Podcast
Questions and Answers
What is the initial impression of the PALS systematic approach algorithm?
What is the initial impression of the PALS systematic approach algorithm?
Appearance, Breathing, Color
Is the child __________ or is immediate __________ needed?
Is the child __________ or is immediate __________ needed?
unresponsive, intervention
What is the next step if the child is determined to be unresponsive or immediate intervention is needed?
What is the next step if the child is determined to be unresponsive or immediate intervention is needed?
Activate emergency response
After the emergency response is activated, what is the next intervention?
After the emergency response is activated, what is the next intervention?
What should be done after it is determined that the child has no pulse?
What should be done after it is determined that the child has no pulse?
What should you do if a child is unresponsive, not breathing, and has a pulse?
What should you do if a child is unresponsive, not breathing, and has a pulse?
What is the next intervention if a child has a pulse less than 60/min and shows signs of poor perfusion?
What is the next intervention if a child has a pulse less than 60/min and shows signs of poor perfusion?
What are the three actions in the right branch of the PALS systematic approach algorithm?
What are the three actions in the right branch of the PALS systematic approach algorithm?
What clinical assessment tools are used in the evaluate portion of the evaluate-identify-intervene sequence?
What clinical assessment tools are used in the evaluate portion of the evaluate-identify-intervene sequence?
The sequence of evaluate-identify-intervene should be used before and after each intervention and should continue until the child is stable.
The sequence of evaluate-identify-intervene should be used before and after each intervention and should continue until the child is stable.
A consistent respiratory rate less than 10 or more than _____ breaths per minute in a child of any age is abnormal.
A consistent respiratory rate less than 10 or more than _____ breaths per minute in a child of any age is abnormal.
The primary objective of the airway assessment in the ABCDE model is to assess airway _________.
The primary objective of the airway assessment in the ABCDE model is to assess airway _________.
What does ABCDE stand for in the primary assessment?
What does ABCDE stand for in the primary assessment?
What are some simple measures for maintaining airway patency?
What are some simple measures for maintaining airway patency?
Select the non-respiratory causes of tachypnea.
Select the non-respiratory causes of tachypnea.
What does Assessment of Breathing include?
What does Assessment of Breathing include?
Stridor is a sign of lower airway problem.
Stridor is a sign of lower airway problem.
Grunting is often a sign of lung tissue disease resulting from small airway collapse.
Grunting is often a sign of lung tissue disease resulting from small airway collapse.
What are the descriptions of Stridor, Grunting, Gurgling, Wheezing, and Crackles?
What are the descriptions of Stridor, Grunting, Gurgling, Wheezing, and Crackles?
An oxygen saturation of ≥ _____% usually indicates adequate oxygenation.
An oxygen saturation of ≥ _____% usually indicates adequate oxygenation.
What are indirect indicators of circulatory status?
What are indirect indicators of circulatory status?
What is the most common cause of bradycardia in children?
What is the most common cause of bradycardia in children?
Tachycardia is a normal physiologic response in the critically ill child?
Tachycardia is a normal physiologic response in the critically ill child?
An observed decrease in systolic blood pressure of ________ mm Hg from baseline should prompt evaluation for signs of shock.
An observed decrease in systolic blood pressure of ________ mm Hg from baseline should prompt evaluation for signs of shock.
In healthy children, the heart rate __________ with inspiration and __________ with expiration.
In healthy children, the heart rate __________ with inspiration and __________ with expiration.
When assessing circulation, it is only necessary to assess the central pulses.
When assessing circulation, it is only necessary to assess the central pulses.
What is a common cause of vasoconstriction and a discrepancy between the peripheral and central pulses in children?
What is a common cause of vasoconstriction and a discrepancy between the peripheral and central pulses in children?
Normal capillary refill time in children is ___________.
Normal capillary refill time in children is ___________.
What are the definitions of Pallor, Mottling, Cyanosis, Acrocyanosis, and Peripheral cyanosis?
What are the definitions of Pallor, Mottling, Cyanosis, Acrocyanosis, and Peripheral cyanosis?
A low hemoglobin (anemia) may make it harder to detect cyanosis in a critically ill child.
A low hemoglobin (anemia) may make it harder to detect cyanosis in a critically ill child.
What is the quick evaluation of neurologic function known as?
What is the quick evaluation of neurologic function known as?
What signs may be present with sudden and severe cerebral hypoxia?
What signs may be present with sudden and severe cerebral hypoxia?
