Free AHA PALS Provider Exam Flashcards

Appearance, work of breathing, and circulation to skin. They form a rapid observational impression before detailed hands-on assessment.

Work of breathing. Retractions and stridor signal increased respiratory effort or upper-airway obstruction even while appearance remains relatively preserved.

An intervention can change the child’s airway, breathing or circulation. Reassessment checks response, identifies the current problem and guides the next action.

No more than 10 seconds while assessing breathing and pulse. If no definite pulse is felt, begin CPR rather than prolonging the check.

Give one breath every 2–3 seconds, about 20–30 breaths per minute, with visible chest rise; reassess pulse and breathing.

Tachycardia and vasoconstriction can preserve pressure temporarily. Abnormal perfusion, mental status, pulses or capillary refill may reveal compensated shock earlier.

A newborn immediately after birth. The 2025 PALS guidance applies to infants and children through age 18 while excluding newborn infants.

Worsening oxygenation or ventilation, reduced effort, altered mental status or apnea indicates failing compensation; a suddenly quiet child may be deteriorating rather than improving.

Stridor, especially on inspiration, points toward upper-airway narrowing; expiratory wheeze commonly reflects lower-airway obstruction. Neither sound alone replaces assessment of severity.

Oxygen can increase inspired concentration but does not reliably move air when ventilation fails. Open the airway and provide effective assisted breaths as needed.

Each breath should produce visible but not excessive chest rise. Reassess the seal, airway position and patient response; avoid rapid or forceful breaths.

Use exhaled carbon dioxide detection, such as waveform capnography or a colorimetric detector, along with clinical assessment; continue monitoring placement.

Activate help and alternate five back blows with five chest thrusts until the object clears or the infant becomes unresponsive. Do not use abdominal thrusts on an infant.

Activate help and alternate five back blows with five abdominal thrusts until the object clears or the child becomes unresponsive. If unresponsive, start CPR and check for a visible object before breaths.

Compensated shock is possible. Normal pressure does not rule out poor perfusion; identify the cause, support oxygenation and reassess frequently.

Septic shock involves dysregulated vascular tone and inflammatory circulatory failure; hypovolemic shock reflects inadequate circulating volume. Both can coexist and both require repeated perfusion assessment.

Give 10-mL/kg or 20-mL/kg aliquots, with reassessment after every bolus for responsiveness and fluid overload. Do not automatically repeat large volumes without examining the child.

Worsening work of breathing, new crackles, hepatomegaly or other evidence of fluid overload calls for reassessment and a different support plan.

Either epinephrine or norepinephrine can be used, chosen for the clinical context with ongoing reassessment and appropriate critical-care support.

The failing pump may worsen with indiscriminate fluid loading; restoring cardiac output often needs tailored inotropic or other specialist-directed support.

Blood products when available, while controlling hemorrhage and treating other reversible traumatic causes. Repeated crystalloid alone does not replace lost blood components.

One rescuer uses 30:2; two rescuers use 15:2. The ratio changes with rescuer count because pediatric ventilation is especially important.

Use 30:2 without an advanced airway after puberty onset; the 15:2 two-rescuer ratio applies before puberty.

Compress at 100–120/min to at least one-third of the chest’s front-to-back depth, allowing full recoil and minimizing interruptions.

Give continuous compressions and about one breath every 2–3 seconds (20–30/min), adjusted to age and physiology; avoid hyperventilation.

Ventricular fibrillation and pulseless ventricular tachycardia are shockable. Asystole and pulseless electrical activity are nonshockable and need CPR, early epinephrine and reversible-cause treatment.

First shock 2 J/kg; second shock 4 J/kg; later shocks at least 4 J/kg, without exceeding 10 J/kg or the adult dose.

Resume high-quality CPR without a prolonged pulse check, then reassess rhythm after about two minutes while addressing vascular access and reversible causes.

As early as possible after recognizing the nonshockable arrest, while CPR and ventilation continue; do not delay it for defibrillation of a nonshockable rhythm.

Prioritize rapid defibrillation and CPR. The 2025 guidance says epinephrine may be given after two defibrillation attempts, or sooner only if rapid defibrillation is not possible.

Amiodarone or lidocaine may be considered after shocks and CPR. Neither replaces defibrillation or treatment of reversible causes.

Start CPR because heart rate is below 60/min with cardiopulmonary compromise despite effective ventilation; obtain IV/IO access and treat the cause.

When increased vagal tone or atrioventricular conduction block is the cause. Hypoxic bradycardia calls first for airway support, oxygenation and effective ventilation.

Those features favor sinus tachycardia, a response to fever or physiologic stress, rather than abrupt fixed-rate SVT. Treat the cause and reassess perfusion.

Perform synchronized cardioversion starting at 0.5–1 J/kg; if unsuccessful, increase to 2 J/kg. Sedation may be considered but must not delay urgent cardioversion.

Titrate oxygen to patient-appropriate normoxemia while avoiding both hypoxemia and unnecessary hyperoxemia; use the child’s physiology and current clinical protocol rather than leaving maximal oxygen indefinitely.

Maintain both systolic and mean arterial blood pressure above the 10th percentile for age, using monitoring and circulatory support as needed.

Treat fever and use continuous central temperature monitoring; the 2025 pediatric guidance recommends avoiding central temperature above 37.5 °C in comatose post-arrest patients.

Sedation, temperature, evolving brain injury and test limitations can mislead early assessment. Use multimodal findings over time with specialist input.

Assess and treat seizures and use electroencephalographic monitoring when available; unrecognized seizures can complicate recovery and neurologic assessment.

Use intraosseous access promptly for resuscitation drugs and fluids rather than delaying time-critical treatment for repeated IV attempts.

Give 0.2 mg, which is 2 mL of 0.1 mg/mL solution (0.01 mg/kg). The arrest algorithm repeats epinephrine about every 3–5 minutes; verify weight and concentration.

First give 0.1 mg/kg rapid IV/IO push (maximum 6 mg) followed by a flush; if needed, repeat at 0.2 mg/kg (maximum 12 mg). Use rhythm monitoring.

Amiodarone 5 mg/kg IV/IO bolus (first-dose maximum 300 mg) or lidocaine 1 mg/kg IV/IO. Follow the arrest algorithm and verify the drug preparation.

Routine use has no established benefit. Bicarbonate is reserved for indications such as hyperkalemia or sodium-channel blocker toxicity; calcium for hypocalcemia, hyperkalemia or calcium-channel blocker overdose.

The leader directs a named person with the drug, dose and route; that person repeats the order; after administration they report completion so the leader can confirm and document it.

Compression rate, depth, recoil, pauses and ventilation coordination; the coach gives immediate feedback so the compressor and airway team can correct performance.

Fatigue can reduce compression quality before it is obvious. Rotate during planned rhythm checks or with minimal interruption, and sooner if quality drops.

State the concern clearly and stop administration, verify the ordered mg dose and vial concentration with the team, then proceed only after correction. Safety concerns override hierarchy.

Pass infant and child BLS skills tests and two PALS core case scenarios—one cardiac and one respiratory or shock—as a team leader or member, showing appropriate treatment and team dynamics.