Pediatric and Emergency Care Quiz

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Questions and Answers

Which of the following medications is contraindicated for pain management in a pediatric patient with abdominal pain?

  • Naloxone
  • Acetaminophen
  • Ibuprofen
  • Morphine (correct)

What is the appropriate treatment for a pediatric patient with a blood glucose level of 60 mg/dL who is unconscious?

  • Administer glucagon
  • Give IV dextrose (correct)
  • No treatment needed, glucose level is normal
  • Administer oral glucose

Which of the following is an early intubation indication for a burn victim?

  • Mild facial burns
  • Total BSA ≥ 40%
  • Hoarseness or stridor (correct)
  • Total BSA ≥ 30%

What is the correct dosage of fentanyl for moderate pain management in an adult?

<p>50-100 mcg IV/IO (A)</p> Signup and view all the answers

Which of the following medications should NOT be given to a patient in cardiac arrest with hyperkalemia?

<p>Sodium bicarbonate (D)</p> Signup and view all the answers

Which of the following positions is appropriate for transporting a pregnant patient with limb presentation?

<p>In left lateral recumbent position (B)</p> Signup and view all the answers

What is the correct APGAR score given for arms and legs flexed?

<p>2 (C)</p> Signup and view all the answers

Which of the following scenarios represents a severe allergic reaction?

<p>Skin disorders with respiratory difficulty and hypotension (D)</p> Signup and view all the answers

When is a DNR/POLST order considered invalid?

<p>When the patient indicates they wish to receive life-resuscitating treatment (A)</p> Signup and view all the answers

How should CPR be performed on a pregnant patient at or over 20 weeks estimated gestational age?

<p>CPR with an additional rescuer applying continuous manual leftward lateral displacement of the uterus (D)</p> Signup and view all the answers

Which of the following is NOT an early intubation indication for burn victims?

<p>Total BSA ≥ 40% (D)</p> Signup and view all the answers

What is the correct dosage for moderate pain management in adults?

<p>All of the above (D)</p> Signup and view all the answers

When should the first epinephrine dose be administered in cardiac arrest VF/VT?

<p>After the first defibrillation (C)</p> Signup and view all the answers

What is the correct management for a patient with an Inferior Wall STEMI?

<p>Perform a right-sided ECG to evaluate RV infarction (B)</p> Signup and view all the answers

Which of the following is NOT a criterion for transport to a trauma center?

<p>Suspected fracture of a single proximal long bone (C)</p> Signup and view all the answers

In a patient with an Inferior Wall STEMI, which medication is generally avoided?

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

A burn victim with which of the following findings would require early intubation?

<p>Hoarseness or stridor (C)</p> Signup and view all the answers

Telemetry contact should be established for which of the following situations?

<p>For all time-sensitive or life-threatening condition transports (B)</p> Signup and view all the answers

What is the appropriate dose of fentanyl for moderate pain management in adults via intravenous (IV) or intraosseous (IO) route?

<p>50-100 mcg (C)</p> Signup and view all the answers

When should the first dose of epinephrine be administered during a witnessed cardiac arrest with ventricular fibrillation (VF) or ventricular tachycardia (VT)?

<p>After the first defibrillation (C)</p> Signup and view all the answers

Which of the following is the correct management for pediatric abdominal pain?

<p>Morphine is contraindicated. (A)</p> Signup and view all the answers

What is the correct treatment for a pediatric unconscious patient with a blood glucose level of 60 mg/dL?

<p>Give IV dextrose. (C)</p> Signup and view all the answers

What is the correct CPR ratio for neonatal resuscitation?

<p>5:1 (C)</p> Signup and view all the answers

Which medication should NOT be given to a patient in cardiac arrest with hyperkalemia?

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

What is the correct dose of Amiodarone for pulseless VT/VF in adults?

<p>300 mg IV/IO. (B)</p> Signup and view all the answers

What is the contraindication for nitroglycerin in patients with Inferior Wall STEMI?

<p>Evidence of a right ventricular infarction. (A)</p> Signup and view all the answers

What is the appropriate management for a pediatric patient experiencing abdominal pain?

<p>Morphine can be administered for pain relief. (B)</p> Signup and view all the answers

Which scenario indicates the need for a tracheostomy tube replacement?

