PALS Megacode Scenario 5

You are working in the pediatric emergency department when a mother brings her 6-year-old daughter into the ED. She reports that the child has a history of asthma. The child’s breathing is rapid and shallow. 

You take vital signs and note that the child’s heart rate is 124 bpm, her respiratory rate is 28 breaths per minute, and her SpO₂ is 92%.

1. The correct order of assessment for this child is:

2. Based on your training in PALS, the subsequent intervention for this child should be to:

3. At this point, you should:

You note that the child has expiratory wheezing and a prolonged expiratory phase during your assessment. 

4. You suspect:

The cardiac monitor shows this rhythm:

5. You recognize this rhythm as:

You connect it to the end-tidal CO₂ monitor and note this waveform

6. At this point, the capnography waveform indicates:

7. The subsequent intervention appropriate for this child is:

You look at the cardiac monitor and see this rhythm:

8. You recognize this rhythm as:

9. Your next intervention is to:

10. The signs and symptoms that indicate that the child is moving toward respiratory failure include:

11. The correct size of ET tube for this 6-year-old child would be: