PALS Megacode Scenario Simulations on Wide Complex Tachycardia (Practice Paper)

The PALS Wide Complex Tachycardia Practice Paper provides essential guidelines for the identification and management of complex tachycardia in pediatric patients. The paper outlines appropriate interventions, including pharmacological treatments and the use of cardioversion. By following these protocols, you can enhance their skills in managing this critical condition effectively.

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What is the most appropriate initial step in management?

A 4-year-old child presents in the emergency department with a heart rate of 210 bpm and shows signs of fatigue and irritability.

Hint: In pediatric emergencies, prioritizing airway and breathing can significantly affect outcomes.

AAdminister atropine
BStart CPR immediately
CAssess airway and breathing
DPrepare for synchronized cardioversion

What should be your first intervention?

During a simulation, a 10-year-old patient is found to be conscious but in complex tachycardia with a blood pressure of 90/50 mmHg.

Hint: This supports circulation in cases of hypotension

A Begin chest compressions
BAdminister IV fluids
CPrepare for immediate defibrillation
DProvide high-flow oxygen

Which medication is most commonly used for pharmacological management?

A pediatric patient is diagnosed with complex tachycardia due to underlying structural heart disease.

Hint: This medication is often used for its antiarrhythmic properties.

AAdenosine
B Amiodarone
CDigoxin
DEpinephrine

What symptom is most concerning that may indicate the need for immediate intervention?

You are caring for a 6-year-old who is experiencing episodes of complex tachycardia.

Hint: Pay attention to symptoms that may suggest inadequate blood flow.

AMild fever
B Increased thirst
C Dizziness and fainting
DMild abdominal pain

What monitoring is essential in this scenario?

A 3-year-old is brought to the ER with complex tachycardia and is found to be stable.

Hint: Keeping track of heart rhythm is critical in managing tachycardia

ADaily blood tests
BContinuous ECG monitoring
COral hydration assessment
DRegular temperature checks

Which additional assessment is crucial in this case?

A child with a history of congenital heart disease presents with complex tachycardia and respiratory distress.

Hint: This imaging can reveal underlying complications related to the heart or lungs.

ANeurological examination
BChest X-ray
CUrinalysis
D Skin assessment

What is the priority intervention after calling for additional help?

During a training session, a nurse encounters a 9-year-old in complex tachycardia who is unconscious. The patient does not have a pulse.

Hint: Although early defibrillation is key to survival, another intervention is more crucial at this time.

AAdminister a loading dose of amiodarone
B Initiate high-quality CPR
CComplete head to toe assessment
D Look for a defibrillator

Which underlying mechanism might explain her condition?

A 12-year-old girl is diagnosed with complex tachycardia after a viral infection.

Hint: Viral infections do not directly cause electrolyte imbalances.

A Electrolyte imbalance
B Structural heart defect
C Inflammatory response
DGenetic predisposition

what would be the most appropriate next step?

A 5-year-old is found to have a narrow complex tachycardia on the monitor. After initial assessments,

Hint: Atropine is indicated for bradycardia, not tachyarrhythmias.

A Start IV antiarrhythmics
B Synchronized cardioversion
CAdminister atropine
DObserve for 30 minutes

What is the best course of action?

A caregiver reports that their child experiences frequent palpitations and has a family history of sudden cardiac events.

Hint: Family history can indicate potential underlying risks. Follow up in a week is not appropriate.

A Schedule a follow-up in a week
BRefer for a cardiac evaluation
C Start home monitoring
D Provide reassurance and educate

PALS Megacode Scenario Simulations on Wide Complex Tachycardia (Practice Paper)

Hurry, don’t let time run out! 5 mins 00 secs

Good try!

Congrats

What is the most appropriate initial step in management?

What should be your first intervention?

Which medication is most commonly used for pharmacological management?

What symptom is most concerning that may indicate the need for immediate intervention?

What monitoring is essential in this scenario?

Which additional assessment is crucial in this case?

What is the priority intervention after calling for additional help?

Which underlying mechanism might explain her condition?

what would be the most appropriate next step?

What is the best course of action?

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