<p>All of the above. (D)</p> Signup and view all the answers

Which of the following is NOT an approved vagal maneuver?

<p>Carotid massage in patients over 40 years old. (A)</p> Signup and view all the answers

When should telemetry contact be established?

<p>All of the above. (D)</p> Signup and view all the answers

What is the maximum single dose of fentanyl for analgesia during transcutaneous pacing?

<p>100 mcg (C)</p> Signup and view all the answers

What is the correct dosage for moderate pain management in adults using fentanyl?

<p>50-100 mcg IV/IO. (C)</p> Signup and view all the answers

Which of the following is NOT an indication for synchronized cardioversion?

<p>Ventricular fibrillation. (C)</p> Signup and view all the answers

What is required for all intubation attempts?

<p>End-tidal CO2 detection/capnography. (D)</p> Signup and view all the answers

In which case is pediatric needle cricothyroidotomy permitted?

<p>Only in traumatic arrests. (C)</p> Signup and view all the answers

What size catheter must be used for needle cricothyroidotomy?

<p>16 gauge (B)</p> Signup and view all the answers

What modifications should be made when performing CPR on a pregnant patient at or over 20 weeks gestation?

<p>CPR with the patient tilted to the left side (A), CPR with an additional rescuer applying continuous manual leftward lateral displacement of the uterus (D)</p> Signup and view all the answers

What is the appropriate management for a CHF/Pulmonary Edema patient with hypotension?

<p>Initiate CPAP and administer furosemide (D)</p> Signup and view all the answers

Which combination of symptoms is a criterion for suspected sepsis?

<p>Fever, tachycardia, and hypotension (D)</p> Signup and view all the answers

Which of the following is NOT a valid criterion for transport to a trauma center?

<p>Suspected fracture of a single proximal long bone (C)</p> Signup and view all the answers

What is the correct category for a patient with a temperature of 87°F?

<p>Severe hypothermia (D)</p> Signup and view all the answers

Flashcards

Management of pediatric abdominal pain

Morphine can be given for pain relief unless contraindicated.

Treatment for unconscious pediatric patient

If blood glucose is 60 mg/dL, give IV dextrose for treatment.

CPR ratio for neonatal resuscitation

The correct CPR ratio for neonates is 30:2.

Contraindication for nitroglycerin

Nitroglycerin is contraindicated in hypotension or right ventricular infarction.

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Dosage of Amiodarone for VT/VF

The correct dose of Amiodarone in adults for pulseless VT/VF is 300 mg IV/IO.

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APGAR score for flexed arms and legs

An APGAR score of 1 is given when the arms and legs are flexed.

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Severe allergic reaction

Skin disorders with respiratory difficulty and hypotension indicate a severe allergic reaction.

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Invalid DNR/POLST Order

A DNR/POLST Order is invalid if the patient wants life-resuscitation.

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CPR for pregnant patients

Pregnant patients at or over 20 weeks should have CPR with left side tilt.

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Inferior Wall STEMI management

Avoid nitroglycerin in cases of suspected right ventricular infarction for Inferior Wall STEMI.

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Telemetry contact timing

Telemetry contact should be established for all time-sensitive or life-threatening conditions.

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Moderate pain management dosage

Moderate pain in adults can be managed with Morphine, Fentanyl, or Hydromorphone.

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First epinephrine dose in cardiac arrest

The first epinephrine dose should be given after the first defibrillation during cardiac arrest.

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Criteria for suspected sepsis

Fever, tachycardia, and hypotension are criteria for suspected sepsis.

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Transport criteria for trauma center

Transport to a trauma center is not required for suspected fractures of a single proximal long bone.

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CPR modification for pregnant patients

Perform CPR with the patient tilted to the left side and consider manual leftward displacement of the uterus after 20 weeks gestation.

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Management of CHF with hypotension

Administer high-flow oxygen and consider CPAP while administering furosemide.

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Categories of hypothermia

A patient with a temperature of 87°F is categorized as having severe hypothermia.

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Pediatric abdominal pain management

Morphine can be given for pain relief.

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Treatment for unconscious child with low glucose

Give IV dextrose if glucose is 60 mg/dL.

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Neonatal CPR ratio

The correct CPR ratio for neonates is 30:2.

