Chapter 32-Pediatric Emergencies

A child may begin to show signs of stranger anxiety as early as

12 months

An infant's fontanels should close completely by the time he or she is

18 months old

The suture of the anterior fontanelle is typically closed by__ months of age, and the suture of the posterior fontanelle is typically closed by__ months of age

18, 6

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:

2 seconds

Blood pressure is usually not assessed in children younger than___years.

3

If the situation allows, a child should be transported in a car seat if he or she weighs less than __lb.

40

A child may begin to show signs of separation anxiety as early as:

6 months

Febrile seizures are MOST common in children between

6 months and 6 years of age.

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:

6 years

The normal respiratory rate for a newborn should not exceed ____ breaths per minute.

60

Which of the following statement regarding a 3 month old infant is correct?

A 3 month old infant can distinguish a parent from a stranger

Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?

A decresed level of consciousness is not a normal part of the aging process

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: A.wheezing B.stridorous breathing C.a cough that resembles the bark of a seal D.a weak cough

A.wheezing

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

Administrating blow by oxygen and transporting the child with her mother

Common causes of seizures in children include all of the following, EXCEPT: A.infection B.electrolyte imbalances C.hyperglycemia D.poisonings or ingestion

C.hyperglycemia

Which of the following statements regarding a pediatric patient's anatomy is correct? (Needs options)

Children have a larger, rounder occiput compared to adults

All of the following are normal findings in an infant or child, EXCEPT: A.quiet breathing B.belly breathing C.fear or anxiety D.head bobbing

D.head bobbing

Which of the following is NOT a known risk factor of SIDS? A.mother younger than 20 years B.mother smoked during pregnancy C.low birth weight D.putting a baby to sleep on his or her back

D.putting a baby to sleep on his or her back

With regard to the legal implications of child abuse

EMT-Bs must report all suspected cases of child abuse

Which of the following factors is associated with the lowest risk of meningitis?

Female gender

Which of the following statements regarding spinal injuries in pediatric patients is correct?

If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head

Bruising to the _______ is LEAST suggestive of child abuse.

Shins

Signs of severe dehydration in an infant include all of the following, EXCEPT

Slowed level of activity

Which of the following statements regarding use of the pneumatic antishock garment (PASG) in children is MOST correct?

They are rarely used in treating children with traumatic shock.

The EMT-B should be MOST concerned when a child presents with fever and

a rash

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence? a) Why did your child ingest the poison? b) What time did the ingestion occur? c) Do you know what substance was ingested? d) Have you noticed any signs or symptoms?

a) Why did your child ingest the poison?

An infant with severe dehydration would be expected to present with:

absent urine output

When caring for a child with suspected meningitis, it is MOST important for the EMT-B to

adhere to BSI precautions

You are dispatched to a residence for a child with respiratory distress. The patient, an 18 month old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

administering blow-by oxygen and transporting the child with her mother.

Submersion injuries in the adolescent age group are MOST commonly associated with

alcohol

During the attempted resuscitation of an infant with suspected SIDS

allow the family to observe if they wish

The primary mechanism that a child's body uses to compensate for decreased perfusion is

an increase in heart rate

Which of the following children would benefit the LEAST from a nonrebreathing mask?

an unresponsive 5 year old male with shallow respirations

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:

assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler

at the hands or feet

A 2 year old female has experienced a seizure. when you arrive at the scene, that child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should:

attempt cooling measures, offer oxygen, and transport

When caring for an ill 5-year-old male, you should

avoid separating him from his parents or caregivers when possible.

Which of the following statements regarding pediatric trauma is MOST correct? a) Children are less likely than adults to be struck by a car b) Children are more likely to experience diving-related injuries c) The child's head is less frequently injured than an adult's d) Inexperience and poor judgment are rare causes of pediatric trauma

b) Children are more likely to experience diving-related injuries.

Which of the following statements regarding sudden infant death syndrome (SIDS) is MOST correct? a) SIDS is most commonly the result of an overwhelming infection b) Most cases of SIDS occur in infants younger than 6 months of age c) The cause of death following SIDS can be established by autopsy d) Certain cases of SIDS are predictable and therefore preventable

b) Most cases of SIDS occur in infants younger than 6 months of age.

Burns in children are commonly caused by all of the following, EXCEPT: a) scalding water in a bathtub b) entrapment in a structural fire c) exposure to caustic chemicals d) hot items on a stovetop

b) entrapment in a structural fire

Common complications associated with central intravenous (IV) lines include all of the following, EXCEPT: a) clotting of the line b) rupture of a central vein c) bleeding around the line d) a local infection

b) rupture of a central vein

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:

be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

Death caused by shaken baby syndrome is usually the result of

bleeding in the brain

When ventilating a pediatric patient with a bag mask device, the EMT should:

block the pop off valve if needed to achieve adequate chest rise

Pale skin in a child indicates that the

blood vessels near the skin are constricted.

