Chapter 35 Pediatric Emergencies:

Which of the following are true about the pediatric airway? The pediatric airway is smaller in diameter and shorter in length. The tongue is proportionally the same but more posterior. Children have a funnel-shaped upper airway. Smaller lungs mean that the oxygen reserves are smaller.

- Children have a funnel-shaped upper airway - The pediatric airway is smaller in diameter and shorter in length - Smaller lungs mean that the oxygen reserves are smaller

You are responding to a 9-1-1 call where the mother reported finding her 3-month-old daughter cyanotic and unresponsive in her crib. When you stimulate the child, she responds. This is an example of what condition? -Apparent life-threatening event -SIDS -Shaken baby syndrome -Febrile seizure

-Apparent life-threatening event

What does the PAT assess? -Airway, breathing, circulation -Appearance, work of breathing, circulation -Alert, responsive, unresponsive -Tone, interactiveness, consolabiliy, look, speech/cry

-Appearance, work of breathing, circulation

What does respiratory syncytial virus (RSV) cause? -Pneumonia -Bronchiolitis -Epiglottitis -Pertussis

-Bronchiolitis

You are assessing a 6-year-old boy who has a fever of 102 and is showing signs of altered LOC. He is complaining of pain when he tries to turn his head. What condition should you suspect? -Anaphylactic shock -Febrile seizure -Meningitis -Spinal cord injury

-Meningitis

What should you use the Wong-Baker FACES scale to determine? -Motor response -LOC -Work of breathing -Pain level

-Pain level

If a pediatric patient begins seizing again during your care, which of the following would be your treatment priority? -Stopping the seizure -Securing and clearing the airway -Providing rapid transport -Maintaining the patient's body temperature

-Securing and clearing the airway

You are using JumpSTART in a triage situation involving several children. How would you rate a patient who is breathing spontaneously, has a peripheral pulse, and is appropriately responsive to painful stimuli? -Green tag -Yellow tag -Red tag -Black tag

-Yellow tag

In a normal adult, greater than 30% to 40% of blood volume loss significantly increases the risk of shock. What is the threshold of blood volume loss in children? 25% 30% 45% 50%

25%

Which of the following assessment tools would you use to form a general impression of a patient without touching them? A. Pediatric assessment triangle (PAT) B. Glasgow Coma Scale C. AVPU scale D. TICLS mnemonic

A. Pediatric assessment triangle (PAT)

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: Select one: A. at the feet. B. in the ambulance. C. en route to the hospital. D. at the head.

A. at the feet.

A viral infection that may cause obstruction of the upper airway in a child is called: Select one: A. croup. B. epiglottitis. C. asthma. D. bronchitis.

A. croup.

The first month of life after birth is referred to as the: Select one: A. neonatal period. B. premature phase. C. start of infancy. D. toddler period.

A. neonatal period.

When a child is struck by a car, the area of greatest injury depends MOSTLY on the: Select one: A. size of the child and the height of the bumper upon impact. B. age of the child and the size of the car that struck him or her. C. speed at which the car was traveling when impact occurred. D. height of the child and the speed at which the car was traveling.

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

A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the MOST indicative of decompensated shock? Select one: A. Pulse rate greater than 120/min B. Blood pressure of 70/40 mm Hg C. Capillary refill time of 4 seconds D. Respiratory rate of 30 breaths/min

B. Blood pressure of 70/40 mm Hg

The purpose of the pediatric assessment triangle (PAT) is to: Select one: A. facilitate a rapid head-to-toe assessment of the child by visualization only. B. allow you to rapidly and visually form a general impression of the child. C. determine if the child's vital signs are within the age-appropriate limits. D. gather critical data by performing a rapid hands-on assessment of the child.

B. allow you to rapidly and visually form a general impression of the child.

A 2-year-old female has experienced a seizure. When you arrive at the scene, the 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: Select one: A. place the child in cold water to attempt to reduce her fever. B. cool the child with tepid water and transport to the hospital. C. suspect that the child has meningitis and transport at once. D. allow the mother to drive her daughter to the hospital.

B. cool the child with tepid water and transport to the hospital.

Burns in children are commonly caused by all of the following, EXCEPT: Select one: A. hot items on a stovetop. B. entrapment in a structural fire. C. exposure to caustic chemicals. D. scalding water in a bathtub.

B. entrapment in a structural fire.

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

B. hyperglycemia.

The teacher reports that after the child was moved to the floor, he stopped "shaking" and his breathing became rapid. This period is referred to as the: A. recovery state. B. postictal state. C. aural state. D. reversal state.

B. postictal state.

Which of the following is true about a child's breathing? -Older children experience intercostal muscle fatigue more quickly than younger children. -A child's oxygen demand is about the same as that of an adult. -Because less air is exchanged with each breath, detection of poor air movement or complete absence of breath sounds can be difficult. -The trachea is proportionally larger in an infant, leading to a greater potential for choking.

Because less air is exchanged with each breath, detection of poor air movement or complete absence of breath sounds can be difficult.

Which of the following findings is LEAST suggestive of child abuse? Select one: A. Evidence of alcohol consumption or drug use at the scene B. An unexplained delay in seeking medical care after the injury C. Consistency in the method of injury reported by the caregiver D. Burns to the hands or feet that involve a glove distribution

C. Consistency in the method of injury reported by the caregiver

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? Select one: A. Certain cases of SIDS are predictable and therefore preventable. B. The cause of death following SIDS can be established by autopsy. C. Death as a result of SIDS can occur at any time of the day or night. D. SIDS is most commonly the result of an overwhelming infection.

C. Death as a result of SIDS can occur at any time of the day or night.

Pale skin in a child indicates that the: Select one: A. oxygen content in the blood is decreased. B. child's core body temperature is elevated. C. blood vessels near the skin are constricted. D. child is in severe decompensated shock.

