Infant Foreign Body Obstruction Quiz

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Questions and Answers

What is a common sign of mild foreign body obstruction in infants?

Cyanosis

Loss of consciousness

Decreased work of breathing

Stridor (correct)

What should be the first action taken if an unresponsive infant is found to have a foreign body obstruction?

Look inside the mouth for the object (correct)

Begin CPR immediately

Attempt to ventilate

Initiate the Heimlich maneuver

Which of the following is NOT a characteristic of severe foreign body obstruction in infants?

Unconsciousness

Good color (correct)

Increased work of breathing

Cyanotic appearance

What should be done if a responsive child is experiencing a foreign body aspiration?

Administer five back slaps followed by five chest thrusts Signup and view all the answers

What should be performed after assessing pulse and attempting ventilation on an unresponsive infant with a foreign body obstruction?

Continue CPR and repeat the process Signup and view all the answers

What characterizes respiratory distress in pediatric emergencies?

Increased work of breathing resulting in adequate gas exchange. Signup and view all the answers

What is the primary difference between respiratory failure and arrest?

In respiratory failure, the patient can still compensate; in arrest, they cannot. Signup and view all the answers

Which of the following indicates a critical state where early intervention is crucial?

Respiratory failure Signup and view all the answers

What is a sign that may indicate the severity of a patient's respiratory condition?

Patient’s position of comfort Signup and view all the answers

Which condition progresses from respiratory distress if fatigue sets in?

Respiratory failure Signup and view all the answers

When managing airway and breathing in pediatric emergencies, what should be assessed to gauge severity?

Presence or absence of retractions Signup and view all the answers

What is one of the main factors to identify before succeeding in airway management?

Severity of respiratory distress Signup and view all the answers

What is the primary objective of reassessing the patient frequently during pediatric respiratory emergencies?

To adjust treatment based on condition changes Signup and view all the answers

What is a key component of asthma that contributes to respiratory issues?

Bronchospasm Signup and view all the answers

Which of the following is the primary treatment for pneumonia?

Supportive care Signup and view all the answers

What is a common trigger for asthma that could lead to an exacerbation?

Exposure to secondhand smoke Signup and view all the answers

Which medication may be given to a patient experiencing moderate to severe respiratory distress due to asthma?

Ipratropium Bromide Signup and view all the answers

What position is recommended for a patient experiencing respiratory distress from asthma?

Sitting upright in a chair Signup and view all the answers

Which clinical sign is commonly associated with asthma?

Frequent cough Signup and view all the answers

Inhaled salbutamol is used primarily for which purpose in asthma management?

Relieving bronchospasm Signup and view all the answers

What symptom is usually more likely in pneumonia compared to asthma?

Fever Signup and view all the answers

What is the primary purpose of using an OPA?

To keep the tongue from blocking the airway Signup and view all the answers

In which scenario is a non-rebreathing mask preferred?

For patients in respiratory distress or failure Signup and view all the answers

When should the blow-by technique be used for oxygenation?

When the patient is unable to wear a mask Signup and view all the answers

What is the first step in addressing foreign body aspiration in children?

Look inside the mouth first Signup and view all the answers

What is a common sign of croup in a pediatric patient?

Barky cough Signup and view all the answers

What is a contraindication for using an OPA in a patient?

Moderate to severe head trauma Signup and view all the answers

What should be the rate of breaths delivered using bag-mask ventilation for infants?

12 to 20 breaths/min Signup and view all the answers

Which management strategy is recommended for a child with severe croup?

Nebulize with Epinephrine Signup and view all the answers

Which method is generally not appropriate for children under 1 year?

OPA Signup and view all the answers

Which of the following symptoms is NOT typically associated with epiglottitis?

Dry cough Signup and view all the answers

How does the appearance of a child with croup typically present?

Alert with normal color Signup and view all the answers

What might indicate the need for a variety of mask sizes during bag-mask ventilation?

Ineffective airway positioning Signup and view all the answers

All pediatric patients with respiratory emergencies should receive:

Supplemental oxygen Signup and view all the answers

What is a primary concern when assessing a child suspected of having epiglottitis?

