EMT Orange Book Ch 32

Neisseria Meningitides

A form of bacterial meningitis characterized by rapid onset of symptoms, often leading to shock and death

Sudden infant death syndrome or SIDS

A sudden and unexpected death of an apparently healthy infant during sleep

Pediatric Resuscitation Tape Measure

A tape used to estimate an infant or child's weight on the basis of length; appropriate drug doses and equipment sizes are listed on the tape.

The normal respiratory rate for a newborn should not exceed ____ breaths/min

A. 60 B. 80 C. 50 D. 70 Answer is A, 60

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

A. infection B. hyperglycemia C. electrolyte imbalances Answer is B, hyperglycemia

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

A. quiet breathing B. fear or anxiety C. head bobbing Answer is C, head bobbing

Pertussis

Acute infectious disease characterized by a cough that has a "whoop" sound; also called whooping cough

Pediatrics

Branch of medicine dealing with children and their diseases

Which of the following statements regarding pediatric trauma is correct?

Children are more likely to experience diving-related injuries

Adolescents

Children between 12-18 years of age.

Apparent life-threatening event or ALTE

Infant found not breathing, cyanotic, and unresponsive but resumes breathing with stimulation.

Toddler

Infant to 3 years of age

Pediatric Assessment Triangle

Method of pediatric assessment: Appearance, Work of Breathing, and Circulation to Skin

Blanching

Turing white

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

a. 0-2 months b. 2-6 months c. 6-12 months Answer is b. 2-6 months

Saying their first word, sitting without support, and teething are initially noticed in what age group?

a. 0-2 months b. 2-6 months c. 6-12 months d. 12-18 months Answer is c. 6-12 months

When assessing capillary refill in pediatric patients, the color should return after

a. 1 second b. 2 seconds c. 3 seconds d. 4 seconds Answer is b. 2 seconds

An infant's heart can beat as many as _________ times or more per minute if the body needs to compensate for injury or illness.

a. 110 b. 120 c. 140 d. 160 Answer is d. 160

Bronchiolitis usually occurs during the first __________ of life.

a. 2 years b. 3 years c. 4 years d. 6 years Answer is a. 2 years

How many triage categories are there in the JumpSTART system? a. 3 b. 4 c. 5 d. 6

a. 3 b. 4 c. 5 d. 6 Answer is b. 4

Toilet training is typically mastered at what age level?

a. 6-12 months b. 12-18 months c. preschool-age d. school-age Answer is c. preschool-age

When obtaining information from the family regarding the pediatric patient's history, which of the following is not an appropriate inquiry?

a. Does the child have any rashes? b. The child's recent activity level? c. Any vomiting or diarrhea? d. what types of toys does the child play with? Answer is d. what types of toys does the child play with?

Which of the following populations is at the greatest risk for contracting meningitis?

a. females b. children who have had head trauma c. children with preexisting heart conditions Answer is b. children who have had head trauma

Tachycardia in pediatric patients may be an indication of all of the following except:

a. hypothermia b. hypoxia c. fever d. pain Answer is a. hypothermia

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

a. infection b. growth abnormalities c. blood loss d. nerve damage Answer is c. blood loss

All of the following are common causes of a fever in pediatric patients except:

a. infection b. status epilepticus c. drug ingestion d. cholecystitis Answer is d. cholecystitis

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

a. look for bruising, swelling, and hematomas b. significant blood loss can come from the scalp c. a bulging fontanels suggests dehydration d. the head is larger in proportion to the rest of the body Answer is c. a bulging fontanels suggests dehydration

Which of the following is not a known risk factor for SIDS?

a. mother younger than 20 years old b. mother smoked during pregnancy c. gestational diabetes d. low birth weight Answer is c. gestational diabetes

Which of the following is not a sign of increased work of breathing in pediatric patients?

a. nasal flaring b. grunting c. equal chest expansion d. retractions Answer is c. equal chest expansion

All children with abdominal injuries should be monitored for signs and symptoms of:

a. pain b. shock c. hypothermia d. nausea Answer is b. shock

Exposure to cold air, infection, and emotional stress are all triggers of:

a. pneumonia b. asthma c. bronchiolitis d. epiglottitis Answer is b. asthma

Which of the following is not an infection that can cause an airway obstruction in pediatric patients?

