-nodal blockers?

Short PR, delta wave, and widened QRS support a WPW pattern. Irregular wide-complex pre-excited AF is a dangerous exception to routine AV-nodal-blocker pathways; obtain expert-directed treatment rather than giving routine adenosine or diltiazem. Source: Atrial Rhythms guide, pre-excitation.

[Adult ACLS 011] An organized ECG rhythm is present, but the patient has no pulse. What is the diagnosis and treatment pathway?

Pulseless electrical activity (PEA): high-quality CPR, epinephrine, and correction of reversible causes. PEA is not shockable unless the rhythm changes to VF/pulseless VT. Source: Week 9 ACLS guide; AHA arrest algorithm.

[Adult ACLS 012] Which adult cardiac-arrest rhythms are shockable, and which are nonshockable?

Shockable: ventricular fibrillation and pulseless ventricular tachycardia. Nonshockable: asystole and PEA. Use unsynchronized defibrillation for VF/pVT, not synchronized cardioversion. Source: Week 9 ACLS guide; AHA arrest algorithm.

[Adult ACLS 013] The monitor appears flat in a pulseless adult. What must you check, and should you shock apparent asystole?

Continue CPR while verifying leads, connections, gain, and the tracing in another lead to exclude equipment failure or fine VF. Confirmed asystole is not defibrillated; use the nonshockable arrest pathway. Source: Week 9 ACLS guide.

[Adult ACLS 014] What concentration does epinephrine 1:10,000 represent?

0.1 mg/mL, equivalent to 1 mg in 10 mL. State the concentration in mg/mL as well as the course ratio notation. It is ten times less concentrated than 1 mg/mL (1:1,000). Source: ALS formulary p. 21; PALS Lecture 2 guide, concentration safety.

[Adult ACLS 015] What is the adult epinephrine dose and volume for cardiac arrest using 0.1 mg/mL?

1 mg IV/IO every 3-5 minutes. At 0.1 mg/mL, 1 mg equals 10 mL. This is a cardiac-arrest bolus, not the dose for a perfusing patient with bradycardia. Source: ALS formulary p. 21.

[Adult ACLS 016] When is epinephrine given in adult nonshockable versus shockable arrest?

As soon as feasible for asystole/PEA. In the standard shockable algorithm, prioritize CPR and initial defibrillation; epinephrine enters during CPR after the second shock. Do not delay an indicated shock to give medication. Source: Week 9 ACLS guide; AHA 2025 arrest algorithm.

[Adult ACLS 017] What are the amiodarone bolus doses for adult shock-refractory VF/pulseless VT?

First dose 300 mg IV/IO push; second dose 150 mg IV/IO if indicated. These arrest boluses differ from the controlled infusion used for VT with a pulse. Source: ALS formulary p. 6.

[Adult ACLS 018] What is the course adult lidocaine arrest regimen, including repeat doses and cumulative limit?

Initial 1-1.5 mg/kg IV/IO; additional 0.5-0.75 mg/kg every 5-10 minutes if indicated, to a cumulative maximum of 3 mg/kg. It is an alternative to amiodarone for VF/pVT. Source: ALS formulary p. 34.

[Adult ACLS 019] A 70-kg adult with refractory VF is prescribed lidocaine 1.5 mg/kg. What is the dose and course cumulative ceiling?

Initial dose: 105 mg. The course cumulative maximum is 3 mg/kg, or 210 mg for 70 kg. Count all loading and supplemental doses already administered. Source: calculation from ALS formulary p. 34.

[Adult ACLS 020] What is the course amiodarone loading dose for an adult with a perfusing ventricular arrhythmia?

150 mg IV over 10 minutes. Monitor blood pressure and rhythm. Do not substitute the 300-mg arrest push for this perfusing-arrhythmia infusion. Source: ALS formulary p. 6; Week 9 ACLS guide.

[Adult ACLS 021] What is the course adult amiodarone maintenance infusion sequence and 24-hour ceiling?

1 mg/min for 6 hours, then 0.5 mg/min for 18 hours. The course maximum cumulative dose is 2.2 g in 24 hours, including loading doses. Source: ALS formulary p. 6.

[Adult ACLS 022] What are lidocaine's antiarrhythmic mechanism, adult maintenance rate, and important toxicity findings?

