Chapter 17: Pediatric Emergencies

Although the technique used to open the airway of an infant is the same as that used for an adult, you should make sure that the infant's head is placed in what position? A. Neutral B. Extended C. Hyperextended D. Turned to the right side

A. Neutral

Signs and symptoms of traumatic shock include all of the following EXCEPT: A. increased blood pressure. B. cool, clammy skin. C. rapid, weak pulse. D. rapid or shallow respirations.

A. increased blood pressure.

Rapid, shallow breathing and/or a rapid, weak pulse should immediately signal that a child is in: A. shock. B. a coma. C. cardiac arrest. D. the middle of a convulsion.

A. shock.

Poisoning by ingestion occurs when a poisonous substance enters the body through: A. the mouth. B. the skin. C. injection. D. the eyes.

A. the mouth.

When performing patient assessment on a child, you should pay special attention to: A. work of breathing. B. the clothing on the patient. C. the child's ability to count. D. the child's ability to hold a conversation.

A. work of breathing.

Define: Asthma

Acute spasm of the smaller air passages marked by labored breathing and wheezing

Define: Suctioning

Aspirating fluid by mechanical means

Epiglottitis usually occurs in children from _______ of age. A. 3 to 6 months B. 3 to 6 years C. 1 to 3 months D. 1 to 3 years

B. 3 to 6 years

When caring for seriously ill or injured pediatric patients, it is important to check the vital signs every minutes. A. 2 B. 5 c. 10 D. 20

B. 5

A hoarse, whooping noise during inhalation and a seal-like barking cough are symptoms of which respiratory illness? A. Asthma B. Croup C. Pneumonia D. Allergies

B. Croup

Which of the following is not a characteristic used for evaluating work of breathing? A. Abnormal breath sounds B. Facial color C. Abnormal positioning D. Flaring

B. Facial color

Appropriate care for a child while he or she is having a seizure includes which of the following? A. Inserting an oral airway to keep the airway open B. Placing the child on the floor or bed to prevent injury C. Raising the child's legs to increase blood flow to the brain D. All of the above

B. Placing the child on the floor or bed to prevent injury

To remove a foreign object from an infant's airway, you should alternate chest thrusts with: A. CPR. B. back slaps. C. rescue breathing. D. the Heimlich maneuver.

B. back slaps.

Unrestrained children involved in motor vehicle crashes tend to have more: A. injuries to the legs. B. injuries to the head. C. injuries to the chest. D. injuries to the abdomen.

B. injuries to the head.

For a severe airway obstruction in a conscious child: A. begin with blind finger sweeps. B. use the Heimlich maneuver. C. use the chest-thrust maneuver. D. hyperextend the neck and recheck for breathing.

B. use the Heimlich maneuver.

You are called to the scene of a motor vehicle crash in which a man and a woman are killed but their 6-month-old son is alive in a car seat in the back seat. You decide to remove the baby from the car because you smell gasoline. You should try to remove the baby: A. after EMS personnel arrive. B. while he is still in the carseat. C. only after you take him out of the car seat. D. only if you can place him on an infant backboard.

B. while he is still in the carseat.

The normal respiratory rate for a 10-year-old is _______ breaths per minute. A. 30 to 60 B. 25 to 50 C. 15 to 20 D. 12 to 16

C. 15 to 20

Which of the following is not a cause of altered mental status in children? A. Head trauma B. Infection C. Low blood glucose level D. Ankle fracture

D. Ankle fracture

Which of the following is false regarding airway obstruction in an unconscious infant? A. You should activate the EMS system. B. Use finger sweeps only if you see a foreign object. C. Open the airway with the head tilt-chin lift maneuver. D. Use back slaps and chest thrusts to relieve the obstruction.

D. Use back slaps and chest thrusts to relieve the obstruction.

To select the proper size of oral airway for a child or an infant, you should measure: A. from the earlobe to the jaw. B. from the earlobe to the nose. C. from the jaw to the corner of the mouth. D. from the earlobe to the corner of the mouth.

D. from the earlobe to the corner of the mouth.

The main signs and symptoms of croup include all of the following EXCEPT: A. noisy, whooping inhalation. B. a seal-like barking cough. C. fright or anxiety. D. history of a recent or current cold.

