An 11 year old male is in 100 degree temperatures and has been drinking caffeinated soft drinks. He complains of palpitations. The cardiac monitor displays a narrow-QRS tachycardia at a rate of 160 beats/minute. Vital signs are BP 110/60, P 160, R 20. What should you do?

Get ready for the Paramedic Readiness Exam 5. Study with multiple-choice questions, detailed explanations, and effective strategies. Enhance your exam preparedness today!

Multiple Choice

An 11 year old male is in 100 degree temperatures and has been drinking caffeinated soft drinks. He complains of palpitations. The cardiac monitor displays a narrow-QRS tachycardia at a rate of 160 beats/minute. Vital signs are BP 110/60, P 160, R 20. What should you do?

The situation tests how you manage a stable pediatric tachycardia with a likely reversible cause. When a child presents with a narrow complex tachycardia but remains hemodynamically stable, the priority is supportive care and addressing factors that can drive or worsen the rhythm—especially dehydration and heat exposure. This patient is hot, possibly dehydrated, and has been drinking caffeinated drinks. Although the rhythm is fast (160 bpm) and the heart rate is high, his blood pressure is adequate and there are no signs of poor perfusion. The best initial step is to transport promptly with continuous monitoring and provide fluids to correct dehydration and help reduce the sympathetic drive contributing to the tachycardia. Administering fluids en route helps improve preload, supports perfusion, and can help stabilize the rhythm while you reach definitive care. Continuous monitoring allows you to detect any signs of deterioration early. Electrical or drug conversion (like adenosine) is more appropriate if the child becomes unstable or if rhythm management fails to respond to initial supportive care. Frantic rescue breaths are not indicated because the patient is ventilating adequately and the issue is a rhythm disturbance, not a respiratory arrest. If the patient worsens (hypotension, altered mental status, signs of shock) or the tachycardia persists despite fluids, escalate per protocol with advanced options.

The situation tests how you manage a stable pediatric tachycardia with a likely reversible cause. When a child presents with a narrow complex tachycardia but remains hemodynamically stable, the priority is supportive care and addressing factors that can drive or worsen the rhythm—especially dehydration and heat exposure.

This patient is hot, possibly dehydrated, and has been drinking caffeinated drinks. Although the rhythm is fast (160 bpm) and the heart rate is high, his blood pressure is adequate and there are no signs of poor perfusion. The best initial step is to transport promptly with continuous monitoring and provide fluids to correct dehydration and help reduce the sympathetic drive contributing to the tachycardia. Administering fluids en route helps improve preload, supports perfusion, and can help stabilize the rhythm while you reach definitive care. Continuous monitoring allows you to detect any signs of deterioration early.

Electrical or drug conversion (like adenosine) is more appropriate if the child becomes unstable or if rhythm management fails to respond to initial supportive care. Frantic rescue breaths are not indicated because the patient is ventilating adequately and the issue is a rhythm disturbance, not a respiratory arrest.

If the patient worsens (hypotension, altered mental status, signs of shock) or the tachycardia persists despite fluids, escalate per protocol with advanced options.

More practice questions