a. pneumonia b. asthma c. croup d. epiglottitis Answer is b. asthma

A pediatric patient with hives, wheezing, increased work of breathing, and hypoperfusion is likely suffering from:

a. pneumonia b. bronchiolitis c. asthma d. anaphylaxis Answer is d. anaphylaxis

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

a. scalding water in a bathtub b. electrocution from poor wiring c. hot items on a stove d. cleaning solvents Answer is b. electrocution from poor wiring

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

a. signs of illness, including medication, humidifiers, and thermometers b. the general condition of the house c. the site where the infant was discovered d. the temperature of the room Answer is d. the temperature of the room

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

a. speak four to six words b. know the major body parts c. can open doors d. understand cause and effect Answer is d. understand cause and effect

Signs and symptoms of a lower airway obstruction in pediatric patients include:

a. stridor b. friction rub c. drooling d. wheezing Answer is d. wheezing

When you assess a pediatric patient, it is best to place _________ on the patient's chest to feel the rise and fall of the chest wall.

a. the left hand b. the right hand c. both hands d. the stethoscope Answer is c. both hands

Which of the following is false regarding the pediatric airway?

a. the trachea is larger in diameter and shorter in length b. the glottis opening is higher and positioned more anterior c. the neck appears to be nonexistent Answer is a. the trachea is larger in diameter and shorter in length

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

a. their chest walls are thinner b. the size of their lungs amplifies the sounds c. the chest cavity is small in proportion to the rest of the body Answer is a. their chest walls are thinner

Which of the following statements regarding pediatric asthma is false?

a. use strong, forceful breaths when ventilating to get air past the obstruction b. the wheezing may be so loud that you can hear it without a stethoscope c. the patient may be in a tripod position Answer is A. use strong, forceful breaths when ventilating to get air past the obstruction

Head and neck injuries are common after high-speed collisions in all of the following contact sports except:

a. wrestling b. football c. lacrosse d. basketball Answer is d. basketball

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

absent urine output

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

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

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

an unresponsive 5-year-old male with shallow respirations

_________ is common in pediatric patients and if left untreated can lead to peritonitis or shock.

appendicitis

Pale skin in a child indicates that the:

blood vessels near the skin are constricted

In pediatric patients, chest injuries are usually the result of ________ _________, rather than penetrating trauma.

blunt trauma

__________ is an acute spasm of the smaller air passages.

asthma

_________ is an infection of the soft tissue in the area above the vocal cords.

epiglottitis

Located on the front (anterior) and back (posterior) portions of the head are soft spots, the _________.

fontaneles

Car seats are designed to be either ________ or ________; they cannot be mounted sideways on a bench seat.

forward-facing, rear-facing

_________ ________ occurs when the pediatric patient has exhausted all compensatory mechanisms and waste products begin to collect.

respiratory failure

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

respiratory or circulatory failure

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

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

Always position the airway in a neutral ________ ________.

sniffing position

__________ is a congenital condition in which the patient lacks one or more of the normal clotting factors of blood.

hemophilia

One common problem following burn injuries in children is __________.

infection

Febrile seizures in a child:

may indicate a serious underlying illness

The secondary assessment of a sick or injured child:

may not be possible if the child's condition is critical.

__________ is refusal or failure on the part of the caregiver to provide life necessities.

neglect

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

oropharyngeal airway

A child in respiratory distress or possible respiratory failure needs supplemental _________.

oxygen

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

Preschool-age

children between 3 to 6 years of age

School-age

children between 6 to 12 years of age

T/F It is considered acceptable to lie to a preschool-age child because they will not be able to understand their true medical condition.

F

T/F Pediatric patients weighing less that 60lbs should be transported by car seat.

F

T/F You should avoid letting the parent or caregiver hold an infant during your assessment.

F

T/F You should use a euphemism such as "passed away" when informing the family of a pediatric death to lessen their emotional pain.

F

Neglect

Failure to provide life necessities

Tachypnea

Fast breathing

Infancy

First year of life

Shaken baby syndrome

Results of a child being violently shaken by someone. Can cause brain injury, blinds, fractures, seizures, paralysis, and death.

Grunting

Sign of increased work of breathing

Bradypnea

Slow respiratory rate;

Central pulses

The carotid and femoral pulses, which can be felt in the central part of the body.

Work of breathing

The effort required to expand and contract the lungs

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

a. drug and alcohol ingestion b. hypertension c. seizure d. hypoglycemia Answer is b. hypertension

__________ is the second most common cause of unintentional death among children in the United States.

drowning

T/F Blood pressure is usually not assessed in pediatric patients younger than 4 years.

