What is the recommended approach to suspected pulmonary embolism causing arrest in a child?

• A. Treat underlying cause; CPR; consider thrombolysis in select cases per protocol; evidence is limited.
• B. Intubate and continue CPR.
• C. Defibrillate immediately.
• D. Wait for imaging before acting.

Answer: (A)

When a pulmonary embolism is suspected as the cause of arrest in a child, the priority is to keep the blood flowing and promptly address the PE itself. High-quality CPR remains essential to preserve organ perfusion while you work on the underlying problem. If the protocol allows and there are no contraindications, thrombolytic therapy can be considered during resuscitation for suspected PE, but this decision is guided by the protocol and the team, since evidence in children is limited. Do not delay resuscitation for imaging or definitive diagnostics; treatment of the cause and continuous chest compressions take precedence. Defibrillation is not the immediate step unless a shockable rhythm is actually present.