PALS Megacode Scenario Simulations on Sinus Tachycardia & SVT (Megacode Practice Paper)

Sinus tachycardia and supraventricular tachycardia (SVT) are two prevalent conditions that pediatric advanced life support (PALS) providers frequently encounter. This practice paper aims to explore the underlying mechanisms, clinical presentations, and management strategies for sinus tachycardia and SVT in pediatric patients. Solve the case scenarios to get the knowledge and skills required to assess and respond to these critical cardiac conditions effectively.

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1

What is the most likely diagnosis?

A 7-year-old presents to the emergency department with a heart rate of 180 bpm. The child is anxious but stable with normal blood pressure.

Hint: A heart rate of 180 bpm indicates a tachyarrhythmia.
2

What is the best initial treatment?

A 5-year-old is brought in with a sudden onset of palpitations and chest pain. An ECG reveals a narrow complex tachycardia at 220 bpm.

Hint: Think about non-invasive interventions to help slow the heart rate.
3

what is the most appropriate immediate action?

 A 3-year-old with a heart rate of 210 bpm is diaphoretic and lethargic. After initial assessment,

Hint: CPR is not indicated yet as the scenario does not state the patient does not have a pulse.
4

Which is NOT a critical piece of information you should gather initially regarding the patient's medical history?

 You are assessing a 10-year-old patient diagnosed with SVT.

Hint: Family history and Tachycardia history are both crucial to a patient's medical history.
5

What treatment should be prioritized in this case?

A 4-year-old is experiencing tachycardia due to a fever.

Hint: Consider the intervention that will not only help resolve the tachycardia but also prevent reoccurrence.
6

What is an essential point to communicate regarding potential triggers?

You are preparing to educate parents about SVT in their child.

Hint: Reflect on common dietary and environmental factors that can increase heart rate.
7

Which vital sign should you monitor closely to ensure patient safety?

A pediatric patient with known sinus tachycardia has been stable for several hours.

Hint: Think about the relationship between heart rate and perfusion.
8

What diagnostic tool is most useful for confirming the diagnosis?

A 6-year-old is admitted for evaluation of recurrent SVT.

Hint: Although an echocardiogram can provide critical information regarding a heart's function, it does not provide a cardiac rhythm..
9

What is the most appropriate intervention?

A 9-year-old presents with a heart rate of 240 bpm and is feeling dizzy. The ECG demonstrates SVT and the nurse confirms the patient has a pulse.

Hint: Defibrillation is not indicated as the patient has a pulse.
10

What should you do first?

During a routine examination, you discover a child has a resting heart rate of 150 bpm.

Hint: A chest x-ray would provide information on underlying pulmonary issues, not cardiac.

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