Chapter 34 Pediatric Emergencies – Flashcards
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In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:
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severe hypoxia and bradycardia.
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A pediatric patient involved in a drowning emergency may present with:
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abdominal distension.
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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:
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inform that mother that, although the event seems to have resolved, transport via EMS is advisable.
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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:
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perform abdominal thrusts.
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When ventilating a pediatric patient with a bag-valve mask, the EMT should:
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block the pop-off valve if needed to achieve adequate chest rise.
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A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following findings would be the most indicative of decompensated shock?
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Blood pressure of 70/40 mm Hg
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Al of the following are normal findings in an infant child, EXCEPT:
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head bobbing.
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Which of the following represents a low normal systolic blood pressure for a 6-year-old child?
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82 mm Hg
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Inserting a(n) ___ in a responsive patient may cause a spasm of the larynx and result in vomiting.
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oropharyngeal airway
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Which of the following assessment findings should concern the EMT the MOST when assessing a child who experienced a seizure?
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Neck stiffness
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Bruising to the ___ is LEAST suggestive of child abuse.
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shins
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Infection should be considered a possible cause of an airway obstruction in an infant of child, especially if he or she presents with:
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drooling or congestion.
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A viral infection that may cause obstruction of the upper airway in a child is called:
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croup.
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When a child is struck by a car, the area of greatest injury depends MOSTLY on the:
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age of the child and the size of the car that struck him or her.
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The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-valve mask ventilations is to:
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observe the chest for adequate rise.
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If a nasopharyngeal airway is too long, it may:
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stimulate the vagus nerve.
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When administering oxygen to a frightened child, it would be MOST appropriate to:
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place oxygen tubing through a hole in a paper cup.
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A common cause of shock in an infant is:
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dehydration from vomiting and diarrhea..
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Which of the following is NOT a known risk factor of SIDS?
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Putting a baby to sleep on his or her back
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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:
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stabilize his head and check for a pulse.
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Febrile seizures in a child:
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may indicate a serious underlying illness.
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Burns in children are commonly caused by all of the following, EXCEPT:
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entrapment in a structural fire.
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Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:
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intercostal muscles are not well developed.
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After determining that an infant or child has strong central pulses, you should:
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not rule out compensated shock.
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Death caused by shaken baby syndrome is usually the result of:
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bleeding in the brain.
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Child 1 to 3 years of age
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Toddler
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First year of life
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Infancy
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Child 3 to 6 years of age
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Preschool-age
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Child 12 to 18 years of age
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Adolescent
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After questioning the parent of a child who injected a poisonous substance, which of the following questions would be of LEAST pertinence initially?
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Why did your child ingest the poison?
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A high-pitched inspiratory sound that indicated a partial upper airway obstruction is called:
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stridor.
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During the attempted resuscitation of an infant with suspected SIDS:
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allow the family yo observe if they wish.
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Children not only have a higher metabolic rate, but also a high ___, which is twice that of an adult.
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oxygen demand
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Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:
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sunken fontanelles.
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Breath sounds in the pediatric population are more easily heard because:
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their chest walls are thinner.
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The purpose of the pediatric assessment triangle (PAT) is to:
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allow you to rapidly and visually form a general impression of the child.
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Which of the following statements regarding spinal injuries in pediatric patients is correct?
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If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.
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When caring for a female child who has possibly been sexually abused, you should:
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have a female EMT remain with her if possible.
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Infants begin saying their first word, sitting without support, and teething at 6 to ___ months.
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12
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Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:
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at the feet.
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A pediatric patient with a fever, pain on palpation of the right lower quadrant, and rebound tenderness is likely suffering from ___.
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appendicitis
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After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:
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2 seconds.
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Immediate transport is indicated for a child when he or she:
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has a history compatible with a serious illness.
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Blood pressure is usually not assessed in children younger than ___ years.
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3
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Which of the following findings is LEAST suggestive of child abuse?
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Consistency in the method of injury reported by the caregiver
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Which of the following statements regarding pediatric trauma is correct?
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Children are more likely to experience diving-related injuries
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Pupillary response in pediatric patients may be abnormal in the presence of all of the following, EXCEPT:
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anxiety.
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The MOST common cause of dehydration in pediatric patients is:
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vomiting and diarrhea.
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Signs of severe dehydration in an infant include all of the following, EXCEPT:
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bulging fontanelles
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In most children, febrile seizures are characterized by:
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generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.
