Back to Basics (BLS)
It's Electric
Under Arrest
Skills
Rhythm n Blues
100
What is the appropriate depth of chest compressions in high quality CPR?
1/3 of the AP diameter of the chest (~1.5" in infant, 2" in child)
100
Name the rhythms on ECG monitoring that would be appropriate to defibrillate.
Vfib
pulseless VTach
100
How often do we administer epinephrine when indicated in cardiac arrest?
Every 3-5 minutes?
100
Name a contraindication to IO placement
- Fracture in the extremity
- overlying infection
- previous attempt in that site
100
What is this rhythm strip showing you and what should you do about it in a stable patient?
Normal sinus rhythm, do nothing
200
Describe (or demonstrate) the 2 methods of delivering high quality chest compressions to an infant (i.e. the 1-rescuer and 2-rescuer techniques)
Single rescuer: 2-finger compression of the lower half of the sternum below the nipple line but above the xyphoid.
2-rescuer: place 2 thumbs on lower half of sternum (same position as single rescuer) with hands encircling the infant's chest.
200
name the rhythms that you should NOT shock
pulseless electrical activity (PEA)
asystole
200
What dose of epinephrine do we use in pediatric cardiac arrest?
Bonus points: what is the endotracheal dose?
0.01mg/kg (of 0.1 mL/kg of the 0.1mg/mL concentration)
ET dose: 0.1 mg/kg (x10!!)
200
Position the head. The ear canal should be aligned with what anatomical landmark for appropriate infant respirations?
Shoulder
200
Name this rhythm, what do you do about this in a stable patient?
Supraventricular tachycardia, give adenosine
300
What is the compression:ventilation ratio in the resuscitation of an infant or child with 2 rescuers?
15:2
300
What is the appropriate dose for the initial shock of defibrillation?
2 J/kg
300
Name at least 5 of the H's and T's. Bonus points for all 10 recognized in the PALS learning materials.
Hypovolemia, hypoxia, h ions (acidosis), hypoglycemia, hypo/hyperkalemia, hypothermia
Tension pneumo, tamponade, toxins, thrombosis (pulm), thrombosis (coronary)
300
Where can you place an IO?
- Anterior tibia
- distal femur
- distal tibia (just above medial malleolus)
- ASIS
300
Name this rhythm, is this a shockable rhythm?
Pulseless electrical activity, not a shockable rhythm, start CPR
400
You must get both:
What is the goal rate of compressions in high quality CPR?
What is the goal respiratory rate in high quality CPR?
100-120 bpm
20-30 breaths/min or 1 breath every 2-3 seconds. Aim for a faster goal rate for infants (25-30) when possible.
400
What is the appropriate initial shock dose for synchronized cardioversion?
1 J/kg
400
What is the maximum time we aim for in rhythm/pulse checks?
10 seconds
400
That ETT isn't giving adequate chest rise. What mnemonic can help you troubleshoot?
D: displacement - readjust the tube
O: obstruction (secretions, foreign body, kinked tube)
P: pneumo (b/l breath sounds?)
E: equipment failure (issues with bag mask, ventilator, etc)
400
Name this rhythm, is it shockable? 
Ventricular tachycardia, yes, synchronized cardioversion
500
You are a single rescuer who just witnessed a sudden collapse of a child. You see no signs of breathing and cannot palpate a pulse. What is your immediate next step?
Activate emergency response system (even if you need to leave the room) and retrieve an AED/Defibrillator.
500
What is the maximum shock dose that can be delivered in defibrillation?
10 J/kg
500
You have followed your PALS guidelines for cardiac arrest and achieved ROSC! The PALS algorithm recommends that you reference this resource for improved outcomes following ROSC.
Post-cardiac arrest care checklist.
500
Why might you opt for an NPA over an OPA in a patient with concern for upper airway obstruction (snoring/stertor)?
NPA for conscious/semi-conscious patients
OPA for unconscious patients without gag reflex
500
Name this rhythm, is it shockable?
Asystole, no, start CPR