Podcast
Questions and Answers
The first month of life after birth is referred to as the:
The first month of life after birth is referred to as the:
Which of the following statements regarding a 3-month-old infant is correct?
Which of the following statements regarding a 3-month-old infant is correct?
A child may begin to show signs of separation anxiety as early as:
A child may begin to show signs of separation anxiety as early as:
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:
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Which of the following statements regarding preschool-age children is correct?
Which of the following statements regarding preschool-age children is correct?
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When assessing an 8-year-old child, you should:
When assessing an 8-year-old child, you should:
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When assessing or treating an adolescent patient, it is important to remember that:
When assessing or treating an adolescent patient, it is important to remember that:
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Which of the following statements regarding a pediatric patient's anatomy is correct?
Which of the following statements regarding a pediatric patient's anatomy is correct?
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The normal respiratory rate for a newborn should not exceed ______ breaths/min.
The normal respiratory rate for a newborn should not exceed ______ breaths/min.
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Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:
Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:
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Pale skin in a child indicates that the:
Pale skin in a child indicates that the:
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Signs of vasoconstriction in the infant or child include:
Signs of vasoconstriction in the infant or child include:
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Which of the following statements regarding spinal injuries in pediatric patients is correct?
Which of the following statements regarding spinal injuries in pediatric patients is correct?
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Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are:
Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are:
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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.
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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The purpose of the pediatric assessment triangle (PAT) is to:
The purpose of the pediatric assessment triangle (PAT) is to:
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The components of the PAT are:
The components of the PAT are:
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After using the PAT to form your general impression of a sick or injured child, you should:
After using the PAT to form your general impression of a sick or injured child, you should:
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A normal level of consciousness in an infant or child is characterized by:
A normal level of consciousness in an infant or child is characterized by:
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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:
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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Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:
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Before assessing the respiratory adequacy of a semiconscious infant or child, you must:
Before assessing the respiratory adequacy of a semiconscious infant or child, you must:
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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:
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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Before positioning an infant or child's airway, you should:
Before positioning an infant or child's airway, you should:
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To ensure that the airway of an infant or small child is correctly positioned, you may have to:
To ensure that the airway of an infant or small child is correctly positioned, you may have to:
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When assessing an infant's ventilation status, you should:
When assessing an infant's ventilation status, you should:
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All of the following are normal findings in an infant or child, EXCEPT:
All of the following are normal findings in an infant or child, EXCEPT:
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Drawing in of the muscles between the ribs or of the sternum during inspiration is called:
Drawing in of the muscles between the ribs or of the sternum during inspiration is called:
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A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:
A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:
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When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse.
When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse.
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After determining that an infant or child has strong central pulses, you should:
After determining that an infant or child has strong central pulses, you should:
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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:
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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Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:
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Immediate transport is indicated for a child when he or she:
Immediate transport is indicated for a child when he or she:
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You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:
You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:
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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.
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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Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?
Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?
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The secondary assessment of a sick or injured child:
The secondary assessment of a sick or injured child:
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Blood pressure is usually not assessed in children younger than _____ years.
Blood pressure is usually not assessed in children younger than _____ years.
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Which of the following represents a low normal systolic blood pressure for a 6-year-old child?
Which of the following represents a low normal systolic blood pressure for a 6-year-old child?
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Early signs of respiratory distress in the child include:
Early signs of respiratory distress in the child include:
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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:
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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The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:
The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:
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A viral infection that may cause obstruction of the upper airway in a child is called:
A viral infection that may cause obstruction of the upper airway in a child is called:
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Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:
Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:
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Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:
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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:
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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Signs of a severe airway obstruction in an infant or child include:
Signs of a severe airway obstruction in an infant or child include:
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A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:
A 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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An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:
An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:
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The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to:
The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to:
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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:
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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When inserting an oropharyngeal airway in an infant or child, what should you ensure?
When inserting an oropharyngeal airway in an infant or child, what should you ensure?
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Which of the following statements regarding the use of nasopharyngeal airways in children is correct?
Which of the following statements regarding the use of nasopharyngeal airways in children is correct?
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If a nasopharyngeal airway is too long, what may it cause?
If a nasopharyngeal airway is too long, what may it cause?
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Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:
Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:
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Which of the following children would benefit the LEAST from a nonrebreathing mask?
Which of the following children would benefit the LEAST from a nonrebreathing mask?
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When administering oxygen to a frightened child, it would be MOST appropriate to:
When administering oxygen to a frightened child, it would be MOST appropriate to:
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When ventilating a pediatric patient with a bag-mask device, the EMT should:
When ventilating a pediatric patient with a bag-mask device, the EMT should:
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The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to:
The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to:
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Cardiac arrest in the pediatric population is MOST commonly the result of:
Cardiac arrest in the pediatric population is MOST commonly the result of:
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In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:
In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:
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A common cause of shock in an infant is:
A common cause of shock in an infant is:
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Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.
Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.
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Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children?
Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children?
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Common causes of seizures in children include all of the following, EXCEPT:
Common causes of seizures in children include all of the following, EXCEPT:
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Febrile seizures are MOST common in children between:
Febrile seizures are MOST common in children between:
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In most children, febrile seizures are characterized by:
In most children, febrile seizures are characterized by:
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Febrile seizures in a child:
Febrile seizures in a child:
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A 2-year-old female has experienced a seizure. When you arrive at the scene, what should you do?
A 2-year-old female has experienced a seizure. When you arrive at the scene, what should you do?
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Which of the following groups of people is associated with the lowest risk of meningitis?
Which of the following groups of people is associated with the lowest risk of meningitis?
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Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:
Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:
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Children with N meningitides would MOST likely present with:
Children with N meningitides would MOST likely present with:
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The signs and symptoms of poisoning in children:
The signs and symptoms of poisoning in children:
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When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence?
When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence?
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A 4-year-old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert. What should you do?
A 4-year-old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert. What should you do?
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Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child?
Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child?
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The MOST common cause of dehydration in pediatric patients is:
The MOST common cause of dehydration in pediatric patients is:
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An infant with severe dehydration would be expected to present with:
An infant with severe dehydration would be expected to present with:
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Signs of severe dehydration in an infant include all of the following, EXCEPT:
Signs of severe dehydration in an infant include all of the following, EXCEPT:
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A 6-month-old male presents with 2 days of vomiting and diarrhea. What should you suspect?
A 6-month-old male presents with 2 days of vomiting and diarrhea. What should you suspect?
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The EMT should be MOST concerned when a child presents with fever and:
The EMT should be MOST concerned when a child presents with fever and:
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Hyperthermia differs from fever in that it is an increase in body temperature:
Hyperthermia differs from fever in that it is an increase in body temperature:
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Submersion injuries in the adolescent age group are MOST commonly associated with:
Submersion injuries in the adolescent age group are MOST commonly associated with:
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Which of the following statements regarding pediatric trauma is correct?
Which of the following statements regarding pediatric trauma is correct?
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When a child is struck by a car, the area of greatest injury depends MOSTLY on the:
When a child is struck by a car, the area of greatest injury depends MOSTLY on the:
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Which of the following is MORE common in children than in adults following a head injury?
Which of the following is MORE common in children than in adults following a head injury?
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When immobilizing an injured child in a pediatric immobilization device, you should:
When immobilizing an injured child in a pediatric immobilization device, you should:
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Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:
Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:
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The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if:
The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if:
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When a child experiences a blunt chest injury:
When a child experiences a blunt chest injury:
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When a child experiences a blunt injury to the abdomen:
When a child experiences a blunt injury to the abdomen:
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Burns in children are commonly caused by all of the following, EXCEPT:
Burns in children are commonly caused by all of the following, EXCEPT:
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Critical burns in children include:
Critical burns in children include:
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Greenstick fractures occur in infants and children because:
Greenstick fractures occur in infants and children because:
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Effective methods for providing pain relief to a child with an extremity injury include:
Effective methods for providing pain relief to a child with an extremity injury include:
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Which of the following findings is LEAST suggestive of child abuse?
Which of the following findings is LEAST suggestive of child abuse?
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Bruising to the _________ is LEAST suggestive of child abuse.
Bruising to the _________ is LEAST suggestive of child abuse.
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Death caused by shaken baby syndrome is usually the result of:
Death caused by shaken baby syndrome is usually the result of:
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With regard to the legal implications of child abuse:
With regard to the legal implications of child abuse:
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Study Notes
Pediatric Emergencies Overview
- The neonatal period spans the first month after birth, crucial for infant health assessments.
- A 3-month-old infant can distinguish parents from strangers, indicating developing social skills.
Developmental Milestones
- Signs of separation anxiety can begin as early as 6 months.
- For toddlers, assessment generally starts at the feet to reduce anxiety.
- Preschoolers can identify painful areas when asked, aiding in pain management.
Assessment Protocols
- Engage with the child directly during assessments, especially for older children.
- Adolescents often prefer privacy during procedures; they may resist direct observation.
Anatomical Considerations
- Pediatric patients possess anatomical differences, such as a larger occiput and a proportionally larger tongue.
- The diaphragm is more significant for respiration in children due to less developed intercostal muscles.
Vital Signs and Indicators
- Normal respiratory rate for newborns should not exceed 60 breaths per minute.
- Weak distal pulses and pale skin are indicators of potential circulatory issues in children.
Respiratory Assessment
- Early signs of respiratory distress include tachypnea and use of accessory muscles for breathing.
- Observe for grunting as a sign of attempting to keep alveoli expanded during respiratory distress.
