PALS Megacode Scenario Simulations on VFib

The PALS megacode simulation covers Ventricular Fibrillation (VFib) and immerses participants in high-stakes scenarios.This hands-on training focuses on recognizing VFib and executing effective CPR and defibrillation protocols. Participants practice teamwork, communication, and critical thinking under pressure. Participate and experience this lifelike simulation to boost your confidence and readiness for real-life emergencies!

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1

What is the next immediate step?

A 6-year-old child collapses at a park. Bystanders call for help, and you arrive as part of the resuscitation team. The child is unresponsive, and the monitor shows a chaotic, irregular rhythm with no pulse.

Hint: Epinephrine 0.01mg/kg every 3-5 minutes is the only appropriate and initial medication in this scenario.
2

What is the first shock energy dose for defibrillation in this child?

A 10-year-old boy collapses during a basketball game. His coach begins CPR, and the emergency team arrives to find VFib on the monitor.

Hint: In VFib, the second dose is 4 joules/kg.
3

What is the recommended medication to administer?

A child in VFib receives the first defibrillation shock, but the rhythm remains unchanged. You continue CPR.

Hint: Consider medications that stimulate heart function during resuscitation.
4

Which medication should be given next to attempt rhythm control?

A 7-year-old child is brought to the ER in VFib arrest. After two defibrillation attempts, the rhythm persists, and CPR is ongoing. Two doses of epinephrine have already been administered.

Hint: Antiarrhythmic medications are used after defibrillation attempts fail.
5

What should be the energy dose for the second defibrillation attempt?

During a PALS code, a child in VFib has already received one dose of epinephrine and a shock. The team prepares for the next defibrillation.

Hint: 2 joules/kg is the first energy shock for defibrillation.
6

Which of the following actions should be performed immediately after defibrillation?

A 9-year-old with no known medical history collapses at home. Upon arrival, the paramedics find the child in VFib and initiate CPR.

Hint: Medication administration is not performed immediately following defibrillation.
7

What is the next recommended antiarrhythmic drug to administer?

A child in VFib has received multiple shocks and epinephrine, but the rhythm persists. CPR is ongoing, and the team considers additional treatments.

Hint: When VFib is refractory, alternative antiarrhythmics can be considered.
8

What other reversible cause should be investigated during this arrest?

A 5-year-old child is in VFib. CPR is in progress, and the team has delivered two shocks and administered epinephrine and amiodarone. The child remains unresponsive with VFib on the monitor.

Hint: Consider electrolyte imbalances during cardiac arrest.
9

What is the recommended dose of amiodarone for this child in VFib?

A 4-year-old child is found in VFib during a resuscitation effort. After several rounds of CPR, defibrillation, and epinephrine, the rhythm remains unchanged. The team prepares to administer amiodarone.

Hint: 0.01 mg/kg is the recommended dose of epinephrine.
10

Which of the following actions might improve the chances of converting VFib?

A 6-year-old child is being resuscitated in VFib. After multiple shocks and medication doses, the team is still struggling to convert the rhythm.

Hint: Refractory VFib sometimes requires utilization of the defibrillator in a different manner.

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