Class Ib fast sodium-channel blocker. Course maintenance: 1-4 mg/min. Watch for confusion, drowsiness, slurred speech, seizures, bradycardia, and hypotension. Source: ALS formulary p. 34.

[Adult ACLS 023] What adult adenosine sequence does your course teach for appropriate stable regular SVT?

6 mg rapid IV/IO push followed immediately by a rapid flush; if needed, 12 mg rapid push and flush. Do not assume unlimited repeat doses. Source: ALS formulary p. 4; Atrial Rhythms guide.

[Adult ACLS 024] Why must adenosine be pushed rapidly and followed immediately by a rapid flush?

It has a very short half-life and must reach the heart promptly to transiently block AV-nodal conduction. Use suitable access, monitor continuously, and record the rhythm; warn the patient about brief unpleasant symptoms when feasible. Source: ALS formulary p. 4; Atrial Rhythms guide.

[Adult ACLS 025] An adult has an irregular wide-complex tachycardia. Is this the routine adenosine pathway?

No. Do not use adenosine for an undifferentiated irregular or polymorphic wide-complex rhythm. Consider pre-excited AF and other dangerous causes. Adenosine may be considered for selected regular monomorphic wide-complex tachycardia when an SVT mechanism is suspected. Source: Atrial Rhythms guide.

[Adult ACLS 026] What adult atropine regimen is taught for symptomatic bradycardia, and what limit needs clarification?

Course: 1 mg IV every 3-5 minutes; the entry also prints 0.04 mg/kg with total 3 mg. CURRENT AHA: maximum total 3 mg; do not interpret the older weight-based wording as the current ACLS maximum. Prepare pacing for unstable high-grade block. Source: ALS formulary p. 8; Week 9 guide; AHA adult bradycardia algorithm.

[Adult ACLS 027] What epinephrine infusion rate is listed for adult severe symptomatic bradycardia?

2-10 micrograms/min IV/IO infusion, titrated to response. The units are micrograms per minute, not mg/min or micrograms/kg/min. Source: ALS formulary p. 21.

[Adult ACLS 028] What dopamine infusion range does the course use for adult bradycardic hypoperfusion?

5-20 micrograms/kg/min, titrated to perfusion and blood pressure. It is medication support, not a reason to delay urgent pacing in an unstable high-grade block. Source: Week 4 heart-block guide, medication support.

[Adult ACLS 029] What are the course adult procainamide loading range, limit, and stop criteria?

20 mg/min; up to 50 mg/min in urgent situations, maximum total 17 mg/kg. Stop for rhythm termination, hypotension, QRS widening over 50%, or reaching the maximum. Maintenance: 1-4 mg/min. Source: ALS formulary p. 51.

[Adult ACLS 030] What magnesium dose does your course list for adult torsades with versus without a pulse?

With a pulse: 1-2 g IV/IO over 5-60 minutes per the course entry. Pulseless torsades: 1-2 g IV/IO push as an adjunct to CPR/defibrillation. Magnesium does not replace immediate defibrillation for sustained unstable polymorphic VT. Source: ALS formulary p. 36; AHA adult ALS.

[Adult ACLS 031] Which findings suggest tachycardia is causing instability requiring the electrical pathway?

Hypotension, acutely altered mental status, signs of shock, ischemic chest discomfort, or acute heart failure attributable to the tachyarrhythmia. Do not cardiovert compensatory sinus tachycardia merely because the rate is high. Source: Week 9 ACLS guide.

[Adult ACLS 032] What does synchronized cardioversion synchronize to, and what must you verify before delivering it?

The QRS/R wave. Confirm a synchronization marker on each appropriate QRS, not the T wave or artifact. Recheck SYNC before repeat shocks because some devices reset. Sedate when feasible without delaying emergency treatment. Source: Bledsoe Volume 2 p. 1136.

[Adult ACLS 033] What initial adult synchronized energy does your course teach for regular SVT, and what is the AHA 2025 value?

COURSE: 50-100 J; the instructor often chooses 100 J. AHA 2025: 100 J for narrow-complex tachycardia. Escalate as indicated using the device/protocol. Source: Week 9 guide; AHA 2025 Electrical Cardioversion Algorithm.

[Adult ACLS 034] What initial adult synchronized energy does your course teach for atrial flutter, and what changed in AHA 2025?

COURSE: 50-100 J. AHA 2025: 200 J initially. Keep the exam value and updated clinical algorithm distinct. Source: Week 9 guide; Bledsoe Volume 2 p. 1101; AHA 2025 Electrical Cardioversion Algorithm.