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Early signs of respiratory distress in pediatric patients include all of the following, EXCEPT:
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cyanosis.
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Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:
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6 years.
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Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:
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wheezing.
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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
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18, 6
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An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:
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cause the child to vomit.
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When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ___ pulse.
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femoral
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Which of the following statements regarding the use of nasopharyngeal airways in children is correct?
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They are rarely used in infants younger than 1 year.
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When assessing an infant's ventilation status, you should:
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palpate the abdomen for rise and fall.
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If the situation allows, a child should be transported in a car seat if he or she weighs less than ___ lb.
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40
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Before assessing the respiratory adequacy of an unconscious infant or child, you must:
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ensure that the airway is patent and clear of obstructions.
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The normal respiratory rate for a newborn should not exceed ___ breaths/min.
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60
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Hyperthermia differs from fever in that it is an increase in body temperature:
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caused by the inability of the body to cool itself.
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When a child experiences a blunt chest injury:
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the flexible ribs can be compressed without breaking.
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A normal level of consciousness in an infant or child is characterized by:
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age-appropriate behavior, good muscle tone, and good eye contact.
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Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?
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Sexual activity
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Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:
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his or her tidal volume is adequate.
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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.
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pediatric assessment triangle
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Which of the following children would benefit the LEAST from a nonrebreathing mask?
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An unresponsive 5-year-old male with shallow respirations.
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Before positioning an infant or child's airway, you should:
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place him or her on a firm surface.
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The signs and symptoms of poisoning in children:
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vary widely, depending on the child's age and weight.
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Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:
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older than 8 to 10 years of age.
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With regard to the legal implications of child abuse:
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EMTs must report all suspected cases of child abuse.
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An infant with severe dehydration would be expected to present with:
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absent urine output.
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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:
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administering blow-by oxygen and transporting the child with her mother.
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When you are performing a scene assessment at an incident involving SIDS, you should focus your attention on all of the following, EXCEPT:
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the temperature of the room.
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Which of the following is MORE common in children than in adults following a head injury?
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Nausea and vomiting
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Early signs of respiratory distress in the child include:
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restlessness.
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Which of the following signs and symptoms would MOST likely cause the EMT to mistake a head injury for an abdominal injury in a child?
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Vomiting
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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:
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encourage him to cough, give oxygen as tolerated, and transport
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Which of the following groups of people is associated with the lowest risk of meningitis?
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Females
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Which of the following is NOT a common cause of altered mental status in pediatric patients?
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Hypertension
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While triaging patients at the scene of a motor-vehicle crash, you encounter a 5-year-old who is unresponsive and apneic. After positioning his airway, you should"
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deliver 5 rescue breaths.
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Which of the following statements regarding sudden infant death syndrome (SIDS) is correct?
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Death as a result of SIDS can occur at any time of day or night.
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A child may begin to show signs of separation anxiety as early as:
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6 months.
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When inserting an oropharyngeal airway in an infant or child, you should:
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depress the tongue with a tongue depressor.
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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:
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inform the child's mother that her son is deceased.
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Children with N. meningitides would MOST likely present with:
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cherry-red spots or a purplish rash.
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Signs of vasoconstriction in the infant or child include:
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weak distal pulses.
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The EMT should be MOST concerned when a child presents with fever and:
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a rash.
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Greenstick fractures occur in infants and children because:
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their bones bend more easily than an adult's.
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An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:
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grunting.
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Which of the following an appropriate dose of activated charcoal for a 20-kg child?
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20 g
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Which of the following is NOT a common exposure when dealing with pediatric burns?
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Electrocution from poor wiring
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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:
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cool the child with tepid water and transport to the hospital.
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When assessing an 8-year-old child, you should:
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talk to the child, not just the caregiver.
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Common causes of seizures in children include all of the following, EXCEPT:
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hyperglycemia
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Drawing in of the muscles between the ribs or of the sternum during inspiration is called:
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retracting.
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The first month of life after birth is referred to as the:
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neonatal period.
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Pale skin in a child indicates that the:
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blood vessels near the skin are constricted.
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When immobilizing an injured child in a pediatric immobilization device, you should:
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secure the torso before the head.
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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:
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moderate dehydration.
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Effective methods for providing pain relief to a child with an extremity injury include:
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positioning, ice packs, and extremity elevation.
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Causes of infant death that mat be mistaken for SIDS include all of the following, EXCEPT:
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hyperglycemia.