F

T/F Blow-by oxygen is as effective as a face mask or nasal cannula for delivering oxygen to a pediatric patient.

F

T/F Bradypnea usually indicates that the pediatric patient's condition is improving.

F

T/F Congenital cardiovascular problems are the leading cause of cardiopulmonary arrest in the pediatric population.

F

T/F Extremity injuries is the pediatric population are managed much differently than extremity injuries in adults.

F

Child abuse

Deliberate action that is harmful to a child's physical, emotional, or sexual well-being

Generalized tonic-clonic seizure

Generalized onset of tonic-clonic movements of the limbs, tongue-biting and incontinence followed by slow, gradual recovery of consciousness and cognition; also called grand mal seizure

Which of the following statements regarding sudden infant death syndrome (SIDS) is MOST correct?

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

Nares

Nostrils

Sniffing position

Optimum neutral head position for the uninjured child who requires airway management

T/F A prolonged asthma attack that is unrelieved may progress to a condition known as status ashtmaticus.

T

T/F A rectal temperature is the most accurate for infants to toddlers.

T

T/F Adolescence is a time for experimentation and risk-taking behaviors.

T

T/F An oropharyngeal airway should be used for pediatric patients who are unconscious and in possible respiratory failure.

T

T/F At around 8 to 10 years of age, children no longer require padding underneath the torso to create a neutral position.

T

T/F Do not examine the genitalia of a young child unless there is evidence of bleeding or there is an injury that must be treated.

T

T/F EMTs in all states must report all cases of suspected abuse, even if the emergency department fails to do so.

T

T/F Infants and young children should be kept warm during a transport or when the patient is exposed to assess or reassess an injury.

T

T/F Some of the risks that adolescents take can ultimately facilitate development and judgment.

T

T/F Sprains are uncommon in the pediatric population.

T

T/F Toddlers have a hard time describing or localizing pain because they do not have the verbal ability to be precise.

T

Activated charcoal is not indicated for pediatric patients who have ingested a

a. acid b. alkali c. petroleum product d. all of the above Answer is d. all of the above

Signs of shock in children include all of the following except:

a. altered mental status b. poor capillary refill c. hypertension d. tachycardia Answer is c. hypertension

Pupillary response in pediatric patients may be abnormal in the presence of all of the following except

a. anxiety b. hypoxia c. brain injury d. drugs Answer is a. anxiety

All of the following are signs associated with pneumonia in pediatric patients except:

a. bradycardia b. grunting c. nasal flaring d. hypothermia Answer is a. bradycardia

Which of the following is not a sign of severe dehydration in pediatric patients?

a. bulging fontanels b. very dry lips and gums c. eyes look sunken d. sleepiness Answer is a. bulging fontanels

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

a. cerebral edema b. hypoglycemia c. abdominal distention d. chest pain Answer is c. abdominal distention

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

a. cholecystitis b. gastroenteritis c. appendicitis d. constipation Answer is c. appendicitis

Which of the following is appropriate when treating pediatric patients with seizures?

a. clear the mouth with suction b. provide 100% oxygen c. consider placing the patient in the recovery position d. all of the above Answer is d. all of the above

Incidents involving the death of a child pose extra stress on EMS workers. Which of the following is not a sign of posttraumatic stress?

a. cold intolerance b. nightmares c. difficult sleeping d. loss of appetite Answer is a sign of posttraumatic stress?

Young children can compensate for fluid losses by:

a. decreasing blood flow to the brain and heart b. decreasing blood flow to the extremities c. increasing blood flow to the extremities d. increasing blood flow to the gastrointestinal tract Answer is b. decreasing blood flow to the extremities

In pediatric patients, guarding of the abdomen suggests:

a. diarrhea b. nausea c. infection d. dehydration Answer is c. infection

Which of the following is not a question you would as if you suspected a poisoning emergency?

a. did the substance have an odor? b. are there any changes in behavior or level of consciousness? c. what is the substance involved? Answer is a. did the substance have an odor?

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

a. diseases of the heart b. severe infection c. dehydration d. renal failure Answer is d. severe infection

Breathing requires the use of the _________ muscles and diaphragm.

chest

_________ __________ are recommended to relieve a severe airway obstruction in an unconscious pediatric patient.

chest compressions

A common cause of shock in an infant is:

dehydration from vomiting and diarrhea