C. blood vessels near the skin are constricted.

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: Select one: A. skin that is cool and dry. B. acute respiratory distress. C. drooling or congestion. D. extreme restlessness.

C. drooling or congestion.

When caring for a female child who has possibly been sexually abused, you should: Select one: A. encourage the child to urinate and take a shower. B. carefully examine the genitalia for signs of injury. C. have a female EMT remain with her if possible. D. immediately report your suspicions to the parents.

C. have a female EMT remain with her if possible.

While triaging patients at the scene of a motor-vehicle crash, you encounter a 5-year-old child who is unresponsive and apneic. After positioning his airway, you should: Select one: A. deliver 5 rescue breaths. B. categorize him as immediate. C. palpate for a carotid pulse. D. categorize him as deceased.

C. palpate for a carotid pulse.

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: Select one: A. altered mental status. B. headache and fever. C. sunken fontanelles. D. a stiff or painful neck.

C. sunken fontanelles.

________ is/are the recommended way to relieve a severe airway obstruction in an unconscious child. Abdominal thrusts Chest compressions Suctioning Sweeping

Chest compressions

Which of the following would be the LEAST likely cause a the patient's altered mental status? A. Hypoglycemia B. Drug ingestion C. Hypoxia D. Head injury

D. Head injury

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence initially? Select one: A. Do you know what substance was ingested? B. What time did the ingestion occur? C. Have you noticed any signs or symptoms? D. Why did your child ingest the poison?

D. Why did your child ingest the poison?

An infant with severe dehydration would be expected to present with: Select one: A. excessive tearing. B. bulging fontanelles. C. moist oral mucosa. D. absent urine output.

D. absent urine output.

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: Select one: A. requesting a paramedic ambulance to insert an advanced airway device. B. separating the child from her mother and providing ventilatory assistance. C. allowing the child to remain with her mother and applying a nasal cannula. D. administering blow-by oxygen and transporting the child with her mother.

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

To evaluate a child's level of consciousness, you must note the mental status and assess his: A. skin color. B. pupil size. C. chest rise. D. age-appropriate responses to your questions.

D. age-appropriate responses to your questions.

When assessing an 8-year-old child, you should: Select one: A. rely solely on the parent for information. B. use a toe-to-head assessment approach. C. refrain from taking a blood pressure. D. talk to the child, not just the caregiver

D. talk to the child, not just the caregiver

Which of the following statements regarding febrile seizures is correct? Febrile seizures usually indicate a serious underlying condition, such as meningitis. Most febrile seizures occur in children between the ages of 2 months and 2 years of age. Febrile seizures are rarely associated with tonic-clonic activity, but last for more than 15 minutes. Febrile seizures usually last less than 15 minutes and often do not have a postictal phase.

Febrile seizures usually last less than 15 minutes and often do not have a postictal phase.

Young children are more likely to experience ________ than adults. Cardiopulmonary arrest Femur fractures Greenstick fractures Sprains

Greenstick fractures

A ________ provides 24% to 44% oxygen concentration. Blow-by BVM Nasal cannula Nonrebreathing mask

Nasal cannula

The AVPU scale is used to monitor a patient's level of consciousness. What does the "P" stand for? Pallor Pediatric Painful Pale

Painful

With which age group should you talk to the child, not just the parent, while taking the medical history? Toddler Preschooler School-age Adolescent

School-age

How does pediatric anatomy differ from adult anatomy? The trachea is more rigid. The tongue is proportionately smaller. The epiglottis is less floppy. The head is proportionately larger.

The head is proportionately larger.

When assessing a conscious and alert 9-year-old child, you should: isolate the child from his or her parent. allow the child to answer your questions. obtain all of your information from the parent. avoid placing yourself below the child's eye level.

allow the child to answer your questions.

When using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall that the "D" stands for: delay in seeking care. divorced parents. dirty appearance. disorganized speech.

delay in seeking care.

You respond to a sick child late at night. The child appears very ill, has a high fever, and is drooling. He is sitting in a tripod position, struggling to breathe. You should suspect: croup. pneumonia. epiglottitis. severe asthma.

epiglottitis

When a small child falls from a significant height, the ______ MOST often strikes the ground first. head back feet side

head

A 4-year-old girl fell from a second-story balcony and landed on her head. She is unresponsive; has slow, irregular breathing; has a large hematoma to the top of her head; and is bleeding from her nose. You should: immediately perform a full-body scan to detect other injuries, administer high-flow oxygen, and transport at once. apply a pediatric-sized cervical collar, administer high-flow oxygen via pediatric nonrebreathing mask, and prepare for immediate transport. manually stabilize her head, open her airway with the jaw-thrust maneuver, insert an airway adjunct, and begin assisting her ventilations with a bag-mask device. suction her airway for up to 10 seconds, insert a nasopharyngeal airway, apply a pediatric-sized cervical collar, and administer oxygen via pediatric nonrebreathing mask.

manually stabilize her head, open her airway with the jaw-thrust maneuver, insert an airway adjunct, and begin assisting her ventilations with a bag-mask device.

The purpose of a shunt is to: minimize pressure within the skull. reroute blood away from the lungs. instill food directly into the stomach. drain excess fluid from the peritoneum.

minimize pressure within the skull.

Treatment for a semiconscious child who swallowed an unknown quantity of pills includes: administering 1 g/kg of activated charcoal and rapidly transporting. monitoring the child for vomiting, administering oxygen, and transporting. positioning the child on his left side, elevating his legs 6 inches, and transporting. contacting medical control and requesting permission to induce vomiting.

monitoring the child for vomiting, administering oxygen, and transporting.