[Adult ACLS 035] What initial adult synchronized energy does your course teach for AF, and what is the AHA 2025 value?

COURSE: 120-200 J. AHA 2025 Electrical Cardioversion Algorithm: 200 J initially. Recheck synchronization and reassess after each attempt. Source: Week 9 guide; AHA 2025 Electrical Cardioversion Algorithm.

[Adult ACLS 036] An adult has monomorphic VT with a pulse, hypotension, and altered mental status. What electrical treatment and initial energy fit?

Synchronized cardioversion, initially 100 J in the course and AHA 2025 algorithm. Sedate if feasible without delaying treatment. If the pulse is lost, use unsynchronized defibrillation and CPR. Source: Week 9 guide; AHA 2025 Electrical Cardioversion Algorithm.

[Adult ACLS 037] An adult has sustained polymorphic VT with poor perfusion. Should you wait for reliable synchronization?

No. Deliver an unsynchronized high-energy shock (defibrillation); synchronization is unreliable in polymorphic VT. Address causes such as long QT/electrolyte problems afterward. Source: AHA 2025 Electrical Cardioversion Algorithm; Week 9 guide.

[Adult ACLS 038] What initial adult defibrillation energies should you recall for biphasic and monophasic devices?

Biphasic: manufacturer recommendation, commonly 120-200 J; if unknown, current AHA says maximum available. Monophasic: 360 J. Follow device-specific settings; adult defibrillation is not calculated in J/kg. Source: Bledsoe Volume 2 p. 1135; AHA 2025 arrest algorithm.

[Adult ACLS 039] What follows a defibrillation shock, and how often is the rhythm reassessed during arrest?

Immediately resume high-quality CPR for about 2 minutes, minimizing pauses. Reassess the rhythm at the cycle end; assess for a pulse when an organized rhythm or other ROSC signs warrant it. Do not pause for a routine pulse check immediately after every shock. Source: Bledsoe Volume 2 p. 1135.

[Adult ACLS 040] When should you prepare prompt transcutaneous pacing rather than wait through ineffective medication attempts?

A bradyarrhythmia is causing serious hypoperfusion, especially Mobitz II/high-grade or complete AV block. Treat reversible causes and prepare medication support concurrently. COURSE/TEXTBOOK DIFFERENCE: Bledsoe p. 1136 includes asystole; current AHA does not recommend routine pacing during established arrest. Source: Week 4 guide; Bledsoe p. 1136; AHA ALS.

[Adult ACLS 041] What initial adult pacing rate does your instructor use, and is it a universal device setting?

COURSE: 80 pulses/min initially, followed by reassessment and adjustment for perfusion. It is an instructor setting, not a universal rate for every device or patient. Source: Week 9 guide, transcutaneous pacing.

[Adult ACLS 042] What do pacing rate and pacing output control, and what are their units?

Rate (pulses/min) determines how often the pacer stimulates. Output (milliamperes, mA) determines current per stimulus. Increase output as indicated to achieve capture; changing rate alone does not fix inadequate capture current. Source: Week 4 and Week 9 guides.

[Adult ACLS 043] How do electrical capture and mechanical capture differ during pacing?

Electrical capture: a pacing stimulus produces a reproducible paced QRS and repolarization. Mechanical capture: matching palpable pulses and improved perfusion/BP. Spikes or chest-wall twitching alone prove neither useful cardiac output nor complete capture. Source: Week 4 guide, pacing.

[Adult ACLS 044] Pacing spikes are visible but no consistent paced QRS or matching pulse is present. What should you reassess?

Pad contact/position, cables, battery, output, sensing, and patient factors such as hypoxia/acidosis. Adjust output according to device instructions and prove both electrical and mechanical capture. If pulseless, move to the arrest pathway. Source: Week 4 guide.

[Adult ACLS 045] Does midazolam provide analgesia for painful transcutaneous pacing?

No. Midazolam (Versed) provides sedation/anxiolysis and amnesia, not analgesia. Pain may require an analgesic such as fentanyl under the authorized order. Monitor breathing/BP and do not delay lifesaving pacing for ideal comfort. Source: Week 4 guide, pacing analgesia/sedation.

[Adult ACLS 046] An adult with complete heart block has a pulse of 30, minimal breathing, and an unobtainable BP. What are the immediate priorities?