The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:

bradycardia

Which of the following is MORE common in children than in adults following a head injury? a) Loss of consciousness b) Seizures and hypoxia c) Nausea and vomiting d) Spinal cord injury

c) Nausea and vomiting

Which of the following statements regarding preschool-age children is MOST correct? a) The preschool age begins after the child turns 2 years old b) They realize that injuries are not a form of punishment c) They can usually identify painful areas when questioned d) Preschoolers are usually not fearful of pain or separation

c) They can usually identify painful areas when questioned.

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum based product because it may

cause the child to vomit

Hyperthermia differs from fever in that it is an increase in body temperature

caused by inability of the body to cool itself

Children with Neisseria meningitidis (N. meningitidis) would MOST likely present with

cherry-red spots or a purplish rash

Which of the following statement regarding a pediatric patient's anatomy is correct?

children have larger, rounder occiput compared to adults

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:

cyanosis.

Which of the following should make you MOST suspicious for child abuse? a) Willingness of the child to speak b) Worried or crying parents c) A laceration to the child's chin d) Bruises in various stages of healing

d) Bruises in various stages of healing

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: a) headache and fever b) an altered mental status c) a stiff or painful neck d) sunken fontanels

d) sunken fontanels

A common cause of shock in an infant is:

dehydration from vomiting diarrhea

A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning. You should

discontinue the ventilator and ventilate with a BVM device

Infection should be a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:

drooling or congestion

A 6 year old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. the child is conscious, obviously frightened, and is coughing forcefully. You should:

encourage him to cough, give oxygen as tolerated, and transport

Before assessing the respiratory adequacy of an unconscious infant or child, you must:

ensure that the airway is patent and clear of obstructions.

when assessing the heart rate of a 6 month old infant. you should palpate the brachial pulse or _____ pulse.

femoral

In most children, febrile seizures are characterized by:

generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by

grunting

Immediate transport is indicated for a child when he or she:

has a history suggestive of a serious illness

When caring for a female child who has possibly been sexually abused, you should:

have a female EMT remain with her if possible

When a child experiences a blunt injury to the abdomen

he or she can compensate for blood loss better than adults.

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:

his or her tidal volume is adequate

Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: a) meningitis b) severe infection c) hyperglycemia d) child abuse

hyperglycemia

Common causes of seizures in children include all of the following, EXCEPT

hyperglycemia

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the

intercostal muscles are not well developed.

Febrile seizures in a child:

may indicate a serious underlying illness.

A 6 month old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect

moderate dehydration

A 4 year old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and had skin burns around her mouth. You should:

monitor her airway and give oxygen

The first month of life after birth is MOST appropriately referred to as the

neonatal period

After determining that an infant or child has strong central pulses, you should

not rule out compensated shock

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag mask ventilations is to:

observe the chest for adequate rise

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:

older than 8 to 10 years

When assessing an infant's ventilation status, you should:

palpate the abdomen for rise and fall

Critical burns in children include

partial-thickness burns covering greater than 20% of the body surface

After using the PAT to form your general impression of a sick or injured child, you should:

perform a hands-on assessment of the ABCs.

To ensure that the airway of an infant or small child is correctly positioned, you may have to:

place a towel or folded sheet behind the shoulders

Before positioning an infant or child's airway, you should

place him or her on a firm surface

When administering oxygen to a frightened child, it would be MOST appropriate to

place oxygen tubing through a hole in a paper cup

Effective methods for providing pain relief to a child with an extremity injury include:

positioning, ice packs, and emotional support.

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are:

proportionately larger and situated more anteriorly.

Cardiac arrest in the pediatric population is MOST commonly the result of:

respiratory or circulatory failure.

Drawing in of the muscles between the ribs or of the sternum during inspiration is called:

retracting

Because a tracheostomy tube bypasses the nose and mouth

secretions can build up in and around the tube

When immobilizing an injured child in a pediatric immobilization device, you should

secure the torso before the head

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?

sexual activity

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid (CSF) is called a

shunt

When a child is struck by a car, the area of the greatest injury depends MOSTLY on the

size of the child and the height of the bumper upon impact

You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars, he is unresponsive and there are no signs of breathing. You should:

stabilize his head and check for a pulse

If a nasopharyngeal airway is too long, it may:

stimulate the vagus nerve

When assessing an 8-year old child, you should

talk to the child, not just the caregiver

When a child experiences a blunt chest injury

the flexible ribs can be compressed without breaking

Greenstick fractures occur in infants and children because

their bones bend more easily than an adult's.

When assessing or treating an adolescent patient, it is important to remember that

they usually do not wish to be observed during a procedure

When caring for an infant who was found apneic and cyanotic and was resuscitated by the parent or caregiver, you should

transport the infant to the hospital.

The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to:

use a length based resuscitation tape measure

The signs and symptoms of poisoning in children:

vary widely,depending on the child's age and weight

The MOST common cause of dehydration in children is

vomiting and diarrhea.