Inquire about immunizations Signup and view all the answers

What should NOT be done when managing a child with croup?

Agitate the child to assess reactions Signup and view all the answers

Which description best fits epiglottitis?

Inflammation of the supraglottic structures Signup and view all the answers

What is the primary initial treatment for anaphylaxis?

Epinephrine Signup and view all the answers

Which of the following symptoms indicates severe anaphylaxis?

Swelling of the lips and oral mucosa Signup and view all the answers

What characteristic findings are associated with bronchiolitis?

Mild to moderate retractions Signup and view all the answers

What should be administered for respiratory distress in anaphylaxis?

Supplemental oxygen Signup and view all the answers

Which medication is used in treating severe allergies or anaphylaxis?

Epinephrine 1:1,000 Signup and view all the answers

What is the main management approach for bronchiolitis?

Supportive care Signup and view all the answers

Which of the following is NOT a symptom of anaphylaxis?

Mild hypoxia Signup and view all the answers

What condition is primarily characterized by inflammation of small airways due to viral infection?

Bronchiolitis Signup and view all the answers

What is a common trigger for anaphylaxis?

Exposure to an antigen Signup and view all the answers

What role does nebulized epinephrine play in pediatric respiratory emergencies?

To treat severe allergic reactions Signup and view all the answers

Study Notes

Pediatric Respiratory Emergencies

Course: HEM - 2123
Instructor: Harmiya Hakkim
Date: November 25, 2024

Section Overview

Respiratory Distress
Respiratory Failure
Upper Airway Problems
Lower Airway Problems
Airway and Breathing Management
- Basic airway management
- Advanced airway management

Respiratory Emergencies

Respiratory failure and arrest frequently precede cardiac arrests
Early identification and intervention are crucial

Respiratory Distress & Failure

Respiratory Distress: Increased work of breathing, adequate gas exchange
Respiratory Failure: Patient can no longer compensate; hypoxia and/or carbon dioxide retention occur
Respiratory Arrest: Patient stops breathing

Respiratory Distress & Failure (Assessment)

Use PAT (Pulse, Appearance, and Tone) to determine severity before touching the patient
Assess patient's work of breathing by:
- Noting patient's position of comfort
- Observing presence or absence of retractions
- Identifying signs of grunting or flaring

Respiratory Distress & Failure (Key Questions)

Determine if patient has respiratory distress, failure, or arrest
Respiratory distress requires generic treatment
With fatigue, distress progresses to failure
Reassess frequently

Upper Airway Problems

Foreign body aspiration (FBAO) and choking
Croup
Epiglottitis
Anaphylaxis

Foreign Body Aspiration/Obstruction

Infants and toddlers at high risk
Mild obstruction: Awake, stridor, increased work of breathing, good color
Severe obstruction: Cyanosis, unconscious
Responsive infants (FBAO/Obstruction): Deliver 5 back slaps, 5 chest thrusts
Unresponsive infants (FBAO/Obstruction):
- Look inside the mouth; remove object if visible
- If not, begin CPR (even if pulse is present)
- 30 compressions
- Look inside the mouth first
- Attempt to ventilate
- Assess for a pulse
- Repeat
Children: Heimlich maneuver
- If unresponsive:
  - Look inside mouth – remove object if visible; if not, begin CPR
  - 30 compressions
  - Look inside the mouth first
  - Attempt to ventilate
  - Assess for pulse
  - Repeat

Croup

Viral infection of the upper airway
Patients typically alert
Clinical signs: Audible stridor, barky cough, some increased work of breathing, normal skin color

Croup (Initial Management)

Position of comfort
Avoid agitating the child
Nebulize with normal 0.9% saline (IV fluid)
If severe, call an Advanced Paramedic
Nebulize with Epinephrine

Epiglottitis

Inflammation of the supraglottic structures
Classic presentation: Sick, anxious, Drooling, Increased work of breathing, Pallor or cyanosis
Symptoms progress rapidly
Ask about immunizations, and get the child to an appropriate hospital
Be prepared with a bag-mask device
Call advanced paramedic
Nebulized Epinephrine
Humidified oxygen

