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Questions and Answers
How does pediatric anatomy differ from adult anatomy?
How does pediatric anatomy differ from adult anatomy?
When a small child falls from a significant height, the ______ MOST often strikes the ground first.
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:
When assessing a conscious and alert 9-year-old child, you should:
The purpose of a shunt is to:
The purpose of a shunt is to:
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Which of the following statements regarding febrile seizures is correct?
Which of the following statements regarding febrile seizures is correct?
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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:
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:
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Treatment for a semiconscious child who swallowed an unknown quantity of pills includes:
Treatment for a semiconscious child who swallowed an unknown quantity of pills includes:
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When using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall that the 'D' stands for:
When using the mnemonic CHILD ABUSE to assess a child for signs of abuse, you should recall that the 'D' stands for:
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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:
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:
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The first month of life after birth is referred to as the:
The first month of life after birth is referred to as the:
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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?
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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:
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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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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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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 _____ seconds.
After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within _____ seconds.
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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, you should:
When inserting an oropharyngeal airway in an infant or child, you should:
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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, it may:
If a nasopharyngeal airway is too long, it may:
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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, 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:
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:
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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, is breathing adequately, and has skin burns around her mouth. You should:
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:
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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. 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:
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:
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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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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.