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Cardiac arrest with hyperkalemia drug

Avoid giving Albuterol in this scenario.

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Amiodarone dose for pulseless VT/VF

The correct dose in adults is 300 mg IV/IO.

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Indication for tracheostomy tube replacement

All of the above: Hypoxia, respiratory failure, obtundation.

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Contraindication for needle thoracostomy

There are no absolute contraindications listed.

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Pediatric cricothyroidotomy catheter size

Use a 14 gauge catheter for this procedure.

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Management of Inferior Wall STEMI

The correct management includes performing a right-sided ECG to evaluate RV infarction.

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Early Intubation Indication for Burns

Hoarseness or stridor indicates the need for early intubation in burn victims.

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Telemetry Contact Establishment

Telemetry should be established for all time-sensitive or life-threatening condition transports.

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Fentanyl Dosage for Moderate Pain

The correct dosage for moderate pain management in adults is 50-100 mcg IV/IO.

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Pediatric Unconscious Patient Treatment

Administer IV dextrose for blood glucose level of 60 mg/dL.

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CPR Ratio for Neonates

Correct ratio is 30:2 for neonatal resuscitation.

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Cardiac Arrest with Hyperkalemia

Avoid giving Albuterol during cardiac arrest with hyperkalemia.

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Nitroglycerin Contraindication

Hypotension and right ventricular infarction contraindicate nitroglycerin.

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Epinephrine in Cardiac Arrest

First epinephrine dose should be given after the first defibrillation.

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Management of Pregnant Patient in Labor

Tilt the patient to the left side during CPR at or over 20 weeks gestation.

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Study Notes

Medical Emergency Scenarios

  • Nitroglycerin Contraindications: Nitroglycerin is contraindicated in patients with hypertension, tachycardia (over 100 bpm) in heart failure, or recent use of erectile dysfunction medications.

  • Burn Victim Intubation: Extensive deep facial burns, total body surface area (BSA) of 30% or greater, and altered mental status are early intubation indicators for burn victims.

  • Telemetry Contact: Telemetry contact should be established for all time-sensitive and life-threatening transports, and explicitly stated in the protocol.

  • Pregnant Patient Transport: Pregnant patients with limb presentation should be transported in the left lateral recumbent position.

  • Severe Allergic Reaction: Skin disorders with respiratory difficulty and hypotension, or wheezing with good tidal volume air exchange signify a severe allergic reaction.

  • DNR/POLST Order Validity: A DNR/POLST order is considered invalid when the patient expresses a desire for life-resuscitating treatment or when emergency medical services providers decide it's in the patient's best interest.

  • CPR in Pregnant Patients: CPR for pregnant patients over 20 weeks gestation requires tilting the patient to the left side.

  • Inferior Wall STEMI Management: For Inferior Wall STEMI, avoid nitroglycerin; instead, administer high-flow oxygen.

  • Sepsis Criteria: Fever, tachycardia, and hypotension are criteria for suspected sepsis.

  • Trauma Center Transport: Criteria for trauma center transport include skull deformity, suspected spinal injury, or fractures of a single proximal long bone.

Medication Dosing and Procedures

  • Moderate Pain Management (Adults): Appropriate doses for moderate pain management in adults include morphine 2-5 mg IV/IO, fentanyl 25-50 mcg IV/IO, and hydromorphone 0.5-1 mg IV/IO.

  • Epinephrine Dosing (Cardiac Arrest): The first epinephrine dose in cardiac arrest VF/VT should be administered immediately upon arrival.

  • Amiodarone Dosing (Pulseless VT/VF): 150 mg IV/IO is the initial dose for pulseless VT/VF in adults.

  • Neonatal Resuscitation CPR Ratio: The correct ratio for neonatal resuscitation CPR is 15:2.

  • Cardiac Arrest Medications (Hyperkalemia): For cardiac arrest with hyperkalemia, avoid administering albuterol. Calcium chloride, sodium bicarbonate, and insulin with glucose are suitable alternatives.

Emergency Procedures

  • Cardiac Arrest (VF/VT): Administer epinephrine immediately upon arrival for cardiac arrest (VF/VT).

  • Pregnant Patients: Pregnant patients with limb presentation should be transported in the left lateral recumbent position.

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