PALS Cheat Sheet 2026

The 30 highest-yield PALS facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What is the correct IV/IO dose of atropine for a pediatric patient with symptomatic bradycardia according to the PALS guidelines? → 0.02 mg/kg, with a maximum single dose of 0.5 mg
2. What is the maximum single dose of adenosine for treating SVT in a pediatric patient? → 12 mg
3. For adults, children, and newborns, what is the appropriate rate of chest compressions per minute? → 100-120 compressions/min
4. A 3-year-old with Down syndrome presents with bradycardia and signs of respiratory distress. Which initial step has the highest priority? → Providing high-flow oxygen and supporting ventilation
5. A 6-month-old with RSV bronchiolitis has SpO2 of 88% on room air. What is the most appropriate initial oxygen delivery method? → High-flow nasal cannula
6. In pediatric assessment, which capillary refill time is considered abnormal? → Greater than 2 seconds
7. A child remains in refractory VF after 3 shocks, epinephrine, and amiodarone. What is the next recommended action? → Give a second dose of amiodarone (5 mg/kg) or lidocaine (1 mg/kg) and shock again
8. Which of the following arrhythmias would be indicated by typical sawtooth P-wave activity on the ECG monitor, using the ILCOR PALS Provider Manual? → Atrial flutter
9. On ECG, a child has a regular rhythm at 40 bpm with P waves that bear no relationship to QRS complexes. What is this rhythm? → Third-degree (complete) AV block
10. A 9-year-old post-drowning victim is intubated and ventilated. ETCO2 reads 55 mmHg. Which action is correct? → Increase the respiratory rate to lower ETCO2
11. Which presentation rhythm is most frequently seen in kids going into cardiac arrest? → PEA/asystole
12. Which medication is CONTRAINDICATED in pediatric SVT management? → Verapamil in infants <1 year
13. A child with wide-complex tachycardia and a pulse receives lidocaine. What is the correct IV/IO dose? → 0.5–1 mg/kg
14. Which arrhythmia in a child with a pulse is treated with adenosine as the first-line pharmacologic therapy? → Supraventricular tachycardia (SVT)
15. Which hemodynamic pattern is characteristic of hypovolemic shock? → Low CO, high SVR
16. What maximum fluid volume (in mL/kg) should be given before reassessing a child in septic shock and considering vasopressors? → 40–60 mL/kg
17. What is the minimum acceptable fraction of chest compression time (CCF) during resuscitation to be considered high-quality CPR? → 80%
18. Which of the following rhythms requires immediate defibrillation rather than synchronized cardioversion? → Pulseless ventricular fibrillation
19. A 7-year-old with acute myocarditis develops cardiogenic shock with severe hypotension despite dobutamine. Which therapy should be added next? → Norepinephrine to support blood pressure
20. Which element is ESSENTIAL for effective 'knowledge sharing' within a resuscitation team? → Team members communicating relevant clinical findings and concerns throughout the event
21. What CPR feedback device metric most directly helps rescuers avoid leaning on the chest during CPR? → Chest recoil (baseline) sensor
22. A child post-ROSC has lactic acidosis with a pH of 7.15. What is the MOST appropriate initial management? → Optimize ventilation, oxygenation, and perfusion to clear the lactate
23. What is the goal SpO2 before performing rapid sequence intubation (RSI) in a pediatric patient if clinical conditions permit? → SpO2 greater than 99%
24. In the PALS systematic approach, what is the primary purpose of the tertiary assessment? → To obtain advanced diagnostics and identify underlying etiology
25. Which of the following best describes the mechanism of action of adenosine in terminating SVT? → Transiently blocks AV nodal conduction, interrupting re-entry circuits
26. Which of the following is a key reason epinephrine is given every 3–5 minutes during CPR? → It has a half-life of approximately 2–3 minutes in circulation
27. You are assigned the role of recorder/timer during a pediatric resuscitation. A critical function of your role is to: → Announce when 2-minute cycles of CPR are complete for a rhythm check.
28. Which of the following assessments are considered essential components of the initial evaluation and management in the immediate post-ROSC period? → Obtaining a 12-lead ECG and monitoring blood glucose levels.
29. Which crystalloid solution is preferred for initial fluid resuscitation in pediatric shock per current PALS guidelines? → Lactated Ringer's or normal saline
30. During post-resuscitation care of a child with bradycardia, continuous epinephrine infusion is ordered. What rate range is used in PALS? → 0.01–1 mcg/kg/min