Assist ventilation/oxygenation and begin prompt pacing while the team obtains access and prepares circulatory support. Do not delay for a diagnostic 12-lead or repeated attempts to make atropine repair an infranodal block. Source: Week 9 guide, complete-block scenario.

[Adult ACLS 047] A 70-kg adult receives lidocaine 1 mg/kg and then 0.5 mg/kg. How much has been given, and how much remains before the course cumulative ceiling?

70 mg + 35 mg = 105 mg (1.5 mg/kg). The 3-mg/kg ceiling is 210 mg, leaving 105 mg before that ceiling. Additional dosing still requires an indication and appropriate timing. Source: calculation from ALS formulary p. 34.

[Adult ACLS 048] An adult is in VF. Should drug preparation delay the first shock?

No. Prioritize CPR and rapid defibrillation. Give epinephrine and an antiarrhythmic at the appropriate points in the algorithm while minimizing interruptions; medication is not a substitute for an indicated shock. Source: Week 9 guide; AHA arrest algorithm.

[Adult ACLS 049] What are the classic adult Hs and Ts to investigate during cardiac arrest?

Hs: hypovolemia, hypoxia, hydrogen-ion excess/acidosis, hypo-/hyperkalemia, hypothermia. Ts: tension pneumothorax, cardiac tamponade, toxins, pulmonary thrombosis, coronary thrombosis. Identify a reversible cause while resuscitation continues. Source: AHA adult arrest algorithm.

[Adult ACLS 050] ETCO2 rises abruptly and stays higher during CPR. What might it indicate, and what should you do?

Possible ROSC. Assess rhythm and circulation appropriately, then transition to post-arrest assessment and support when ROSC is confirmed. A monitor change alone is not the complete assessment. Source: Week 9 ACLS guide.

[Pediatric PALS 051] For BLS/PALS recognition, how are infant and child age categories distinguished?

Infant: younger than 1 year, excluding the newly born infant at birth. Child BLS: about 1 year until puberty. Newly born resuscitation uses its neonatal algorithm; distinguish it from pediatric arrest. Source: supplied pediatric algorithms; PALS Lecture 2 guide.

[Pediatric PALS 052] A child is restless, tachycardic, cool, and poorly perfused but still has an age-appropriate BP. Does a normal BP exclude shock?

No. This can be compensated shock. Use appearance, breathing, skin perfusion, pulse quality, and the trend; do not wait for hypotension to recognize deterioration. Source: PALS Lecture 2 guide, shock.

[Pediatric PALS 053] What commonly causes serious pediatric bradycardia, and what must be addressed early?

Hypoxia/respiratory failure. Open and support the airway and provide effective oxygenation/ventilation while assessing circulation. A primary electrical block requires a different emphasis than asphyxial bradycardia. Source: PALS Lecture 2 guide, bradycardia.

[Pediatric PALS 054] A 3-year-old is unresponsive, breathing 4/min, with a pulse of 40. What are the immediate priorities?

Provide effective bag-mask ventilation with oxygen. If HR remains below 60/min with poor perfusion despite oxygenation/ventilation, start CPR, obtain IV/IO access, and give indicated epinephrine. Source: PALS Lecture 2 guide, slide-24 scenario; supplied bradycardia algorithm.

[Pediatric PALS 055] When is CPR indicated for pediatric bradycardia despite a palpable pulse?

HR below 60/min with cardiopulmonary compromise/poor perfusion despite effective oxygenation and ventilation. Continue treating the underlying cause. If the pulse disappears, use the pediatric cardiac-arrest algorithm. Source: supplied 2025 PALS Bradycardia Algorithm.

[Pediatric PALS 056] What is the pediatric IV/IO epinephrine bolus dose, concentration, volume, maximum, and repeat interval for arrest/indicated bradycardia?

0.01 mg/kg using 0.1 mg/mL (1:10,000), equivalent to 0.1 mL/kg; maximum single dose 1 mg. Repeat every 3-5 minutes while indicated. Source: supplied PALS arrest/bradycardia algorithms; PALS Lecture 2 guide.

[Pediatric PALS 057] A 10-kg child requires IV/IO arrest-dose epinephrine from a 0.1-mg/mL syringe. Calculate mg and mL.

