Chapter 32-Pediatric Emergencies

Chapter 32-Pediatric Emergencies

Hyperthermia differs from fever in that it is an increase in body temperature
caused by inability of the body to cool itself
When caring for an infant who was found apneic and cyanotic and was resuscitated by the parent or caregiver, you should
transport the infant to the hospital.
The MOST common cause of dehydration in children is
vomiting and diarrhea.
When caring for an ill 5-year-old male, you should
avoid separating him from his parents or caregivers when possible.
Pale skin in a child indicates that the
blood vessels near the skin are constricted.
A tube from the brain to the abdomen that drains excessive cerebrospinal fluid (CSF) is called a
shunt
Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?
A decresed level of consciousness is not a normal part of the aging process
Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: a) meningitis b) severe infection c) hyperglycemia d) child abuse
hyperglycemia
Which of the following factors is associated with the lowest risk of meningitis?
Female gender
Because a tracheostomy tube bypasses the nose and mouth
secretions can build up in and around the tube
Greenstick fractures occur in infants and children because
their bones bend more easily than an adult’s.
Death caused by shaken baby syndrome is usually the result of
bleeding in the brain
Which of the following should make you MOST suspicious for child abuse? a) Willingness of the child to speak b) Worried or crying parents c) A laceration to the child’s chin d) Bruises in various stages of healing
d) Bruises in various stages of healing
Children with Neisseria meningitidis (N. meningitidis) would MOST likely present with
cherry-red spots or a purplish rash
When assessing or treating an adolescent patient, it is important to remember that
they usually do not wish to be observed during a procedure
The first month of life after birth is MOST appropriately referred to as the
neonatal period
An infant’s fontanels should close completely by the time he or she is
18 months old
When caring for a child with suspected meningitis, it is MOST important for the EMT-B to
adhere to BSI precautions
When a child experiences a blunt injury to the abdomen
he or she can compensate for blood loss better than adults.
A child may begin to show signs of stranger anxiety as early as
12 months
Common complications associated with central intravenous (IV) lines include all of the following, EXCEPT: a) clotting of the line b) rupture of a central vein c) bleeding around the line d) a local infection
b) rupture of a central vein
Which of the following is NOT a known risk factor of SIDS?
A.mother younger than 20 years
B.mother smoked during pregnancy
C.low birth weight
D.putting a baby to sleep on his or her back
D.putting a baby to sleep on his or her back
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:
Administrating blow by oxygen and transporting the child with her mother
Bruising to the _______ is LEAST suggestive of child abuse.
Shins
With regard to the legal implications of child abuse
EMT-Bs must report all suspected cases of child abuse
Which of the following statements regarding pediatric trauma is MOST correct? a) Children are less likely than adults to be struck by a car b) Children are more likely to experience diving-related injuries c) The child’s head is less frequently injured than an adult’s d) Inexperience and poor judgment are rare causes of pediatric trauma
b) Children are more likely to experience diving-related injuries.
The primary mechanism that a child’s body uses to compensate for decreased perfusion is
an increase in heart rate
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler
at the hands or feet
Which of the following statements regarding use of the pneumatic antishock garment (PASG) in children is MOST correct?
They are rarely used in treating children with traumatic shock.
During the attempted resuscitation of an infant with suspected SIDS
allow the family to observe if they wish
Burns in children are commonly caused by all of the following, EXCEPT: a) scalding water in a bathtub b) entrapment in a structural fire c) exposure to caustic chemicals d) hot items on a stovetop
b) entrapment in a structural fire
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:
6 years
Submersion injuries in the adolescent age group are MOST commonly associated with
alcohol
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning. You should
discontinue the ventilator and ventilate with a BVM device
Febrile seizures are MOST common in children between
6 months and 6 years of age.
The EMT-B should be MOST concerned when a child presents with fever and
a rash
When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence? a) Why did your child ingest the poison? b) What time did the ingestion occur? c) Do you know what substance was ingested? d) Have you noticed any signs or symptoms?
a) Why did your child ingest the poison?
When a child experiences a blunt chest injury
the flexible ribs can be compressed without breaking
Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the
intercostal muscles are not well developed.
Which of the following statements regarding preschool-age children is MOST correct? a) The preschool age begins after the child turns 2 years old b) They realize that injuries are not a form of punishment c) They can usually identify painful areas when questioned d) Preschoolers are usually not fearful of pain or separation
c) They can usually identify painful areas when questioned.