Anaphylaxis

Potentially life-threatening allergic reaction
Triggered by exposure to an antigen
Typically affects children older than 2 years
Onset of symptoms occurs immediately
- Hives
- Respiratory distress
- Circulatory compromise
- Gastrointestinal symptoms
Severe anaphylaxis: Child may be unresponsive, primary assessment may reveal
- Hives
- Swelling of lips/oral mucosa
- Stridor/wheezing
- Diminished pulses

Anaphylaxis (Treatment)

Epinephrine
Supplemental oxygen
Fluid resuscitation for shock
Antihistamine medications
Bronchodilator medications

Anaphylaxis (Medications)

Epinephrine (1:1,000): Severe allergy or anaphylaxis
- Adult/child over 8 years: 0.5 mg injection
- Child (6-8 years): 0.25 mg injection
- Child (6 months - 5 years): 0.125 mg injection
- Infant (less than 6 months): 0.05 mg injection
Chlorpheniramine:
Mild: 4 mg tablet
Moderate: 10 mg injection
Severe: 10 mg injection

Lower Airway Problems

Bronchiolitis
Asthma
Pneumonia

Bronchiolitis

Inflammation/swelling of small airways in the lower respiratory tract due to viral infection
Highly contagious
Characteristic findings: Mild to moderate retractions, Tachypnea, Diffuse wheezing, Mild hypoxia

Bronchiolitis (Management)

Management entirely supportive
Position of comfort
Supplemental oxygen
Humidified oxygen
Inhaled salbutamol may be given for moderate to severe respiratory distress

Asthma

Chronic disease
Generally diagnosed only after 2 years of age
Disease of the small airways
Main Components: Bronchospasm, Mucus production, Airway inflammation, Results in hypoxia
Triggers: Upper respiratory infections, Allergies, Exposure to cold, Changes in the weather, Secondhand smoke
Clinical signs: Frequent cough, Wheezing, General signs of respiratory distress

Asthma (Symptoms)

Coughing, Wheezing, Difficulty breathing, Fatigue
Warning Signs: Headache, Stuffy/runny nose, Sore throat, Coughing/wheezing after exercise, Difficulty sleeping, Feeling moody/irritable, Tiredness/weakness during physical activity

Asthma (Management)

Initial management: Position of comfort, Supplemental oxygen, Bronchodilators
- Salbutamol, Ipratropium Bromide

Pneumonia

Disease infecting lower airway and lung
Normally a bacterial infection
Child will require antibiotics
Signs: Unusually rapid breathing, Grunting/wheezing/crackles, Hypothermia/fever
Primary treatment is supportive

Airway Management

Look for obstructions
Position airway
Sniffing position
Airway adjunct (OPA/NPA) may be helpful - OPA keeps tongue from blocking airway
Rarely used for children under 1 year
Avoid if facial trauma or moderate/severe head trauma

Airway Management (Oxygenation)

All children with respiratory emergencies should receive supplemental oxygen.
Common methods for pediatric patients:
- Blow-by technique
- Non-rebreathing mask

Airway Management (Bag-Mask Ventilation)

Use if airway positioning/adjunct does not improve respiratory effort
May need to try a variety of mask sizes
Deliver breaths at a rate of 12 to 20 breaths/min for infants and children (depends on age)
Ensure equipment is the right size
Maintain a good seal with the face
Ventilate at the appropriate rate and volume
Do not hyperventilate
Squeeze only until you see chest rise
Two-person bag-mask ventilation is usually more effective

Advanced Airway Management (CPG)

Assess for apnoea or special clinical considerations (e.g. GCS 3, SpO2 < 92%, RR ≤ 9, BVM ineffective).
Minimum age for advanced airway is 2 years old.
Consider FBAO.
Proceed with supraglottic airway (maximum two attempts).
If unsuccessful, revert to basic airway management.
Ensure CO2 detection device in ventilation circuit and placement of advanced airway checked after each patient movement.

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Description

Test your knowledge on recognizing and responding to foreign body obstruction in infants. This quiz covers signs, initial actions, and appropriate responses during emergencies. Improve your understanding of this critical topic to ensure better infant care.