0.01 mg/kg x 10 kg = 0.1 mg. Volume = 0.1 mg / 0.1 mg/mL = 1 mL. Confirm concentration and route; 1 mg/mL would produce a tenfold overdose if the same volume were used. Source: PALS Lecture 2 guide, concentration safety.

[Pediatric PALS 058] When is pediatric atropine appropriate, and what does the supplied 2025 algorithm specify?

For increased vagal tone or primary AV block: 0.02 mg/kg IV/IO; minimum 0.1 mg, maximum single dose 0.5 mg; may repeat once. COURSE FORMULARY DIFFERENCE: it permits broader repeated dosing/cumulative limits; do not merge that wording with the algorithm. Source: supplied bradycardia algorithm; ALS formulary p. 8.

[Pediatric PALS 059] A 10-kg child with vagally mediated bradycardia needs atropine. What dose results from 0.02 mg/kg?

0.2 mg IV/IO. It is above the 0.1-mg minimum and below the 0.5-mg single-dose maximum. Volume depends on the actual preparation; at 0.1 mg/mL, it is 2 mL. Source: PALS Lecture 2 guide; supplied bradycardia algorithm.

[Pediatric PALS 060] When might pacing help a child with persistent bradycardic hypoperfusion?

Consider it for a primary electrical problem such as severe AV block or sinus-node dysfunction when poor perfusion persists. Correct hypoxia/ventilation first when the mechanism is respiratory; pacing does not replace oxygen delivery. Source: PALS Lecture 2 guide; supplied bradycardia algorithm.

[Pediatric PALS 061] What pediatric pacing rate does the instructor describe, and what part is device-specific?

COURSE: 100 pulses/min in the described pacing sequence, with current chosen under physician/device direction and capture reassessed. This is not a universal PALS current/rate prescription. Titrate according to the actual device and prove electrical AND mechanical capture. Source: PALS Lecture 2 guide, when pacing fits.

[Pediatric PALS 062] A child has a fast rate, visible sinus P waves, variable RR intervals, fever, and dehydration. What is the treatment target?

The cause of sinus tachycardia, such as hypovolemia, fever, pain, or hypoxia. Rate alone does not establish SVT; do not cardiovert compensatory sinus tachycardia. Source: PALS Lecture 2 guide, sinus tachycardia versus SVT.

[Pediatric PALS 063] What rate and tracing clues support probable SVT in infants versus children?

Infant rate usually at least 220/min; child rate usually at least 180/min, with a very regular RR interval, absent/abnormal P waves, and abrupt onset. These are clues, not diagnosis by rate alone. Source: supplied 2025 PALS Tachycardia Algorithm.

[Pediatric PALS 064] What QRS duration separates the narrow and wide branches in the supplied pediatric tachycardia algorithm?

Narrow: 0.09 second or less. Wide: greater than 0.09 second. COURSE NOTE: the instructor discusses 0.08 second as a reason to inspect closely, but the printed branching cutoff is 0.09 second. Source: supplied tachycardia algorithm; PALS Lecture 2 guide.

[Pediatric PALS 065] Which vagal maneuvers does the course discuss for stable pediatric SVT?

A brief approved cold facial stimulus for an infant, keeping the airway unobstructed; a Valsalva-type maneuver for a cooperative older child. Monitor the rhythm/perfusion, avoid ocular pressure, and do not delay cardioversion in an unstable child. Source: PALS Lecture 2 guide.

[Pediatric PALS 066] What are the first and second pediatric adenosine doses for appropriate SVT?

First: 0.1 mg/kg rapid IV/IO push, maximum 6 mg. Second: 0.2 mg/kg rapid push, maximum 12 mg. Immediately follow each with a rapid flush. Source: supplied tachycardia algorithm; ALS formulary p. 4.

[Pediatric PALS 067] A stable 20-kg 5-year-old with SVT needs adenosine after an unsuccessful vagal maneuver. Calculate both doses.

First: 0.1 x 20 = 2 mg. Second, if still indicated while appropriately perfusing: 0.2 x 20 = 4 mg. Both are below the dose ceilings and require rapid delivery/flush. Source: supplied 5 y_o SVT scenario; PALS tachycardia algorithm.

[Pediatric PALS 068] Why is tubing dead space important when giving a tiny pediatric adenosine dose?

A small dose may remain in the extension tubing instead of reaching the heart. Use appropriate access, a measured dose, and an immediate effective flush; observe/record the rhythm. Source: PALS Lecture 2 guide, adenosine delivery.

