Pediatric Emergencies Quiz & Flashcards for Parents

Questions and Answers

How does pediatric anatomy differ from adult anatomy?

The trachea is more rigid.

The head is proportionately larger. (correct)

The tongue is proportionately smaller.

The epiglottis is less floppy.

When a small child falls from a significant height, the ______ MOST often strikes the ground first.

head

When assessing a conscious and alert 9-year-old child, you should:

Obtain all of your information from the parent.

Allow the child to answer your questions. (correct)

Isolate the child from his or her parent.

Avoid placing yourself below the child's eye level.

The purpose of a shunt is to:

Minimize pressure within the skull. Signup and view all the answers

Which of the following statements regarding febrile seizures is correct?

Febrile seizures usually last less than 15 minutes and often do not have a postictal phase. Signup and view all the answers

You respond to a sick child late at night. The child appears very ill, has a high fever, and is drooling. He is sitting in a tripod position, struggling to breathe. You should suspect:

Epiglottitis. Signup and view all the answers

Treatment for a semiconscious child who swallowed an unknown quantity of pills includes:

Monitoring the child for vomiting, administering oxygen, and transporting. Signup and view all the answers

When using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall that the 'D' stands for:

Delay in seeking care. Signup and view all the answers

A 4-year-old girl fell from a second-story balcony and landed on her head. She is unresponsive, has slow, irregular breathing, has a large hematoma to the top of her head, and is bleeding from her nose. You should:

Manually stabilize her head, open her airway with the jaw-thrust maneuver, insert an airway adjunct, and begin assisting her ventilations with a bag-mask device. Signup and view all the answers

The first month of life after birth is referred to as the:

Neonatal period. Signup and view all the answers

Which of the following statements regarding a 3-month-old infant is correct?

A 3-month-old infant can distinguish a parent from a stranger. Signup and view all the answers

A child may begin to show signs of separation anxiety as early as:

6 months. Signup and view all the answers

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:

At the feet. Signup and view all the answers

Which of the following statements regarding preschool-age children is correct?

They can usually identify painful areas when questioned. Signup and view all the answers

When assessing an 8-year-old child, you should:

Talk to the child, not just the caregiver. Signup and view all the answers

When assessing or treating an adolescent patient, it is important to remember that:

They usually do not wish to be observed during a procedure. Signup and view all the answers

The normal respiratory rate for a newborn should not exceed ______ breaths/min.

60 Signup and view all the answers

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:

Intercostal muscles are not well developed. Signup and view all the answers

Pale skin in a child indicates that the:

Blood vessels near the skin are constricted. Signup and view all the answers

Signs of vasoconstriction in the infant or child include:

Weak distal pulses. Signup and view all the answers

Which of the following statements regarding spinal injuries in pediatric patients is correct?

If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head. Signup and view all the answers

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are:

Proportionately larger and situated more anteriorly. Signup and view all the answers

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.

18, 6 Signup and view all the answers

The purpose of the pediatric assessment triangle (PAT) is to:

Allow you to rapidly and visually form a general impression of the child. Signup and view all the answers

The components of the PAT are:

Appearance, work of breathing, and skin circulation. Signup and view all the answers

After using the PAT to form your general impression of a sick or injured child, you should:

Perform a hands-on assessment of the ABCs. Signup and view all the answers

A normal level of consciousness in an infant or child is characterized by:

Age-appropriate behavior, good muscle tone, and good eye contact. Signup and view all the answers

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:

Administering blow-by oxygen and transporting the child with her mother. Signup and view all the answers

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:

Cyanosis. Signup and view all the answers

Before assessing the respiratory adequacy of a semiconscious infant or child, you must:

Ensure that the airway is patent and clear of obstructions. Signup and view all the answers

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:

Stabilize his head and check for a pulse. Signup and view all the answers

Before positioning an infant or child's airway, you should:

Place him or her on a firm surface. Signup and view all the answers

To ensure that the airway of an infant or small child is correctly positioned, you may have to:

Place a towel or folded sheet behind the shoulders. Signup and view all the answers

When assessing an infant's ventilation status, you should:

Palpate the abdomen for rise and fall. Signup and view all the answers

All of the following are normal findings in an infant or child, EXCEPT:

Head bobbing. Signup and view all the answers

Drawing in of the muscles between the ribs or of the sternum during inspiration is called:

Retracting. Signup and view all the answers

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse.

femoral Signup and view all the answers

After determining that an infant or child has strong central pulses, you should:

Not rule out compensated shock. Signup and view all the answers

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within _____ seconds.

2 Signup and view all the answers

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:

6 years. Signup and view all the answers

Immediate transport is indicated for a child when he or she:

Has a history suggestive of a serious illness. Signup and view all the answers

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:

Assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center. Signup and view all the answers

If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ lb.

40 Signup and view all the answers

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?

Sexual activity. Signup and view all the answers

The secondary assessment of a sick or injured child:

May not be possible if the child's condition is critical. Signup and view all the answers

Blood pressure is usually not assessed in children younger than _____ years.