When cerebral hypoxia develops more gradually, the neurologic signs are the same as when severe cerebral hypoxia develops suddenly.
When cerebral hypoxia develops more gradually, the neurologic signs are the same as when severe cerebral hypoxia develops suddenly.
What does the AVPU scale evaluate?
What does the AVPU scale evaluate?
The child's best responses in the Glasgow coma scale are scored on the _____________ response.
The child's best responses in the Glasgow coma scale are scored on the _____________ response.
Pupil response to light is an indicator of ______________ function.
Pupil response to light is an indicator of ______________ function.
What standard evaluations are included in the disability assessment?
What standard evaluations are included in the disability assessment?
The E of the ABCDE primary assessment acronym stands for: ____________.
The E of the ABCDE primary assessment acronym stands for: ____________.
What does the secondary assessment consist of?
What does the secondary assessment consist of?
What is the primary diagnostic test for assessing the severity of respiratory problems?
What is the primary diagnostic test for assessing the severity of respiratory problems?
Within the evaluate-identify-intervene sequence, there are three clinical assessments: primary assessment, secondary assessment, and _________ tests.
Within the evaluate-identify-intervene sequence, there are three clinical assessments: primary assessment, secondary assessment, and _________ tests.
What do the following abbreviations stand for: pH, PaO₂, PaCO₂, HCO₃, SaO₂?
What do the following abbreviations stand for: pH, PaO₂, PaCO₂, HCO₃, SaO₂?
Hemoglobin concentration determines the oxygen carrying capacity of the blood.
Hemoglobin concentration determines the oxygen carrying capacity of the blood.
In the seriously ill or injured child, the arterial lactate level can __________ as a result of tissue hypoxia.
In the seriously ill or injured child, the arterial lactate level can __________ as a result of tissue hypoxia.
Study Notes
PALS Systematic Approach Algorithm Overview
- Initial impression involves assessing appearance, breathing, and color.
- Determine if the child is unresponsive or needs immediate intervention.
- If unresponsive, activate emergency response.
Emergency Response Steps
- After activating emergency response, check for breathing and pulse.
- Begin CPR if no pulse is found.
- If a pulse is present, open the airway and provide ventilation and oxygen.
Evaluate-Identify-Intervene Sequence
- Right branch involves three actions: evaluate, identify, intervene.
- Evaluation includes diagnostic tests, primary assessment, and secondary assessment.
- Primary assessment utilizes ABCDE model (airway, breathing, circulation, disability, exposure).
Respiratory Assessment
- Consistent respiratory rate < 10 or > 60 breaths/min is abnormal.
- Airway assessment's primary objective is to ensure airway patency.
- Simple airway maintenance techniques include head tilt-chin lift and jaw thrust.
Vital Signs and Indicators
- Oxygen saturation ≥ 94% indicates adequate oxygenation.
- Direct indicators of circulatory status include heart rate, pulses, capillary refill, skin color, and blood pressure.
- Indirect indicators are urine output and level of consciousness.
Circulatory Status
- Common cause of bradycardia in children is hypoxia.
- Tachycardia is a normal physiological response in critically ill children.
- Capillary refill time in children should be ≤ 2 seconds.
Neurological Assessment
- Disability section evaluates neurologic function using the AVPU scale (Alert, Voice, Painful, Unresponsive).
- Glasgow coma scale primarily assesses motor responses.
- Pupil response to light indicates brainstem function.
Condition Indicators
- Sudden severe cerebral hypoxia may present with decreased LOC, loss of muscular tone, seizures, and pupil dilation.
- Signs of respiratory distress include stridor (upper airway) and grunting (lung tissue disease).
Blood Gas Values
- pH indicates acid-base balance; PaO₂ measures oxygenation; PaCO₂ assesses ventilation adequacy.
- HCO₃ helps determine the source of an acid-base disturbance.
- Hemoglobin concentration affects the blood's oxygen-carrying capacity.
Emergency Procedures
- After the primary assessment, secondary assessment involves focused history and physical exam.
- Diagnostic tests, like arterial blood gas, evaluate respiratory problem severity.
- If systolic BP drops by 10 mm Hg from baseline, further evaluation is necessary.
Common Misconceptions
- Grunting indicates lung tissue disease, while stridor signals upper airway problems.
- A low hemoglobin level can complicate cyanosis detection.
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Description
Test your knowledge on the PALS systematic approach algorithm through these flashcards. Each card challenges you to recall key characteristics and decisions involved in pediatric assessments. Perfect for medical students and professionals looking to sharpen their skills.
