PALS - Pediatric Advanced Life Support High-Quality Pediatric BLS Questions and Answers — Questions and Answers
Question 1: When performing two-rescuer CPR on a 4-year-old child, what is the correct chest compression-to-ventilation ratio?
- 30:2
- 15:1
- 15:2 (Correct answer)
- 30:1
Correct answer: 15:2
For two-rescuer CPR on infants and children (up to the age of puberty), the recommended compression-to-ventilation ratio is 15:2. This provides more frequent ventilations, which is critical as pediatric cardiac arrest is often secondary to respiratory failure. The 30:2 ratio is used for single-rescuer CPR for all ages.
Question 2: You are performing high-quality CPR on a 7-year-old child. What is the recommended depth for chest compressions?
- At least one-fourth the anterior-posterior diameter of the chest, approximately 1.5 inches (4 cm).
- At least one-third the anterior-posterior diameter of the chest, approximately 2 inches (5 cm). (Correct answer)
- At least one-half the anterior-posterior diameter of the chest.
- A depth of 2.5 inches (6.5 cm) to maximize cardiac output.
Correct answer: At least one-third the anterior-posterior diameter of the chest, approximately 2 inches (5 cm).
For children, chest compressions should have a depth of at least one-third the anterior-posterior (AP) diameter of the chest. This correlates to approximately 2 inches or 5 cm. A depth of 1.5 inches is for infants, and compressing to one-half the chest diameter is too deep and could cause injury.
Question 3: Which of the following is the primary physiological reason for allowing the chest to fully recoil between each compression?
- To prevent rescuer fatigue and maintain a consistent rate.
- To allow the heart to adequately fill with blood before the next compression. (Correct answer)
- To reduce the risk of iatrogenic injuries such as rib fractures.
- To create positive intrathoracic pressure, which aids lung inflation.
Correct answer: To allow the heart to adequately fill with blood before the next compression.
Allowing complete chest recoil is critical because it creates negative intrathoracic pressure, which helps draw venous blood back into the heart's chambers (preload). This ensures that there is sufficient blood in the ventricles to be circulated with the next compression.
Question 4: A lone rescuer finds a 10-month-old infant in cardiac arrest. An AED with only adult-sized pads is available. What is the most appropriate action regarding AED pad placement?
- Do not use the AED, as adult pads will deliver an excessive shock.
- Cut the adult pads to better fit the infant's torso before applying.
- Place one pad on the center of the infant's chest and the other on the back, ensuring they do not touch. (Correct answer)
- Place both pads side-by-side on the infant's chest, even if they overlap slightly.
Correct answer: Place one pad on the center of the infant's chest and the other on the back, ensuring they do not touch.
If only adult pads are available for an infant or small child, an anterior-posterior placement should be used. One pad is placed on the center of the chest and the other on the back between the shoulder blades. This prevents the pads from touching or overlapping, which could cause arcing and an ineffective shock. It is critical to use the AED rather than withhold defibrillation.
Question 5: To ensure high-quality CPR and maximize coronary perfusion pressure, interruptions in chest compressions should be limited to no more than:
- 20 seconds
- 15 seconds
- 10 seconds (Correct answer)
- 5 seconds
Correct answer: 10 seconds
A core principle of high-quality CPR is minimizing interruptions in chest compressions. Each pause results in a drop in vital organ perfusion. Guidelines emphasize that interruptions for actions such as rhythm analysis, defibrillation, or airway placement should be limited to less than 10 seconds.
Question 6: What is the recommended chest compression rate for high-quality BLS in all pediatric age groups, from infants to adolescents?
- Exactly 100 per minute
- 80-100 per minute
- 120-140 per minute
- 100-120 per minute (Correct answer)
Correct answer: 100-120 per minute
The American Heart Association guidelines specify a universal compression rate of 100 to 120 compressions per minute for all victims of cardiac arrest, regardless of age. This rate optimizes cardiac output and perfusion to vital organs during CPR.
PALS - Pediatric Advanced Life Support High-Quality Pediatric BLS Questions and Answers
When performing two-rescuer CPR on a 4-year-old child, what is the correct chest compression-to-ventilation ratio?