PALS

umcRN, BSN, RN · Mar 30, 2013

We were not allowed to reference anything during the exams (written and skills) but we were all ICU/ER nurses taking the course and familiar with the meds. What kind of experience do you have? You should at least know the drugs in the algorithms though the written test might ask you for others, I can't remember. At minimum you should know all the doses for Epi (IV, ETT & IO) as well as adenosine and lidocaine

brithoover · Mar 30, 2013

In my class we could reference our pocket card for the skills part. Written test was not open book

Pediatric Critical Care Columnist · Mar 30, 2013

Pocket cards are allowed for the skills testing but that's all. Memorize the Big Six... epi, amiodarone, adenosine, calcium chloride, sodium bicarbonate and dextrose. The others may be on the exam but more likely as "select the drug of choice for...." rather than doses.

alr25 · Mar 31, 2013

Thank you so much!

Music in My Heart · Mar 31, 2013

Hi everyone,
I'm taking PALS this month and I'm seeking some clarification about the pharmacology that we need to know for the class. There are 28 drugs on the list provided by AHA most with IV/IO and ET dosages. Do we need to know the dosages for ALL of these drugs or just the main ones in the algorithms (e.g. epi, adenosine, amiodarone, dopamine, dobutamine, etc.). Are we allowed to reference our medication list or does this depend on the instructor?
Thank you for your help!

Each time I've taken PALS, we've used Broslow tapes as part of our megacodes so the doses are worked out right there.

I wouldn't worry at all about ET doses because nearly everybody's got IO devices of some sort or other and ET absorption is highly variable.

umcRN, BSN, RN · Mar 31, 2013

Each time I've taken PALS, we've used Broslow tapes as part of our megacodes so the doses are worked out right there.
I wouldn't worry at all about ET doses because nearly everybody's got IO devices of some sort or other and ET absorption is highly variable.

My first real life code...ett epi. It was horrid :speechless:

But you're right, not as likely during pals

Music in My Heart · Apr 1, 2013

Why would they ETT epi instead of going IO? You can even IO with a 14 ga angiocath needle.

umcRN, BSN, RN · Apr 1, 2013

Why would they ETT epi instead of going IO? You can even IO with a 14 ga angiocath needle.

Kid was ready to be transferred to the floor when they coded. Had a PIV in the foot that went bad after one dose of epi and a fluid bolus. Placed two IO's. They were being "manned" by the doc who said they weren't good, we gave fluid through them then stopped using them. I asked over and over in my pals courses what would make an IO "bad" but the answers didn't make sense in the situation. Maybe the doc didn't know what an IO was supposed to feel like (though doubtful since he's been an ICU attending for years and this was in an ICU). I don't know. In any case we gave ETT epi till we had the kids chest cracked and on ecmo (post cardiac surgery kiddo), all our ecmo meds were given once on pump and I only hope the child was far enough gone to have not been able to feel the pain of the scalpel and rib spreader. The child passed away a few days later - herniated.

Music in My Heart · Apr 1, 2013

Badness all the way around :-(