EMT chapter 38

While you are caring for a 6 year old girl who was struck by a car on the street in front of her home, her distraught father yells at you to hurry up and says, "if this was a kid on the other side of the tracks, you would be moving faster!" Which of the following is the MOST appropriate response?

"I know this is so upsetting. We are moving as fast as we can without making her condition worse. As long as I have your word you wont yell at us, you can ride in the ambulance and we will tell you everything we are doing."

While you are caring for a 5 year old who has a fractured forearm after falling from a backyard play set, his mother is distraught, crying, and trying to hold on to her son, and saying, "Oh, this is my fault. This is all my fault." Which of the following would be the MOST appropriate reaction?

"Lets not worry about who's fault it is, lets get Danny feeling better. I can help him a little better if you move to this side of him and hold his hand."

You are working with a new partner who was just hired. During the morning equipment check, he makes a comment about not feeling very comfortable with sick or injured children. Which of the following statements should the EMT respond with to help alleviate his fear?

"Remember that much of what you learned about adults also pertains to children."

If your new EMT partner is struggling with stress levels every time you have a pediatric​ call, what recommendation could you​ provide? A. ​"The best defense against anxiety with children is​ preparation, practice, and then more​ practice." B. ​"Tell all of your partners that you are uncomfortable with​ children, so if a pediatric call is​ dispatched, you will drive the ambulance instead of being the care​ provider." C. ​"Consider quitting EMS and becoming either a police officer or a​ firefighter." D. ​"Rely on the family to tell you what is wrong with their child and what you should do for​ them."

"The best defense against anxiety with children is preparation, practice, and then more practice."

Which of the following is the upper limit of normal systolic blood pressure in a 6 year old child?

102

You are assessing a 3 year old male child. He opens his eyes to command, localized pain, and is disoriented. What is his Pediatric Glasgow Coma Scale?

12

A Brief Resolved Unexplained Event applies to infants less than:

12 months old

Cervical immobilization devices on the market are designed to fit a child about what age?

24 months

According to the Pediatric Glasgow Coma Scale, a 9 month old infant who opens her eyes to shout would receive a:

3

You are determining the Glasgow Coma Scale for a male who is 20 months old. His best verbal response is crying. For this response, the patient would receive a:

4

At what age is the peak incidence of SIDS?

4 months

The adult Glasgow Come Scale score is assessed only in children who are over what age?

5 years

You are assessing a patient after the parent described a Brief Resolve Unexplained Event. You should maintain an SPO2 of at least:

94%

Congenital heart disease is typically due to:

Abnormal heart valves or chambers

Which choice is part of the assessment of the work of breathing in the Pediatric Assessment Triangle?

Abnormal posture or position

Which choice is NOT a principle of family-centered care?

Allowing family members to determine what the medically appropriate care is for pediatric patients

Which of these steps is included in the emergency care of a pediatric patient with epiglottitis?

Avoid agitating the child with unnecessary assessment and treatment

Which choice is an expected psychosocial characteristic of adolescents?

Believing that dangers and risks do not apply to them

Which choice is an expected psychosocial characteristic of an adolescent?

Believing that dangers and risks do not apply to them

You are caring for a 2 year old child who has been sick with a fever, diarrhea, and vomiting for 24 hours. To assess perfusion, which choice would provide you with the LEAST reliable information about dehydration?

Blood pressure

You are treating a patient who presents with a slight fever, tachycardia, rapid breathing, respiratory distress, and audible wheezing on exhalation. The patients is about 14 months old, and the mother states that this has been developing over the past few days. What is this patient MOST likely to have?

Bronchiolitis

Of which of these situations should you be aware in the assessment and treatment of pediatric patients?

Children's increased metabolic rate creates greater oxygen demand

You are on scene for a 6 month old pediatric patient who is unresponsive at home. The parents state that he suffers from a congenital heart defect, but they cannot pronounce its name. You find the patient to be cyanotic, with a weak carotid pulse. You note vomit in the airway, and breathing is labored. The closest ED is 25 minutes away from your location. What should you do first?