Airway Management
- In cases of suspected airway obstruction, abdominal thrusts are indicated, especially if the child is cyanotic.
- Avoid using oropharyngeal airways in children who might have ingested caustic substances, as it may induce vomiting.
Pediatric Transport Needs
- Immediate transport is necessary for children showing signs of severe illness or critical condition.
- In non-responsive cases, stabilize the head and check for pulse before initiating further interventions.
Equipment and Interventions
- Use a length-based resuscitation tape measure for accurate pediatric equipment sizing.
- Ensure adequate tidal volume before using nonrebreathing masks or nasal cannulas in children.
Special Situations
- Children with severe respiratory distress, even with normal consciousness, may need ventilation assistance.
- Postural adjustments, like placing towels behind shoulders, can help maintain an open airway in small children.
Signs of Severe Conditions
- Rapidly identify severe airway obstructions characterized by ineffective coughing.
- Bradycardia is a concerning sign indicating potential cardiopulmonary arrest in pediatric patients.
Infections and Emergencies
- Conditions like croup can cause upper airway obstruction and need immediate attention.
- Drooling in conjunction with respiratory distress may indicate a severe infection or obstruction.
Capillary Refill and Blood Pressure
- Normal capillary refill time in children is ideally within 2 seconds; assess reliability when under 6 years old.
- Blood pressure assessments are generally not performed on children younger than 3 years, focusing on other vital signs.
Conclusion
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Maintaining a child-focused approach during assessments and interventions is vital for effective emergency care.
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Recognizing developmental stages and physiological differences enhances the quality of care for pediatric patients.### Pediatric Emergency Care Notes
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During oxygen administration, a parent should restrain the child while using a nasal cannula instead of a non-rebreathing mask to ensure comfort and safety.
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Proper ventilation technique for pediatric patients includes blocking the pop-off valve as needed to achieve adequate chest rise when using a bag-mask device.
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Monitoring chest rise is the most accurate way to assess if adequate tidal volume is being delivered during bag-mask ventilations.
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The leading cause of cardiac arrest in pediatrics is respiratory or circulatory failure, rather than various other factors such as congenital defects or arrhythmias.
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Infants and children usually experience deterioration to cardiac arrest associated with severe hypoxia and bradycardia, as opposed to adults who may show arrhythmic disturbances.
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Shock in infants is commonly due to dehydration resulting from vomiting and diarrhea.
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Blood loss of over 25% of total blood volume significantly increases the risk of shock in children.
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Blood pressure is the least reliable indicator of shock presence when evaluating infants and children; heart rate, skin condition, and capillary refill are more reliable.
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Common causes of seizures in children include infection, electrolyte imbalances, and poisonings, while hyperglycemia is not typically a cause.
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Febrile seizures are most frequent in children aged 6 months to 6 years and are characterized by generalized tonic-clonic activity lasting under 15 minutes, with a short or absent postictal phase.
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When assessing a child with a seizure and fever, cool the child and provide oxygen but transport immediately; meningitis must be considered in the presence of a rash.
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For children experiencing poisoning, assessment varies widely based on age and weight; questions about the substance ingested are critical, while the reason for ingestion is less relevant.
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A child with burns around the mouth from liquid drain cleaner should be monitored closely and given oxygen, with airway protection being the priority.
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The standard dose of activated charcoal for a 20 kg child is 20 grams, which aids in managing poison ingestion.
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The most common cause of dehydration in pediatric patients is vomiting and diarrhea, with signs of severe dehydration including absent urine output and extreme thirst.
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Assess for a rash when a child presents with fever, as it may indicate more serious conditions.
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Hyperthermia is regulated by the body’s failure to cool itself, distinguishing it from fever which is typically due to infection.
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Submersion injuries among adolescents are often linked to alcohol consumption; preventive education is key.
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Pediatric trauma often results from recklessness or accidents, with specific injuries depending on child size and location of impact.
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When immobilizing injured children, secure the torso before the head to ensure stability and proper alignment.
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Burns in children are frequently due to hot surfaces or scalds, while burns from structural fires are less common.
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Partial-thickness burns exceeding 20% are classified as critical burns in children, requiring comprehensive medical evaluation.
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Greenstick fractures are more common in children due to their more flexible bones compared to adults.
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Emotional support, proper positioning, and the application of ice packs are effective pain relief methods for children with injuries.
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Signs that suggest potential child abuse include atypical bruising patterns (not localized to shins) and inconsistent accounts of injury.
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Shaken baby syndrome typically leads to death due to brain hemorrhaging; all suspected child abuse cases must be reported by EMTs to ensure child safety.
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Description
This quiz focuses on Pediatric Emergencies as covered in EMT Chapter 34. Test your knowledge on key concepts related to neonatal care and infant development. Prepare to enhance your understanding of the critical first month of life and common emergencies.