D. history of a recent or current cold.

A sign of respiratory failure in a child is: A. a respiratory rate of more than 30 breaths per minute. B. combativeness or restlessness. C. stridor, a high-pitched sound on inspiration. D. limp muscle tone.

D. limp muscle tone.

If you encounter a child with a fever above 104°F ( 40°C), you should: A. soak the child in ice water. B. attempt to reduce the high temperature by spraying the child with water. C. wrap the child in blankets to help break the fever. D. protect the child during any seizure that might result.

D. protect the child during any seizure that might result.

Define: Epilepsy

Disease manifested by seizures; caused by abnormal focus of electrical activity in the brain

________ is the second most common cause of accidental death among children 5 years of age or younger in the United States.

Drowning

What should you do if you suspect that a child has been sexually or physically abused but the parents refuse to allow you to arrange to have the child seen by a physician?

Obtain information from the child and witnesses, approach them with a caring demeanor, and take appropriate action towards onlookers. Provide transportation to an appropriate medical facility.

_______ is a characteristic of circulation to the skin that demonstrates white or pale skin or mucous membranes.

Pallor

Define: Mottling

Patchy skin discoloration caused by too little or too much circulation

Skill Drill 17.1: Inserting an Oral Airway in a Child - Fill in the blanks and add the step number. (1-3) _______ the pediatric patient's airway with the appropriate method.

Position/2

Name four steps in caring for a child who has a high fever.

Remove clothing and blankets from their body, fan them, protect the child during a seizure and check their breathing.

Describe how you would care for a child who has heatstroke.

Remove the child's clothing, apply water to their body, fan their body, apply wet sheets on their body, and arrange a rapid transport to a medical facility.

Define: Epiglottitis

Severe inflammation and swelling of the epiglottis

Define: Drowning

Submersion in water that results in suffocation or respiratory impairment

Prolonged vomiting and diarrhea may produce severe ______.

dehydration

Skill Drill 17.1: Inserting an Oral Airway in a Child - Fill in the blanks and add the step number. (1-3) Select the proper size oral airway by measuring from the patient's ______ ______ to the comer of the ________.

ear lobe/mouth/1

Skill Drill 17.1: Inserting an Oral Airway in a Child - Fill in the blanks and add the step number. (1-3) Depress the patient's tongue and press the tongue ______ and away from the _______ of the mouth. Follow the anatomic curve of the roof of the patients mouth to _______ the airway into place.

forward/roof/slide/3

The most dangerous heat-related illness in children is ______.

heatstroke

You can usually relieve a(n) ________ airway obstruction by placing the child on his or her ______ tilting the head, and lifting the ______ in the usual manner.

mild/back/chin

Asthma can occur in children older than _______.

one

The _________ ___________ __________ (PAT) is an easy-to-remember tool that allows you to quickly form a general impression of a. child and incorporates an assessment of appearance, work of breathing, and circulation to the skin.

pediatric assessment triangle

Which of the following is not a sign of respiratory distress in a child? A. A breathing rate of more than 30 to 40 breaths per minute in infants B. Retraction of the skin between the ribs and around the neck muscles C. Altered mental status D. Nasal flaring on each breath

A. A breathing rate of more than 30 to 40 breaths per minute in infants

SIDS usually occurs in infants between the ages of _______ and ______.

3 weeks/7 months

Normal vital signs for a newborn are a pulse rate of ________ beats per minute and a respiratory rate of ________ breaths per minute.

90-180/30-60

List four signs and symptoms of possible neglect in a child.

A lack of adult supervision, the child appears to be malnourished, the living arrangement is unsafe, and chronic illnesses are untreated.

Name three objects a child might swallow that would have to be removed at the hospital.

A small toy, candy, or a ballon.

Appendicitis is most often seen in people between the ages of: A. 10 and 25 years. B. 5 and 10 years. C. 20 and 35 years. D. 35 and 50 years.

