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Pediatric supraventricular tachycardia — ABEM Board MCQ

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ModeratePediatric emergenciesPediatric supraventricular tachycardiaABEM Board

A 6-month-old infant arrives with poor feeding and irritability. Triage acuity is ESI 2; HR 254/min, BP 72/42 mm Hg, SpO2 95%. ECG shows regular narrow-complex tachycardia. The infant is mottled with delayed capillary refill but has a pulse. Which of the following is the most appropriate initial action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Perform synchronized cardioversion

Unstable pediatric tachyarrhythmia with a pulse and poor perfusion requires synchronized cardioversion.

Reference: AHA PALS 2025 tachyarrhythmia algorithm