[Pediatric PALS 069] What synchronized cardioversion energies does the course use for pediatric unstable tachycardia with a pulse?

Initial 0.5-1 J/kg; if ineffective, increase to 2 J/kg. Verify QRS synchronization before delivery and each repeat. Sedate if feasible without delaying urgent treatment. Source: supplied PALS Tachycardia Algorithm.

[Pediatric PALS 070] Your 20-kg SVT patient becomes unstable. At the instructor's initial 1 J/kg setting, what are the first and second synchronized energies?

First: 20 J. Second, if needed at 2 J/kg: 40 J. The algorithm's initial permitted range is 10-20 J (0.5-1 J/kg); the course instructor favors 1 J/kg. Source: PALS Lecture 2 guide; 5 y_o SVT scenario.

[Pediatric PALS 071] A child with SVT deteriorates after the first adenosine dose and now has hypotension/altered mental status. Must you complete the stable drug sequence first?

No. Reassess the pulse and prepare prompt synchronized cardioversion for instability attributable to the tachyarrhythmia. Adenosine may be considered if access is already present, but do not delay indicated electrical treatment to complete a stable-path sequence. Source: supplied tachycardia algorithm; 5 y_o SVT scenario.

[Pediatric PALS 072] What must you verify before a synchronized pediatric shock, and should sedation delay it?

Verify synchronization markers identify QRS complexes, not tall T waves/artifact, and recheck SYNC after each shock. Sedate when feasible, but do not delay urgent cardioversion in cardiovascular compromise. Source: PALS Lecture 2 guide.

[Pediatric PALS 073] A child has a regular monomorphic wide-complex tachycardia with adequate perfusion. Is adenosine ever considered?

Yes, in selected regular monomorphic cases when an SVT mechanism is considered, with expert consultation. Do not generalize this to irregular or polymorphic wide-complex tachycardia. If compromise develops, use the appropriate electrical pathway. Source: supplied PALS Tachycardia Algorithm.

[Pediatric PALS 074] What pediatric amiodarone infusion does Lecture 2 teach for a perfusing arrhythmia, and what source conflict must you remember?

LECTURE: 5 mg/kg IV/IO over 20-60 minutes, maximum single dose 300 mg. FORMULARY p. 6: the same weight-based load but maximum 150 mg for perfusing arrhythmias. These are conflicting course ceilings; confirm the exam/instructor's requested source. Neither is an arrest push. Source: PALS Lecture 2 guide, section 9; ALS formulary p. 6.

[Pediatric PALS 075] What pediatric procainamide regimen is listed for selected refractory SVT or VT with a pulse?

15 mg/kg IV/IO over 30-60 minutes with expert direction. Monitor blood pressure, rhythm, and QRS. Do not routinely combine it with amiodarone. Source: ALS formulary p. 51; PALS Lecture 2 guide.

[Pediatric PALS 076] What lidocaine regimen does the course describe for pediatric VT with a pulse?

Initial 1 mg/kg IV/IO, given over about 2 minutes in the lecture. Additional 0.5 mg/kg when indicated; formulary repeat interval 5-10 minutes, cumulative maximum 3 mg/kg. Do not confuse the perfusing-rhythm administration speed with an arrest push. Source: PALS Lecture 2 guide; ALS formulary p. 34.

[Pediatric PALS 077] What pediatric lidocaine maintenance infusion rate is listed after stabilization?

20-50 micrograms/kg/min. Watch for neurologic toxicity, bradycardia, and hypotension; confirm units and concentration. This maintenance infusion is separate from the mg/kg loading dose. Source: ALS formulary p. 34; PALS Lecture 2 guide.

[Pediatric PALS 078] Which pediatric arrest rhythms receive defibrillation, and which receive the nonshockable pathway?

VF and pulseless VT receive unsynchronized defibrillation plus CPR. Asystole and PEA receive CPR, epinephrine as soon as feasible, and correction of reversible causes, without a shock unless the rhythm becomes shockable. Source: supplied PALS Cardiac Arrest Algorithm.

[Pediatric PALS 079] What are the first and second pediatric defibrillation energies?

First shock: 2 J/kg. Second shock: 4 J/kg. Immediately resume CPR after each shock. These are defibrillation settings, not the 0.5-1 J/kg initial synchronized-cardioversion dose. Source: supplied PALS Cardiac Arrest Algorithm.

