AHA PALS Provider flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Pediatric Assessment Triangle components

Appearance, work of breathing, and circulation to skin; used in the first seconds to identify respiratory, circulatory, or neurologic emergencies.

Respiratory distress versus failure

Distress shows increased work of breathing with preserved ventilation; failure includes hypoxemia, apnea, bradycardia, cyanosis, or altered mentation and requires immediate assisted ventilation.

Pediatric hypotension thresholds

Systolic hypotension is <60 mm Hg in neonates, <70 in infants 1-12 months, <70 plus twice age in children 1-10 years, and <90 in children over 10.

Compensated shock signs

Tachycardia, cool extremities, delayed capillary refill, weak pulses, and narrow pulse pressure occur while blood pressure remains normal; hypotension is a late and decompensated sign.

Anaphylaxis first-line treatment

Give intramuscular epinephrine 0.01 mg/kg of the 1 mg/mL concentration, maximum 0.3-0.5 mg, into the anterolateral thigh, then support airway, oxygen, and fluids.

Septic shock fluid bolus

Give isotonic crystalloid 10-20 mL/kg over 5-20 minutes and reassess for improvement or fluid overload; repeated boluses may be needed, but hypotension is not required to treat shock.

Foreign body airway obstruction

For ineffective cough, start CPR; conscious infant gets 5 back slaps then 5 chest thrusts, while a conscious child gets abdominal thrusts, repeating until the object is expelled.

Croup severe treatment

Nebulized epinephrine treats severe croup with stridor at rest or retractions, while dexamethasone reduces airway edema; observe for recurrence after epinephrine because symptoms can rebound.

Two-person bag-mask ventilation

One rescuer holds the mask with two hands and lifts the jaw; the other squeezes the bag enough to produce visible chest rise while avoiding excessive volume or gastric inflation.

Compression-to-ventilation ratios

For pediatric cardiac arrest without an advanced airway, use 30:2 with one rescuer and 15:2 with two rescuers; switch compressors about every 2 minutes to limit fatigue.

Advanced airway ventilation rate

During infant or child CPR with an advanced airway, give one breath every 2-3 seconds, which is 20-30 breaths per minute, without pausing compressions for ventilation.

Cuffed endotracheal tube size

For children older than 1 year, choose a cuffed tube size of 3.5 plus age in years divided by 4, then verify fit and leak before securing.

End-tidal CO2 confirmation

Continuous waveform capnography confirms endotracheal tube placement and detects dislodgment; a sudden loss of waveform suggests tube displacement, obstruction, or absent pulmonary blood flow.

Avoiding hyperventilation

Excessive rate or volume lowers carbon dioxide, raises intrathoracic pressure, reduces venous return, and can worsen cerebral perfusion; give only enough ventilation for visible chest rise.

Tidal volume with advanced airway

Deliver about 6-7 mL/kg per breath and watch for visible chest rise; larger volumes increase the risk of barotrauma, gastric inflation, and hemodynamic compromise.

Shockable arrest sequence

For ventricular fibrillation or pulseless ventricular tachycardia, deliver a shock immediately, then resume CPR for 2 minutes; give epinephrine after the second shock and an antiarrhythmic if refractory.

Pediatric defibrillation energy

Use 2 J/kg for the first shock, 4 J/kg for the second, and at least 4 J/kg for later shocks, up to 10 J/kg or the adult maximum dose.

Synchronized cardioversion energy

For unstable tachyarrhythmia with a pulse, start synchronized cardioversion at 0.5-1 J/kg; if unsuccessful, increase to 2 J/kg and consider sedation if the child is awake.

Bradycardia with poor perfusion

If heart rate is below 60 per minute with poor perfusion despite oxygenation and ventilation, start CPR; give epinephrine and consider atropine for vagal tone or primary AV block.

Adenosine dosing for SVT

Give 0.1 mg/kg rapid IV/IO push, maximum 6 mg, followed by a saline flush; a second dose of 0.2 mg/kg, maximum 12 mg, may be given.

Torsades de pointes treatment

For polymorphic ventricular tachycardia with prolonged QT, give magnesium 25-50 mg/kg IV/IO, remove offending drugs, correct electrolytes, and consider overdrive pacing or defibrillation if unstable.

AED use in children

Use an AED as soon as available; for infants and children under 8 years or about 25 kg, use a pediatric dose attenuator if available, otherwise use the standard adult pads.

Cardiac arrest epinephrine dose

Give 0.01 mg/kg (0.1 mL/kg of 1:10,000) IV/IO, maximum 1 mg, every 3-5 minutes during pediatric cardiac arrest; flush the line after each dose.

Amiodarone for VF or pVT

Give 5 mg/kg IV/IO bolus, maximum 300 mg, for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia; it may be repeated for recurrent or refractory arrhythmia.

Atropine dose for bradycardia

Give 0.02 mg/kg IV/IO, with a minimum of 0.1 mg and maximum of 0.5 mg in a child or 1 mg in an adolescent; repeat once if needed.

Naloxone for opioid toxicity

Give 0.1 mg/kg IV/IO/IM/SC, maximum 2 mg, for opioid-induced respiratory depression; repeat every 2-3 minutes as needed and support ventilation because effects may wear off.

Hypoglycemia dextrose dosing

Treat with 0.5-1 g/kg of dextrose; use D10 at 5-10 mL/kg in children, and recheck blood glucose because extravasation of concentrated dextrose can cause tissue injury.

Inodilator for shock

For fluid-refractory shock with adequate blood pressure but poor perfusion, consider an inodilator such as milrinone; monitor for hypotension and adjust vasoactive infusions to perfusion goals.

Post-arrest oxygen target

Titrate inspired oxygen to keep SpO2 between 94% and 99% after return of circulation, avoiding both hypoxemia and unnecessary hyperoxia while continuing to monitor ventilation.

Targeted temperature management

For comatose children after cardiac arrest, consider targeted temperature management at 32-34°C for 24 hours, then slow rewarming, and prevent fever afterward.

Closed-loop communication

The team leader gives a clear order to a named person, who repeats it back; the leader confirms understanding, reducing errors during resuscitation and clarifying who is responsible.

High-quality pediatric compressions

Compress at 100-120 per minute to at least one third of chest depth, about 4 cm in infants and 5 cm in children, allowing full recoil and minimizing interruptions.