Critical burns in children include
partial-thickness burns covering greater than 20% of the body surface
When assessing an 8-year old child, you should
talk to the child, not just the caregiver
Which of the following statements regarding a pediatric patient’s anatomy is correct? (Needs options)
Children have a larger, rounder occiput compared to adults
Which of the following statements regarding sudden infant death syndrome (SIDS) is MOST correct? a) SIDS is most commonly the result of an overwhelming infection b) Most cases of SIDS occur in infants younger than 6 months of age c) The cause of death following SIDS can be established by autopsy d) Certain cases of SIDS are predictable and therefore preventable
b) Most cases of SIDS occur in infants younger than 6 months of age.
When a child is struck by a car, the area of the greatest injury depends MOSTLY on the
size of the child and the height of the bumper upon impact
Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: a) headache and fever b) an altered mental status c) a stiff or painful neck d) sunken fontanels
d) sunken fontanels
Common causes of seizures in children include all of the following, EXCEPT
hyperglycemia
Which of the following is MORE common in children than in adults following a head injury? a) Loss of consciousness b) Seizures and hypoxia c) Nausea and vomiting d) Spinal cord injury
c) Nausea and vomiting
The normal respiratory rate for a newborn should not exceed ____ breaths per minute.
60
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:
A.wheezing
B.stridorous breathing
C.a cough that resembles the bark of a seal
D.a weak cough
A.wheezing
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.
Immediate transport is indicated for a child when he or she:
has a history suggestive of a serious illness
Effective methods for providing pain relief to a child with an extremity injury include:
positioning, ice packs, and emotional support.
Common causes of seizures in children include all of the following, EXCEPT:
A.infection
B.electrolyte imbalances
C.hyperglycemia
D.poisonings or ingestion
C.hyperglycemia
A child may begin to show signs of separation anxiety as early as:
6 months
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.
After squeezing the end of a child’s finger or toe for a few seconds, blood should return to the area within:
2 seconds
Before assessing the respiratory adequacy of an unconscious infant or child, you must:
ensure that the airway is patent and clear of obstructions.
Cardiac arrest in the pediatric population is MOST commonly the result of:
respiratory or circulatory failure.
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.
Drawing in of the muscles between the ribs or of the sternum during inspiration is called:
retracting
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:
cyanosis.
Febrile seizures in a child:
may indicate a serious underlying illness.
If a nasopharyngeal airway is too long, it may:
stimulate the vagus nerve
when assessing the heart rate of a 6 month old infant. you should palpate the brachial pulse or _____ pulse.
femoral
An infant with severe dehydration would be expected to present with:
absent urine output
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
Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:
older than 8 to 10 years
A common cause of shock in an infant is:
dehydration from vomiting diarrhea
Which of the following children would benefit the LEAST from a nonrebreathing mask?
an unresponsive 5 year old male with shallow respirations
When assessing an infant’s ventilation status, you should:
palpate the abdomen for rise and fall
Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:
his or her tidal volume is adequate
Which of the following statement regarding a pediatric patient’s anatomy is correct?
children have larger, rounder occiput compared to adults
The signs and symptoms of poisoning in children:
vary widely,depending on the child’s age and weight
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
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
Which of the following statement regarding a 3 month old infant is correct?
A 3 month old infant can distinguish a parent from a stranger
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
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
Blood pressure is usually not assessed in children younger than___years.
3
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
The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to:
use a length based resuscitation tape measure
When caring for a female child who has possibly been sexually abused, you should:
have a female EMT remain with her if possible
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 had skin burns around her mouth. You should:
monitor her airway and give oxygen
A 2 year old female has experienced a seizure. when you arrive at the scene, that 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
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.
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.
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
Infection should be a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:
drooling or congestion
The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:
bradycardia
An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by
grunting
Signs of severe dehydration in an infant include all of the following, EXCEPT
Slowed level of activity
Before positioning an infant or child’s airway, you should
place him or her on a firm surface
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
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
All of the following are normal findings in an infant or child, EXCEPT:
A.quiet breathing
B.belly breathing
C.fear or anxiety
D.head bobbing
D.head bobbing
Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?
sexual activity
When administering oxygen to a frightened child, it would be MOST appropriate to
place oxygen tubing through a hole in a paper cup
After determining that an infant or child has strong central pulses, you should
not rule out compensated shock
When immobilizing an injured child in a pediatric immobilization device, you should
secure the torso before the head
If the situation allows, a child should be transported in a car seat if he or she weighs less than __lb.
40
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