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?

<p>Administer five back slaps followed by five chest thrusts (C)</p> 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?

<p>Continue CPR and repeat the process (C)</p> Signup and view all the answers

What characterizes respiratory distress in pediatric emergencies?

<p>Increased work of breathing resulting in adequate gas exchange. (A)</p> Signup and view all the answers

What is the primary difference between respiratory failure and arrest?

<p>In respiratory failure, the patient can still compensate; in arrest, they cannot. (D)</p> Signup and view all the answers

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

<p>Respiratory failure (B)</p> Signup and view all the answers

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

<p>Patient’s position of comfort (D)</p> Signup and view all the answers

Which condition progresses from respiratory distress if fatigue sets in?

<p>Respiratory failure (A)</p> Signup and view all the answers

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

<p>Presence or absence of retractions (B)</p> Signup and view all the answers

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

<p>Severity of respiratory distress (B)</p> Signup and view all the answers

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

<p>To adjust treatment based on condition changes (D)</p> Signup and view all the answers

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

<p>Bronchospasm (B)</p> Signup and view all the answers

Which of the following is the primary treatment for pneumonia?

<p>Supportive care (D)</p> Signup and view all the answers

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

<p>Exposure to secondhand smoke (D)</p> Signup and view all the answers

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

<p>Ipratropium Bromide (A)</p> Signup and view all the answers

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

<p>Sitting upright in a chair (D)</p> Signup and view all the answers

Which clinical sign is commonly associated with asthma?

<p>Frequent cough (A)</p> Signup and view all the answers

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

<p>Relieving bronchospasm (D)</p> Signup and view all the answers

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

<p>Fever (A)</p> Signup and view all the answers

What is the primary purpose of using an OPA?

<p>To keep the tongue from blocking the airway (A)</p> Signup and view all the answers

In which scenario is a non-rebreathing mask preferred?

<p>For patients in respiratory distress or failure (C)</p> Signup and view all the answers

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

<p>When the patient is unable to wear a mask (C)</p> Signup and view all the answers

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

<p>Look inside the mouth first (D)</p> Signup and view all the answers

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

<p>Barky cough (B)</p> Signup and view all the answers

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

<p>Moderate to severe head trauma (C)</p> Signup and view all the answers

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

<p>12 to 20 breaths/min (D)</p> Signup and view all the answers

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

<p>Nebulize with Epinephrine (C)</p> Signup and view all the answers

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

<p>OPA (C)</p> Signup and view all the answers

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

<p>Dry cough (D)</p> Signup and view all the answers

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

<p>Alert with normal color (D)</p> Signup and view all the answers

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

<p>Ineffective airway positioning (C)</p> Signup and view all the answers

All pediatric patients with respiratory emergencies should receive:

<p>Supplemental oxygen (A)</p> Signup and view all the answers

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

<p>Inquire about immunizations (C)</p> Signup and view all the answers

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

<p>Agitate the child to assess reactions (C)</p> Signup and view all the answers

Which description best fits epiglottitis?

<p>Inflammation of the supraglottic structures (B)</p> Signup and view all the answers

What is the primary initial treatment for anaphylaxis?

<p>Epinephrine (C)</p> Signup and view all the answers

Which of the following symptoms indicates severe anaphylaxis?

<p>Swelling of the lips and oral mucosa (C)</p> Signup and view all the answers

What characteristic findings are associated with bronchiolitis?

<p>Mild to moderate retractions (B)</p> Signup and view all the answers

What should be administered for respiratory distress in anaphylaxis?

<p>Supplemental oxygen (B)</p> Signup and view all the answers

Which medication is used in treating severe allergies or anaphylaxis?

<p>Epinephrine 1:1,000 (B)</p> Signup and view all the answers

What is the main management approach for bronchiolitis?

<p>Supportive care (D)</p> Signup and view all the answers

Which of the following is NOT a symptom of anaphylaxis?

<p>Mild hypoxia (A)</p> Signup and view all the answers

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

<p>Bronchiolitis (B)</p> Signup and view all the answers

What is a common trigger for anaphylaxis?

<p>Exposure to an antigen (A)</p> Signup and view all the answers

What role does nebulized epinephrine play in pediatric respiratory emergencies?

<p>To treat severe allergic reactions (C)</p> Signup and view all the answers

Flashcards

Respiratory Distress

Increased work of breathing, but adequate gas exchange

Respiratory Failure

Patient cannot compensate; hypoxia or CO2 buildup.

Respiratory Arrest

Patient stops breathing.

Respiratory Distress vs. Failure

Distress = increased work, failure = inability to compensate.

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Assessing Respiratory Distress

Use PAT (Position, Airway, Talk), look for retractions, grunting, flaring.

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Initial Evaluation

Quickly determining respiratory distress severity before touching the patient.

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Work of Breathing

Effort required by the lungs, chest, and body muscles for breathing

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Respiratory Emergency Treatment

Distress needs general treatment, leading to failure with fatigue. Frequent reassessment needed.

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Foreign Body Aspiration Risk

Infants and toddlers are more likely to inhale foreign objects due to their smaller airways and exploratory behavior.

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Mild Foreign Body Obstruction

The airway is partially blocked, causing noisy breathing, increased effort to breathe, but the child remains conscious and has good skin color.

