EMT Chapter 34: Pediatric Emergencies

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial 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 compatible with a serious illness.

All of the following are normal findings in an infant or child, EXCEPT:

head bobbing

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:

hyperglycemia.

EMTs are called for an unresponsive infant. When they arrive, they find the mother holding her child. She advises that the child became limp, blue, and stopped breathing. Assessment reveals that the infant is conscious and crying, and has good muscle tone and pink skin color. The mother states that she will take her child to the doctor. The EMTs should:

inform that mother that, although the event seems to have resolved, transport via EMS is advisable.

A 2-month-old infant was found unresponsive in his crib by his mother. When you arrive, you determine that the infant is apneic and pulseless. His skin is pale and cold and his arms are stiff. You should:

inform the child's mother that her child is deceased

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

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-valve 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 of age.

Inserting a(n) ___ in a responsive patient may cause a spasm of the larynx and result in vomiting.

oropharyngeal airway

Children not only have a higher metabolic rate, but also a higher _____, which is twice that of an adult.

oxygen demand

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

palpate the abdomen for rise and fall.

The ________ is a structured assessment tool that allows you to rapidly form a general impression of the pediatric patient's condition without touching him or her.

pediatric assessment triangle

A 2-year-old child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:

perform abdominal thrusts

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.

Activated charcoal is indicated for pediatric patients who have ingested:

poison

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

positioning, ice packs, and extremity elevation.

Which of the following represents a low normal systolic blood pressure for a 6-year-old child?

82 mm Hg

When examining the head of a pediatric patient, which of the following statements is FALSE?

A bulging fontanelle suggests dehydration

Infants begin saying their first word, sitting without support, and teething at 6 to ______ months.

12

An infant's heart can beat as many as ____ times or more per minute if the body needs to compensate

160

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

Bronchiolitis usually occurs during the first ___ of life

2 years

Making eye contact, recognizing caregivers, and following a bright light with their eyes are initially noticed in what age group?

2-6 months

Which of the following an appropriate dose of activated charcoal for a 20-kg child?

20g

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

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/min.

60

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

An unresponsive 5-year-old male with shallow respirations

Which of the following statements regarding pediatric trauma is correct?

Children are more likely to experience diving-related injuries.

With regard to the legal implications of child abuse:

EMTs must report all suspected cases of child abuse.

Which of the following is NOT a common exposure when dealing with pediatric burns?

Electrocution from poor wiring

Which of the following groups of people is associated with the lowest risk of meningitis?

Females

Which of the following is NOT a common cause of altered mental status in pediatric patients?

Hypertension

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.

Which of the following is MORE common in children than in adults following a head injury?

Nausea and vomiting

Which of the following assessment findings should concern the EMT the MOST when assessing a child who experienced a seizure?

Neck stiffness

Toilet training is typically mastered at what age level?

Preschool age

Which of the following is NOT a common cause of shock in pediatric patients

Renal failure

Which of the following is NOT appropriate when treating pediatric patients with seizures?

Restrain the patient

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

Sexual activity

Which of the following statements regarding the use of nasopharyngeal airways in children is correct?

They are rarely used in infants younger than 1 year.

Which of the following is NOT initially seen in children 12-18 months old?

Understand cause and effect

Which of the following statements regarding pediatric asthma is FALSE?

Use strong, forceful breaths when ventilating to get air past the obstruction

Which of the following signs or symptoms would MOST likely cause the EMT to mistake a head injury for an abdominal injury in a child?

Vomiting

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

a rash

A pediatric patient involved in a drowning emergency may present with:

abdominal distension

A normal level of consciousness in an infant or child is characterized by:

age-appropriate behavior, good muscle tone, and good eye contact.

During the attempted resuscitation of an infant with suspected SIDS:

allow the family to observe if they wish

Pupillary response in pediatric patients may be abnormal in the presence of all of the following, EXCEPT:

anxiety

A pediatric patient with a fever, pain on palpation of the right lower quadrant, and rebound tenderness is likely suffering from _____

appendicitis

Death caused by shaken baby syndrome is usually the result of:

bleeding in the brain

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

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

A fracture of the femur is rare and is a major source of ___ in the pediatric population

blood loss

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

bulging fontanelles

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 the inability of the body to cool itself.

Children with N. meningitides would MOST likely present with:

cherry-red spots or a purplish rash.

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

cyanosis

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.

Young children can compensate for fluid losses by:

decreasing blood flow to the extrimities

A common cause of shock in an infant is:

dehydration from vomiting and diarrhea.

When inserting an oropharyngeal airway in an infant or child, you should:

depress the tongue with a tongue depresser

Before assessing the respiratory adequacy of a semiconscious infant or child, you must:

ensure that the airway is patent and clear of obstructions.

Which of the following is NOT a known risk factor of SIDS?

putting a baby to sleep on the back

Early signs of respiratory distress in the child include:

restlessness

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

retracting

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

secure the torso before the head

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:

severe hypoxia and bradycardia.

Bruising to the _________ is LEAST suggestive of child abuse.

shins

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

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:

stridor

When a child experiences a blunt chest injury:

the flexible ribs can be compressed without breaking.

When you are performing a scene assessment at an incident involving SIDS, you should focus your attention on all of the following, EXCEPT:

the temperature of the room

Which of the following is FALSE regarding the pediatric airway

the trachea is larger in diameter and shorter in length

Greenstick fractures occur in infants and children because:

their bones bend more easily than an adult's

Breath sounds in the pediatric population are more easily heard because:

their chest walls are thinner

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 pediatric patients is:

vomiting and diarrhea

Signs of vasoconstriction in the infant or child include:

weak distal pulses

Signs and symptoms of a lower airway obstruction include

wheezing

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:

wheezing