Tachycardia With a Pulse Flashcards

A 7-year-old with a known history of WPW presents with a wide-complex tachycardia and a pulse. Which drug should be AVOIDED?

Answer: Adenosine

Adenosine can enhance accessory pathway conduction in WPW during wide-complex tachycardia, potentially causing ventricular fibrillation.

What is the maximum single dose of adenosine for treating SVT in a pediatric patient?

Answer: 12 mg

The maximum single dose of adenosine in pediatric PALS is 12 mg, regardless of weight.

An infant presents with a heart rate of 280 bpm, pallor, and cool extremities. Which finding would MOST indicate SVT over sinus tachycardia?

Answer: Absent P-waves with retrograde conduction on ECG

Absent or retrograde P-waves are characteristic of SVT, whereas sinus tachycardia always shows normal P-waves preceding each QRS.

Which of the following is TRUE regarding vagal maneuvers in pediatric SVT?

Answer: Ice water facial immersion is preferred over carotid sinus massage in infants

Ice water facial immersion activates the diving reflex and is the preferred vagal maneuver in infants; carotid massage is reserved for older children.

A 10-year-old with SVT successfully converts with adenosine. Thirty seconds later, the heart rate rises to 230 bpm again. What is the next step?

Answer: Administer a second dose of adenosine at 0.2 mg/kg

Recurrent SVT after adenosine conversion warrants a second adenosine dose at the higher dose of 0.2 mg/kg before escalating therapy.

Which of the following best describes the typical heart rate range for SVT in infants?

Answer: 220–300 bpm

SVT in infants typically presents with heart rates of 220–300 bpm, which is substantially higher than sinus tachycardia.

Amiodarone is ordered for a stable child with wide-complex tachycardia. Over what time frame should the 5 mg/kg dose be infused?

Answer: 20–60 minutes

Amiodarone 5 mg/kg for stable tachycardia is infused over 20–60 minutes to minimize hypotension and bradycardia.