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Severe Foreign Body Obstruction

The airway is severely blocked, leading to cyanosis (blue skin color) and unconsciousness.

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Foreign Body Removal in a Responsive Infant

Five back blows followed by five chest thrusts are used to dislodge the object.

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Foreign Body Removal in an Unresponsive Infant

First, look inside the mouth for the object and remove it if visible. If not, begin CPR with 30 compressions and then attempt to ventilate. Assess for a pulse and repeat the cycle.

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Croup

A viral infection of the upper airway that causes a barking cough, stridor, and some increased work of breathing, but usually with normal skin color.

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Epiglottitis

Inflammation of the supraglottic structures causing a sick, anxious child with drooling, increased work of breathing, and pallor or cyanosis.

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Croup Management

Position of comfort, avoid agitation, nebulize with normal saline, call Advanced Paramedics for severe cases, consider Epinephrine nebulization.

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Foreign Body Aspiration - Mild

Partial airway obstruction causing noisy breathing, increased effort to breathe, but the child remains conscious and has good skin color.

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Foreign Body Aspiration - Severe

Complete or near-complete airway obstruction causing cyanosis and unconsciousness.

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Foreign Body Removal - Responsive Infant

For a conscious infant, administer five back blows followed by five chest thrusts to dislodge the object.

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Foreign Body Removal - Unresponsive Infant

For an unconscious infant, check the mouth for the object, remove it if visible. If not, begin CPR with 30 compressions, attempt ventilation, assess for a pulse, and repeat.

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Foreign Body Aspiration - Advanced Paramedics

Advanced Paramedics may use McGill's Forceps to remove foreign objects from the airway.

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Position of Comfort

Placing the patient in a bodily position that minimizes respiratory distress. Often involves sitting upright or leaning forward.

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Supplemental Oxygen

Providing extra oxygen to a patient who is experiencing breathing difficulties. Often administered via a mask or nasal cannula.

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Humidified Oxygen

Oxygen that has been moistened to reduce dryness in the airways. Useful for patients with dry coughs or respiratory illnesses.

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What is Inhaled Salbutamol Used For?

Inhaled salbutamol is a bronchodilator, used to relax constricted airways and improve breathing in patients with moderate to severe respiratory distress. Primarily used for asthma.

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Asthma Triggers

Factors that can worsen asthma symptoms, leading to airway inflammation, bronchospasm, and mucus production.

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Asthma Clinical Signs

Observable symptoms of an asthma attack, including coughing, wheezing, and difficulty breathing, indicating a need for medical attention.

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Asthma Management

A comprehensive approach to managing asthma, including identifying triggers, administering medications, and developing an individualised asthma action plan.

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Pneumonia Signs

Symptoms that indicate pneumonia, a lung infection, including rapid breathing, grunting, wheezing, and fever.

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Anaphylaxis Trigger

Anaphylaxis is caused by exposure to an antigen, which is a substance that causes an allergic reaction in the body.

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Anaphylaxis Symptoms

Anaphylactic reactions usually present with hives, respiratory distress, circulatory compromise, and gastrointestinal symptoms.

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Anaphylaxis Severity

Severe anaphylaxis can lead to unresponsiveness, swelling of the lips and oral mucosa, stridor or wheezing, and weak pulses.

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Anaphylaxis Treatment

The primary treatments for anaphylaxis include Epinephrine, supplemental Oxygen, fluid resuscitation for shock, antihistamines, and bronchodilators.

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Epinephrine for Anaphylaxis

Epinephrine (1:1,000) is the first-line medication for severe allergic reactions or anaphylaxis.

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Bronchiolitis Cause

Bronchiolitis is caused by an inflammation or swelling of the small airways in the lower respiratory tract due to a viral infection.

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Bronchiolitis Symptoms

Bronchiolitis typically presents with mild to moderate retractions, rapid breathing (tachypnea), wheezing, and mild oxygen deprivation (hypoxia).

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Bronchiolitis Management

Management of bronchiolitis is primarily supportive, focusing on airway management, oxygen supplementation, hydration, and symptom relief.

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Asthma Definition

Asthma is a chronic inflammatory condition of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.

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Pneumonia Definition

Pneumonia is an inflammation of the lung tissue caused by a bacterial, viral, or fungal infection.

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OPA

Oropharyngeal airway: A curved, plastic tube inserted into the mouth to keep the tongue from blocking the airway. It's used for unconscious patients or those with altered level of consciousness.

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NPA

Nasopharyngeal airway: A flexible tube inserted through the nose to maintain an open airway. It's used for patients with a gag reflex or who are conscious.

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Why are OPAs not recommended for children under 1 year?

Their small airways and anatomy make it more likely for OPAs to cause injury or obstruction.

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When is blow-by oxygen used?

When a small amount of oxygen is needed, and the patient can't tolerate a mask.

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When is a non-rebreathing mask used?

For children with respiratory distress or failure, especially older children.

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What is bag-mask ventilation?

It's a way to manually provide breaths to a patient whose airway is compromised. It involves a mask and a bag that delivers oxygen.

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What is the proper rate for bag-mask ventilation in infants and children?

12 to 20 breaths per minute.

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What should we avoid when using OPAs?

Avoid using OPAs with facial trauma or moderate to severe head trauma, as it could worsen the injury.

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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.

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