[Pediatric PALS 080] How should you interpret the instructor's pediatric defibrillation shorthand '2, 4, 10 J/kg'?

COURSE shorthand: 2, then 4, with escalation toward 10 J/kg. The supplied 2025 algorithm says subsequent shocks at least 4 J/kg, maximum 10 J/kg OR the adult dose, whichever is lower. Ten J/kg is a ceiling, not a mandatory third-shock setting. Source: PALS Lecture 2 guide; supplied arrest algorithm.

[Pediatric PALS 081] Calculate defibrillation energies for a 20-kg child in VF.

First: 40 J (2 J/kg). Second: 80 J (4 J/kg). Later shocks: at least 80 J, escalating as appropriate; 10 J/kg gives a 200-J ceiling, subject to any lower device adult maximum. Source: supplied arrest algorithm; PALS Lecture 2 guide.

[Pediatric PALS 082] When is epinephrine given in pediatric nonshockable versus shockable arrest?

Asystole/PEA: as soon as feasible. Standard VF/pVT sequence: CPR and shocks first; epinephrine during CPR after the second shock, then every 3-5 minutes. Source: supplied 2025 PALS Cardiac Arrest Algorithm.

[Pediatric PALS 083] What pediatric arrest amiodarone regimen is taught, and what does the supplied 2025 algorithm add?

COURSE: 5 mg/kg IV/IO bolus, up to 3 total doses (15 mg/kg cumulative), with a 300-mg initial ceiling. SUPPLIED 2025 AHA/AAP algorithm: subsequent-dose maximum 150 mg. Do not interpret 'repeat' as an initial dose plus three additional doses. Source: PALS Lecture 2 guide; supplied arrest algorithm.

[Pediatric PALS 084] A 20-kg child with shock-refractory VF is prescribed amiodarone 5 mg/kg. How much is the first dose?

100 mg IV/IO bolus. It is below the first-dose 300-mg ceiling. Keep arrest bolus administration separate from the slower infusion for a perfusing rhythm. Source: supplied arrest algorithm; calculation from PALS Lecture 2 guide.

[Pediatric PALS 085] What pediatric lidocaine arrest dose does Lecture 2 teach, and how does its repeat dose differ from the formulary?

LECTURE: 1 mg/kg IV/IO initially; another 1 mg/kg for refractory VF, cumulative maximum 3 mg/kg. FORMULARY p. 34: supplemental 0.5 mg/kg doses at 5-10 minutes. The supplied AHA 2025 algorithm specifies the initial 1 mg/kg but does not specify a repeat regimen. Do not blend these sources. Source: PALS Lecture 2 guide; formulary; arrest algorithm.

[Pediatric PALS 086] A 20-kg child in refractory VF receives initial lidocaine 1 mg/kg. What is the dose and course cumulative maximum?

Initial dose 20 mg IV/IO. Course cumulative maximum 60 mg (3 mg/kg). Whether the next dose is 1 mg/kg or 0.5 mg/kg depends on the specifically named lecture versus formulary regimen. Source: PALS Lecture 2 guide; ALS formulary p. 34.

[Pediatric PALS 087] Why should amiodarone and procainamide not be casually combined for pediatric refractory tachyarrhythmias?

Both can depress hemodynamics and prolong repolarization. Choose an expert/protocol-directed strategy, monitor continuously, and communicate prior doses; do not stack alternatives merely because the first treatment has not worked. Source: PALS Lecture 2 guide, refractory SVT.

[Pediatric PALS 088] What compression-to-ventilation ratios apply without an advanced airway in pediatric CPR?

One rescuer: 30:2. Two healthcare rescuers in infants/prepubertal children: 15:2. The supplied 2025 arrest algorithm uses 30:2 after puberty onset. Source: supplied PALS Cardiac Arrest Algorithm.

[Pediatric PALS 089] What compression rate and depth should you recall for infant/child CPR?

100-120 compressions/min with full recoil and minimal pauses. Depth: at least one-third the chest's AP diameter, about 4 cm in an infant and 5 cm in a child. Change compressors about every 2 minutes. Source: supplied arrest algorithm; PALS Lecture 2 guide.

[Pediatric PALS 090] What pediatric ventilation rate is used with an advanced airway during CPR, and which older lecture value conflicts?

