Final answer:
The initial step of the In-Hospital Pediatric Cardiac Chain of Survival is surveillance and prevention, followed by steps like CPR and advanced support if an emergency occurs.
Step-by-step explanation:
The first step of the In-Hospital Pediatric Cardiac Chain of Survival is surveillance and prevention. By consistently monitoring and taking preventative measures, it's possible to significantly reduce the occurrence of cardiac emergencies in children. Upon recognizing a cardiac emergency, the next steps include activation of the emergency response system, followed by high-quality CPR and pediatric advanced life support measures, as needed.