PALS prehospital cardiac scenario


The quiz
You are called to the house of a 9-year-old male with complaints of lethargy and heart racing. You arrive and find your patient lying supine on the couch. When you talk to him, you note that he is obviously confused. His mother says this happened suddenly. He was complaining that his heart was racing and then he started acting strange. You take vital signs and his pulse is too fast to count. His blood pressure is 68/50 respiratory rate is 36/min. His Spo2 is 92% on room air. His mother tells you he weighs about 50kg. You perform an ECG and it reveals the following:


about 3–5 minutes

Question 1 of 5

This patient's rhythm is:
Quiz question

Question 2 of 5

Given the patient’s presentation; is this patient stable or unstable?

Question 3 of 5

The first intervention for this patient would be:

Question 4 of 5

An IV is established easily and quickly. Your next action would be:

Question 5 of 5

Following administration of adenosine, nothing happens, and the patient’s level of consciousness is quickly getting worse. Your next action would be;

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The quiz

Correct answers

  • Supraventricular tachycardia
  • Unstable because of blood pressure and altered level of consciousness
  • Oxygen 100% via non rebreather
  • Administer adenosine 0.1mg/kg (max 6mg) IV rapid bolus followed by a saline flush.
  • Perform synchronized cardioversion at 0.5 to 1 Joules per kg.

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