During PALS resuscitation of a pulseless child, after two minutes of CPR the rhythm check shows pulseless electrical activity (PEA). Which of the following reversible causes (Hs and Ts) is MOST common in the paediatric age group?

• A Tension pneumothorax
• B Hypothermia
• C Thromboembolism
• D Hypoxia ✓

Explanation

In children, cardiac arrest is most commonly preceded by respiratory failure, making hypoxia the predominant reversible cause of pulseless electrical activity. Paediatric arrest is primarily asphyxial, unlike adults where primary cardiac arrhythmia is more common. Tension pneumothorax is important but less frequent. Hypothermia and thromboembolism are rare paediatric causes of PEA. Ensuring effective ventilation and oxygenation is therefore the most critical corrective step.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.