20-30 breaths/min (one every 2-3 seconds) with continuous compressions. The older embedded slide algorithm's 10/min is outdated for pediatric CPR. Your updated study guide and supplied 2025 algorithm use 20-30/min. Source: PALS Lecture 2 guide; supplied arrest algorithm.

[Pediatric PALS 091] What does the instructor say about pediatric pad selection, and what actually governs use?

COURSE: about 1 year or 10 kg as a transition from smaller infant pads. Actual pad type, attenuation, and compatibility are device-specific. Use approved pads that fit without touching/overlap; anterior-posterior placement can help on a small chest. Source: PALS Lecture 2 guide.

[Pediatric PALS 092] A 20-kg child has suspected hypovolemic shock without evidence of pump failure. What initial course fluid amount is calculated, and what changes if cardiac dysfunction is suspected?

Course 20 mL/kg isotonic crystalloid = 400 mL, with reassessment. The supplied post-ROSC algorithm suggests considering smaller aliquots such as 10 mL/kg (200 mL here) if poor cardiac function is suspected. Do not automatically repeat a large bolus into a failing pump. Source: PALS Lecture 2 guide; supplied ROSC algorithm.

[Pediatric PALS 093] Using the course hypotension rule for ages 1-10 years, what is the systolic threshold for a 5-year-old?

70 + (2 x age) = 80 mmHg; a systolic pressure below 80 is hypotensive by this rule. A pressure at or above 80 does not exclude compensated shock. Source: PALS Lecture 2 guide, five-year-old scenario.

[Pediatric PALS 094] What oxygen-saturation target is printed in your supplied pediatric post-ROSC algorithm?

94-99%, adjusted for the patient's condition. It says to reduce FiO2 if possible when saturation is 100% and avoid unnecessary hyperventilation. This is the specific supplied algorithm's target, not a universal target for every cyanotic congenital heart patient. Source: supplied Cardiovascular Management After ROSC Algorithm.

[Pediatric PALS 095] Which vasoactive medications appear in the supplied post-ROSC algorithm for hypotensive versus normotensive shock?

Hypotensive shock: epinephrine or norepinephrine. Normotensive shock: epinephrine. Assess contributing causes, volume status, and cardiac function and use titrated expert/protocol-directed support. Source: supplied Cardiovascular Management After ROSC Algorithm.

[Pediatric PALS 096] A child collapses immediately after a blow to the chest during sports and is pulseless with VF. What mechanism and treatment should you recognize?

Commotio cordis: a blow during a vulnerable repolarization phase can trigger VF. Start CPR and defibrillate promptly using the pediatric shockable-arrest pathway. Source: PALS Lecture 2 guide, karate/VF scenario.

[Pediatric PALS 097] Which reversible causes are listed in your pediatric arrest algorithm, including the extra glucose reminder?

Hypovolemia, hypoxia, hydrogen-ion excess/acidosis, hypoglycemia, hypo-/hyperkalemia, hypothermia; tension pneumothorax, tamponade, toxins, pulmonary thrombosis, and coronary thrombosis. Investigate them during ongoing resuscitation. Source: supplied PALS Cardiac Arrest Algorithm.

[Pediatric PALS 098] What magnesium dose does your formulary list for pediatric torsades, and how does administration differ by pulse status?

25-50 mg/kg IV/IO, maximum 2 g. With a pulse, the course specifies infusion over 10-20 minutes; without a pulse, it specifies a bolus with resuscitation/defibrillation. It is not routine medication for all VF/pVT. Source: ALS formulary p. 37; AHA adult ALS supports rhythm-specific magnesium use.

[Pediatric PALS 099] What pediatric norepinephrine upper infusion rate is listed in your formulary?

2 micrograms/kg/min IV/IO infusion. This is the listed upper limit, not a starting rate or universal maximum for every service. The entry omits its lower pediatric range; do not invent one. Source: ALS formulary p. 47.

[Pediatric PALS 100] A 20-kg child is ordered epinephrine infusion at 0.1 microgram/kg/min. What is the delivered dose per minute, and why can't you state mL/hour yet?

0.1 x 20 = 2 micrograms/min. To calculate mL/hour, first verify the prepared concentration in micrograms/mL; then mL/hour = (micrograms/min x 60) / concentration. Never confuse the infusion with a 0.01-mg/kg arrest bolus. Source: calculation; ALS formulary p. 21; PALS Lecture 2 guide.