3 Signup and view all the answers

Which of the following represents a low normal systolic blood pressure for a 6-year-old child?

82 mm Hg. Signup and view all the answers

Early signs of respiratory distress in the child include:

Restlessness. Signup and view all the answers

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:

Grunting. Signup and view all the answers

The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:

Bradycardia. Signup and view all the answers

A viral infection that may cause obstruction of the upper airway in a child is called:

Croup. Signup and view all the answers

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:

Drooling or congestion Signup and view all the answers

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:

Wheezing Signup and view all the answers

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:

Encourage him to cough, give oxygen as tolerated, and transport Signup and view all the answers

Signs of a severe airway obstruction in an infant or child include:

An ineffective cough Signup and view all the answers

A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:

Perform abdominal thrusts Signup and view all the answers

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:

Be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital Signup and view all the answers

The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to:

Use a length-based resuscitation tape measure Signup and view all the answers

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:

Cause the child to vomit Signup and view all the answers

When inserting an oropharyngeal airway in an infant or child, you should:

Depress the tongue with a tongue depressor Signup and view all the answers

Which of the following statements regarding the use of nasopharyngeal airways in children is correct?

They are rarely used in infants younger than 1 year Signup and view all the answers

If a nasopharyngeal airway is too long, it may:

Stimulate the vagus nerve Signup and view all the answers

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:

His or her tidal volume is adequate Signup and view all the answers

Which of the following children would benefit the LEAST from a nonrebreathing mask?

An unresponsive 5-year-old male with shallow respirations Signup and view all the answers

When administering oxygen to a frightened child, it would be MOST appropriate to:

Place oxygen tubing through a hole in a paper cup Signup and view all the answers

When ventilating a pediatric patient with a bag-mask device, the EMT should:

Block the pop-off valve if needed to achieve adequate chest rise Signup and view all the answers

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to:

Observe the chest for adequate rise Signup and view all the answers

Cardiac arrest in the pediatric population is MOST commonly the result of:

Respiratory or circulatory failure Signup and view all the answers

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:

Severe hypoxia and bradycardia Signup and view all the answers

A common cause of shock in an infant is:

Dehydration from vomiting and diarrhea Signup and view all the answers

Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.

25% Signup and view all the answers

Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children?

Blood pressure Signup and view all the answers

Common causes of seizures in children include all of the following, EXCEPT:

Hyperglycemia Signup and view all the answers

Febrile seizures are MOST common in children between:

6 months and 6 years Signup and view all the answers

In most children, febrile seizures are characterized by:

Generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase Signup and view all the answers

Febrile seizures in a child:

May indicate a serious underlying illness Signup and view all the answers

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:

Attempt cooling measures, offer oxygen, and transport Signup and view all the answers

Which of the following groups of people is associated with the lowest risk of meningitis?

Females Signup and view all the answers

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:

Sunken fontanelles Signup and view all the answers

Children with N. meningitides would MOST likely present with:

Cherry-red spots or a purplish rash Signup and view all the answers

The signs and symptoms of poisoning in children:

Vary widely, depending on the child's age and weight Signup and view all the answers

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence?

Why did your child ingest the poison? Signup and view all the answers

A 4-year-old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should:

Monitor her airway and give oxygen Signup and view all the answers

Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child?

20 g Signup and view all the answers

The MOST common cause of dehydration in pediatric patients is:

Vomiting and diarrhea Signup and view all the answers

An infant with severe dehydration would be expected to present with:

Absent urine output Signup and view all the answers

Signs of severe dehydration in an infant include all of the following, EXCEPT:

Slowed level of activity Signup and view all the answers

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:

Moderate dehydration Signup and view all the answers

The EMT should be MOST concerned when a child presents with fever and:

A rash Signup and view all the answers

Hyperthermia differs from fever in that it is an increase in body temperature:

Caused by the inability of the body to cool itself Signup and view all the answers

Submersion injuries in the adolescent age group are MOST commonly associated with:

Alcohol Signup and view all the answers

Which of the following statements regarding pediatric trauma is correct?

Children are more likely to experience diving-related injuries Signup and view all the answers

When a child is struck by a car, the area of greatest injury depends MOSTLY on the:

Size of the child and the height of the bumper upon impact Signup and view all the answers

Which of the following is MORE common in children than in adults following a head injury?

Nausea and vomiting Signup and view all the answers

When immobilizing an injured child in a pediatric immobilization device, you should:

Secure the torso before the head Signup and view all the answers

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:

Older than 8 to 10 years Signup and view all the answers

The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if:

The car seat is visibly damaged Signup and view all the answers

When a child experiences a blunt chest injury:

The flexible ribs can be compressed without breaking Signup and view all the answers

When a child experiences a blunt injury to the abdomen:

He or she can compensate for blood loss better than adults Signup and view all the answers

Study Notes

Pediatric Anatomy and Physiology

Pediatric anatomy features a proportionately larger head, making them more prone to specific injuries.
The trachea in children is less rigid compared to adults, impacting airflow during emergencies.