Clear the airway

Which choice is part of the assessment of appearance in the Pediatric Assessment Triangle?

Consolability

If resuscitation is NOT attempted in a possible SIDS death​ case, which choice is the BEST action to​ take? A. Contact law enforcement or the coroner or follow your protocol on transport. B. Call for an ALS response. C. Reassure the parents that the cause of death is SIDS and there is nothing they could have done to prevent it. D. Wait 10 minutes after confirming absence of vital​ signs, and check a second of vital signs for verification.

Contact law enforcement or the coroner or follow your protocol on transport

Which of these statements BEST describe the early presentation of appendicitis in a child?

Cramps, diffuse pain around the umbilical area

A 3 year old female child presents with a low grade fever and seal-like bark. You should suspect:

Croup

Which of these findings is an indication that a pediatric patient has a partial upper airway obstruction?

Crowing or other noisy respirations

Which of the following may be considered a Brief Resolved Unexplained Event?

Cyanosis

Which of the following is a step in the management of complete foreign body airway obstruction in an unresponsive infant?

Deliver 30 chest compressions, using the landmarks and criteria for CPR

Which choice is LEAST likely as a cause of EMS provider stress related to pediatric calls?

Dislike of children

What is the name of the program that is designed to ensure the appropriate care in a health emergency care of all children?

Emergency Medical Services for Children

Which of the following is a general indicator of child abuse?

Fearful child

Which choice is a common cause of seizures in young children but NOT in adults?

Fever

The soft spot of a baby's head is called a:

Fontanelle

Which of the following is considered a bumper area on a child?

Forehead

Which of these guidelines apply when examining and caring for an infant?

Form a general impression as you approach the patient, before reaching his side

You have arrived on the scene of a child with reported difficulty breathing. The patient is a 4 year old male child who is sitting on the floor, putting together a puzzle with his mother. One of the FIRST things that you notice is that the child is grunting with each expiration. Which choice is the cause of the grunting that you should suspect?

He is having difficulty keeping his lower airways open

Which of these findings indicates that an infant or child is in decompensated respiratory failure?

Head bobbing

Which of these is NOT a principle of family-centered care?

Health care providers remove children from unstable or abusive families as soon as such a family is identified

Which choice is the MOST common cause of death in pediatric drowning patients, and therefore the target of your resuscitation efforts?

Hypoxia

At the scene of a sick child, why would asking the parents to hold the oxygen mask close to the child's face generally be a good idea?

If the parents are involved in the assessment and care of the patient, it can reduce their anxiety level

Which of the following should you do if you find that you do NOT have a cervical immobilization device that will fit a child who requires spinal immobilization?

Improvise a cervical immobilization device with a rolled towel fashioned into a horseshoe shape and taped in place

What is the leading cause of death and disability in children and adolescents?

Injuries

Which of these terms should be used with regard to pediatric trauma to convey the preventable nature of childhood injuries?

Injury

Which choice BEST describes the role of Emergency Medical Services for Children (EMSC)?

It is a program that provides grant funding to states for a variety of programs aimed at improving emergency care for children

Which of the following diseases is an infection of the membranes surrounding the brain and spinal cord?

Meningitis

You have been called to the home of a 5 year old patient whose mother called 911 because he was choking. He is coughing and able to speak between coughing. What action should you take?

Monitor the patient and encourage him to keep coughing

Which of these statements about responding to pediatric calls should help you put the stress and anxiety of responding to pediatric calls in perspective?

Much of what you have learned about adult patients also applies to pediatric patients, meaning you know more than you might think about caring for pediatric patients

When assessing a child's appearance in the Pediatric Assessment Triangle, what is meant by assessing the patients tone?

Muscle tone and movement

Which of the following is true in regards to a child's head in relation to trauma?