A. 10 and 25 years.

The normal respiratory rate for a newborn is ________ breaths per minute. A. 30 to 60 B. 20 to 30 C. 18 to 22 D. 12 to 18

A. 30 to 60

The normal pulse rate for a newborn is _______ beats per minute. A. 90 to 180 B. 140 c. 120 D. 100 to 160

A. 90 to 180

Which of the following is considered a key pediatric medical emergency or illness? A. Drowning B. Road rash C. Headache D. Coughing

A. Drowning

What are the four essential skills required for treating respiratory emergencies in infants and children? A. CPR, maintaining normal body temperature, use of oxygen, and rescue breathing B. CPR, use of a defibrillator, splinting of extremities, and starting an IV C. Opening the airway, basic life support, suctioning, and use of airway adjuncts D. Use of oxygen, application of a backboard, assessing breath sounds, and chest compressions

C. Opening the airway, basic life support, suctioning, and use of airway adjuncts

Which of the following statements regarding parents is false? A. Many parents can become emotionally distraught by large amounts of blood. B. A child's parents or caregivers can be either allies or a potential problem. C. Parents are generally unable to tell you how the child's behavior is different. D. Children get many of their behavioral cues from their parents.

C. Parents are generally unable to tell you how the child's behavior is different.

Which of the following is not an indication of child abuse? A. Withdrawn, fearful, or even hostile child B. History of "accidents" C. Spider bite D. Bruises in various stages of healing

C. Spider bite

All of the following illustrate differences between the adult and pediatric airway EXCEPT: A. a child:S tongue is relatively larger than the tongue of an adult. B. an adult's airway is more flexible than a child's airway. C. a child's airway is smaller in relation to the rest of the body. D. infants breathe only through their noses for at least the first 6 months of their lives.

C. a child's airway is smaller in relation to the rest of the body.

High body temperatures in children are often accompanied by: A. wheezing and dry skin. B. unresponsiveness and a lackluster appearance. C. flushed, red skin; sweating; and restlessness. D. decreased pulse rate.

C. flushed, red skin; sweating; and restlessness.

The most common cause of circulatory failure in a child is: A. traumatic injury. B. sudden infant death syndrome. C. respiratory failure. D. drowning.

C. respiratory failure.

The signs and symptoms of epiglottitis include all of the following EXCEPT: A. the child is drooling. B. the child cannot swallow. C. the child is lying down. D. the child is anxious and frightened.

C. the child is lying down.

Poisoning by absorption occurs when a poisonous substance enters the body through: A. the mouth. B. injection. C. the skin. D. the eyes.

C. the skin.

Children lose relatively more heat than adults do because: A. they tend to wear fewer outer garments. B. they use more energy. C. they have a greater surface area relative to the mass of their body. D. they have a slower metabolism.

C. they have a greater surface area relative to the mass of their body.

Define: Croup

Causes a barking cough, hoarseness, and a harsh, high-pitched breathing sound

As you are returning to your station, you notice a small child dart from the curb, right into the path of an oncoming car. The child is struck by the vehicle. He is approximately 2 years old, and the car was moving at a speed of approximately 30 miles per hour. What should you do?

Check patient's ABCs, stop severe bleeding, treat them for shock, do a full-body assessment, and stabilize all injuries. Treat the child's wounds with direct pressure and appropriate bandaging techniques.

You respond to a local residence for an unresponsive child. When you arrive on scene, you find a child lying next to a swimming pool, being attended to by her parents. The mother is hysterical and is screaming for you to save her child. The child is unresponsive and does not appear to be breathing. What should you do?

Check the patient's ABCs, turn the child to one side to remove water from their airway, and use a suction. Do rescue breathing and provide supplemental oxygen. Begin chest compression if there seems to be no pulse. Dry the child off with a dry cloth and arrange prompt transportation for a medical facility.

Name the three most important things you can do for a child who has traumatic injuries.

The child's overall appearance, work of breathing, and circulation to the skin.

Under what circumstances should you begin CPR on an infant who has been found dead for no apparent reason?

The infant becomes unresponsive.

What is the most important rule of thumb when responding to cases of abdominal pain in children?

Treat every patient with abdominal pain as an emergency and arrange for transportation to a medical facility.

The number one killer of children is _______.

trauma