Assessing Pediatric Patients

Inquire directly with the child, especially if old enough, to gather accurate information.
The pediatric assessment triangle (PAT) evaluates appearance, work of breathing, and skin circulation.
Before physical assessment, ensure the child's airway is patent and free from obstructions.

Common Pediatric Emergencies

High fever and drooling in a child can indicate epiglottitis, requiring immediate medical attention.
Febrile seizures are brief (usually less than 15 minutes) and do not typically indicate severe underlying conditions.

Trauma Considerations

Children often land on their heads when falling from significant heights.
Assess unresponsive children by stabilizing the head and checking vital signs before beginning treatment.

Respiratory Challenges

Signs of respiratory distress include tachypnea, retractions, and difficulty in breathing.
Infants typically exhibit grunting to keep alveoli expanded at the end of inhalation.

Recognizing Signs of Abuse

A delay in seeking care can signify potential child abuse.
Conduct private inquiries when discussing sensitive topics with adolescent patients, such as sexual activity.

Vascular and Cardiac Characteristics in Children

Pale skin may indicate vasoconstriction due to decreased blood flow near the skin.
Accurate assessment of capillary refill time is crucial; it is most reliable in children under 6 years.

Special Considerations in Pediatrics

The neonatal period lasts for the first month of life, marking significant developmental milestones.
Children under 3 typically do not require routine blood pressure assessments.

Treatment Protocols

In cases of poisoning or unknown ingestion, monitor the child closely and prepare for transportation while administering supportive care.
A child who is conscious but experiencing respiratory distress should be assisted with oxygen, ensuring they remain with parents for comfort.

Examination Techniques

Prioritize a head-to-toe examination except when the child's condition is critically unstable.
During respiratory assessments, observe chest movements for discrepancies in inhalation and exhalation.

Conclusion

Pediatric emergencies require a tailored approach, emphasizing attentive assessment, correct positioning, and prompt recognition of life-threatening conditions to ensure optimal care for young patients.### Pediatric Ventilation and Airway Management
Assist with ventilation when necessary and transport immediately; ALS intercept may be needed en route to the hospital.
High-flow oxygen therapy should continue, and medical control should be contacted for further instructions.
Oropharyngeal airways are contraindicated in children who ingested caustic substances due to the risk of vomiting.

Pediatric Equipment Sizing

Use length-based resuscitation tape to identify the correct size of equipment for pediatric patients, as estimating by weight or appearance can be inaccurate.

Airway Insertion Techniques

During oropharyngeal airway insertion, always depress the tongue using a tongue depressor to prevent choking.
Nasopharyngeal airways are rarely used in infants under 1 year due to tolerance issues.

Oxygen Administration

Administer oxygen using nonrebreathing masks or nasal cannulas only if tidal volume is adequate; assess the child’s respiratory status reliably first.
A frightened child can be calmed by using a paper cup with oxygen tubing instead of a mask to avoid distress.

Pediatric Cardiac Arrest and Shock

Pediatric cardiac arrest typically arises from respiratory or circulatory failure rather than direct cardiac issues.
Children are more susceptible to hypoxia and bradycardia as they deteriorate toward cardiac arrest, contrasting with adults.
Blood loss exceeding 25% of a child's total blood volume significantly heightens shock risk.

Dehydration and Gastrointestinal Issues

Common causes of dehydration in infants include vomiting and diarrhea. Signs of severe dehydration may include absent urine output.
A decrease in activity level and tachycardia may indicate moderate dehydration in young patients.

Seizures and Meningitis in Children

Febrile seizures are prevalent in children aged 6 months to 6 years and typically result in generalized tonic-clonic activity.
Recognize signs of meningitis, such as fever, headaches, and mental status changes. Meningitis may present with a cherry-red rash or purplish spots.

Trauma and Injuries

Pediatric trauma often leads to distinct patterns; small children are more likely to sustain injuries related to their size and vehicle height during accidents.
For head injuries in children, nausea and vomiting are more commonly observed than in adults.

Emergency Management and Treatment

Always secure the torso before the head in pediatric immobilization to ensure stability.
Activated charcoal can be administered in specific dosages; for a 20 kg child, the appropriate dose is 20 grams.

Hyperthermia vs. Fever

Hyperthermia results from the body’s inability to cool down, while fever usually indicates an underlying infection or response.

Key Pediatric Differences

Children are more prone to certain conditions, such as dehydration and mild head trauma consequences. The signs can vary widely based on age and physiological differences as compared to adult patients.

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Description

Explore critical concepts in pediatric emergencies through flashcards that highlight key anatomical differences and emergency responses. This quiz is designed to test your knowledge on how pediatric anatomy varies from adult anatomy and the implications in emergency situations. Perfect for healthcare students and professionals.

Pediatric Emergencies Flashcards