Tachycardia With a Pulse Flashcards
7 cards from real PALS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Tachycardia With a Pulse flashcards as text
A 5-year-old with SVT remains stable. Vagal maneuvers and two doses of adenosine have failed. What is the next recommended treatment?
Answer: Synchronized cardioversion at 1 J/kg with sedation
After two failed adenosine doses, synchronized cardioversion with sedation is the next step for SVT even if still stable.
Which finding on ECG indicates that a synchronized cardioversion shock is delivered correctly?
Answer: Shock fires on the R-wave of the QRS complex
The 'sync' mode delivers the shock on the R-wave to avoid the vulnerable T-wave period and prevent ventricular fibrillation.
Which of the following statements about adenosine administration is CORRECT?
Answer: It must be given as a rapid IV bolus followed immediately by a saline flush
Adenosine has an extremely short half-life (~10 seconds) and must be given as a rapid bolus followed by an immediate saline flush to reach the heart.
A 4-year-old develops a wide-complex tachycardia at 190 bpm with signs of shock. The team is uncertain if this is VT or SVT with aberrancy. What is the correct approach?
Answer: Treat as VT; perform synchronized cardioversion immediately
In an unstable child with wide-complex tachycardia, treat as VT and perform synchronized cardioversion without delaying for diagnostic workup.
Which accessory pathway conduction syndrome is most commonly associated with recurrent SVT in pediatric patients?
Answer: Wolff-Parkinson-White (WPW) syndrome
WPW syndrome, caused by an accessory bundle (Bundle of Kent) bypassing the AV node, is the most common structural cause of SVT in children.
When assessing a child with tachycardia and a pulse, which clinical finding most urgently indicates the need for immediate intervention regardless of rhythm analysis?
Answer: Signs of shock such as hypotension, altered consciousness, and poor perfusion
Hemodynamic instability (shock signs) requires immediate intervention, as the child's condition may rapidly deteriorate without treatment.
After successful cardioversion of SVT in a 2-year-old, which action is most important before leaving the bedside?
Answer: Confirm sinus rhythm on the monitor and assess perfusion
After cardioversion, immediate reassessment of rhythm and perfusion confirms successful conversion and identifies potential re-initiation of SVT.