Nausea is a common symptom of a head injury

Failing to provide adequate attention to a child is an example of:

Neglect

Which of these guidelines should be followed in the secondary assessment of younger pediatric patients?

Obtain the respiratory rate prior to the physical examination

Which choice is part of the assessment of circulation to the skin in the Pediatric Assessment Triangle?

Petechiae

Improper or excessive action that injures or harms a child is called:

Physical abuse

Which of these modifications should you use when caring for pediatric patients?

Place padding behind the shoulders and neck of an infant or small child to maintain neutral alignment of the neck.

Because of anatomical differences, which of these modifications is needed for effected spinal immobilization in younger pediatric patients?

Placing padding beneath the neck and shoulders

A 4 year old child has been sick with an apparent viral respiratory infection for 3 days, and today he has a higher fever and increased difficulty breathing, according to his parents. The child is lying curled up on his side. He appears sick but makes eye contact with you and interacts with his parents. He has a cough that sounds productive, but which does NOT produce and sputum. His skin is warm, flushed, and moist. His respirations are 40 per a minute with nasal flaring and "seesaw" breathings. His radial pulse is 124. When you auscultate his lung sounds, you notice a decrease on the right side when you auscultate just beneath the scapula. Otherwise, there are scattered rhonchi but NO wheezing. Which illness is MOST consistent with the patients presentation and history?

Pneumonia

Which of these terms is BEST applied to the majority of childhood injuries?

Preventable

Which of these statements regarding pediatric cardiovascular emergencies is accurate?

Recognition and management of respiratory problems is a critical step in preventing pediatric cardiac arrest

Which of the following is the proper technique for documenting an incident in which you suspect child abuse?

Record spontaneous statements as a quotation

Most pediatric cardiac arrests are a result of:

Respiratory distress

Which choice is the MOST common cause of cardiac arrest in pediatric patients?

Respiratory failure

With which of the following injury prevention programs would EMS providers be LEAST likely involved?

Road design and construction

While evaluating a patient who experienced a Brief Resolved Unexplained Event, you should attempt to:

Rule out underlying causes

A sudden an unexpected death of an infant is called:

SIDS

Which age group begins to become more cooperative than the groups before them?

School-age children

Which statement regarding shock in children is most accurate?

Severe shock in children is unusual

Which of these factors helps explain the greater risk of upper airway obstruction in children as compared to adults?

Small children have proportionally larger tongues than adults

Which choice is NOT a relevant observation of the scene of a suspected SIDS death?

The apparent age of the parents

Which of the following BEST describes the cause of SIDS?

The cause is not understood

When determining if you have the CORRECT size of blood pressure cuff for a child, which of these guidelines should you follow?

The cuff should cover three-quarters the distance from the shoulder to the elbow

If you allow yourself to get frustrated or emotionally distraught at the scene of a pediatric trauma, what is likely to happen?

The parents frustration or agitation level will rapidly escalate

Which choice is a criterion for a minor vehicle collision for the purposes of using a child's car safety seat to transport him in the ambulance?

The vehicle could be driven from the crash site

Which of these statements regarding burns in pediatric patients is CORRECT?

Thinner skin results in more severe burns with lower temperatures and duration of exposures

What is a child between 1 and 2 years of age?

Toddler

Which pediatric age group is characterized as challenging to assess and having numerous "do not like.." considerations, such as NOT liking to be touched, NOT liking to have their clothing removed, and fearing shots and pain?

Toddlers

Which of these factors is LEAST likely to account for the risk of acute hypoglycemia in a pediatric patient?

Undiagnosed type 2 diabetes mellitus

Which of the following statements is TRUE regarding patterns of injury in pediatric patients?

Unrestrained pediatric vehicle occupants are highly prone to head and neck injuries

If you do not have a small enough cervical collar to place on an infant during immobilization, what should you consider doing?

Using a rolled-up towel