PALS Megacode Scenario 2


  1. Cindy South-McCracken says

    Hi. Just checking to see if you will be updating the Peds section to the 2020 guidelines soon? I don’t see the page numbers corresponding to the answers of the questions on this end. Also do you have anything for Prehospital Trauma or Peds (more outside of hospital–for paramedic)?

    • ACLS says

      ACLS is complete and up to date and I’m now working to gets all of the reference page numbers and changes in PALS updated. I hope to be complete in the next 60 days.

      I do not have any strictly out of hospital training.

      Kind regards,

  2. Carol RAmos says

    this website of PALS review is much clearer and easy to understand.I hope you will provide more scenarios that will help us to learn and manage the treatments for each cases. Thank you very much.

  3. Fred Bozeman says

    I probably would have recommended BiPAP earlier but I question mag. PEEP, bronchodilator, and steroids are working. Isn’t the choice of magnesium more for refractory bronchospasms. Also, living in the Rocky Mountains, I wouldn’t be alarms by a SpO2 less than 94% even for an adolescent.

  4. Alan Mclean says

    Hi Jeff, I think that the wording of this question leads to the correct answer being “provide oxygen” rather than “all of the above”
    [1]we have already established that the problem is a lower respiratory obstruction so really at this point there is NOTHING you can do for the airway and
    [2]this patient is fully self ventilating. “Supporting the ventilation” means either providing BMV or ventilating with a LMA or ETT etc: and at this point, in this patient, this is entirely the wrong management
    Airway and ventilation support may be needed later but at this point assess, give oxygen and try to relieve the bronchospasm if that is the problem

    • ACLS says

      I understand what you’re saying with regard to the scenario, however, these scenarios are designed to help the learner apply the systematic approach algorithm to each situation. Within the systematic approach algorithm, all of the interventions are necessary as you initiate support for the critically ill child. Kind regards, Jeff

  5. Sonny Yates says

    I certainly agree that intubation is out of the realm but bibap/cpap. Pretty simple to do and seems there would not be anything wrong with that in this scenario. That’s actually a question not a statement.

    • Jeff with admin. says

      This is covered later on in the scenario.

      The least invasive measures should be attempted prior to using more invasive measures such as BiPAP or CPAP.

      Oxygen via non-rebreathing mask is quite often effective with asthmatic patient while the airway is treated with bronchodilators and systemic corticosteroids initiated.

      Kind regards,

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