PALS Megacode Scenario 10
By Gina Maria Jansheski, MD | Medically reviewed by Lisa Wright, MHA, RRT-NPS on January 4, 2025
Quiz Summary
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Question 1 of 8
1. Question
You are an emergency department physician trained in Pediatric Advanced Life Support.You are working in the pediatric emergency department when a mother brings her 10-year-old son into the ED. The child states his heart is “beating really fast.” The mother denies any history of cardiac problems. She states the boy has been confused in the car ride to the hospital. A nurse takes vital signs.
The pulse is palpable but weak at a rate of 180 bpm, blood pressure is 84/62 mmHg, and respiratory rate is 28 bpm. The child’s SpO2 is 89%. You start oxygen at 100% via a non-rebreather mask.
You ask a nurse to start an IV while you attach the child to a cardiac monitor. You see this rhythm.
You measure the QRS duration and note that it is 0.16 seconds.
1. You recognize this rhythm as:
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Question 2 of 8
2. Question
You identify that the rhythm is ventricular tachycardia. The boy’s blood pressure is 74/60 mmHg, and he is lethargic.His pulse is still palpable at 180 bpm.
2. You determine that the child is:
CorrectIncorrect -
Question 3 of 8
3. Question
3. At this point, you should:
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Question 4 of 8
4. Question
You immediately begin to prepare for synchronized cardioversion. Since the child is unstable, you do not delay synchronized cardioversion to administer sedation to the child.4. The correct initial dose for this child is:
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Question 5 of 8
5. Question
As you watch the monitor following the synchronized cardioversion, you see this rhythm:
5. You recognize this rhythm as:CorrectIncorrect -
Question 6 of 8
6. Question
The nurse has established an IV in the child’s left arm.6. The appropriate next step is to:
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Question 7 of 8
7. Question
7. The correct second energy dose for this child is:
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Question 8 of 8
8. Question
After the second synchronized cardioversion, you look at the monitor and see this rhythm:
The child has a strong, palpable pulse with the rhythm.
8. Your next intervention is to:
CorrectIncorrect
PALS Megacode Scenario 10 Video
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