9- Pediatrics, Critical And Non

Question 1

In 1984 congress authorized money for EMS-C for what (3)

Answer 1

• State of the art care
• Optimal resources
• Prevention, acute care and rehab

Question 2

5 steps to the pediatric chain of survival

Answer 2

1. Prevention
2. Early CPR
3. Early EMS activation
4. Early advanced care
5. Post resuscitative care

Question 3

Pediatric differences (4)

Answer 3

1. Solid parts are larger, passageways are smaller
2. Unable to control temp
3. Faster HR and Resp rate
4. Dehydrate easily

Question 4

Parts of the general impression PAT; Appearance (5)

Answer 4

• Tone
• Interactiveness
• Consolability
• Look and Gaze
• Speech and cry

Question 5

Parts of the general impression PAT; Work of Breathing (5)

Answer 5

• Sounds
• Position
• Retractions
• Flaring
• Gasping/Apnea

Question 6

Parts of the general impression PAT; Circulation (3)

Answer 6

• Pallor
• Mottling
• Cyanosis

Question 7

What is a normal PAT

Answer 7

Appearance = Normal
WOB = Normal
Circulation = Normal

Question 8

Respiratory Distress PAT and treatment

Answer 8

Appearance = Normal
WOB = Abnormal
Circulation = Normal

Treatment - O2, Nebulizer

Question 9

Respiratory Failure PAT and treatment

Answer 9

Appearance = Abnormal or normal (Decreased LOC?)
WOB = Abnormal
Circulation = Normal

Treatment - O2, BVM?

Question 10

Shock PAT and treatment

Answer 10

Appearance = Abnormal
WOB = “Normal”
Circulation = Abnormal

Treatment - O2, Fluid (20 mL/kg)

Question 11

CNS or Metabolic PAT and main causes

Answer 11

Appearance = Abnormal
WOB = Normal
Circulation = Normal

Main causes - Hypoglycemia, Febrile seizure

Question 12

Cardiopulmonary Failure PAT

Answer 12

Appearance = Abnormal
WOB = Abnormal
Circulation = Abnormal

Question 13

Steps of the initial assessment for Peds (4)

Answer 13

1. LOC
2. ABC’s
3. Broselow Tape
4. Critical or Not?

Question 14

Normal RR for Infant, Toddler, Preschooler, School-aged and Adolescents

Answer 14

Infant = 25-50
Toddler = 20-30
Preschooler = 20-25
School-aged = 15-20
Adolescents = 12-16

Question 15

Normal HR for Infant, Toddler, Preschooler, School-aged, Adolescent

Answer 15

Infant = 100-160
Toddler = 90-150
Preschooler = 80-140
School-aged = 70-120
Adolescent = 60-100

Question 16

Systolic BP for Infant, Toddler, Preschooler, School-aged, Adolescent

Answer 16

Infant = 70
Toddler = 80
Preschooler = 80
School-aged = 80
Adolescent = 90

Question 17

Croup; Age, S/S, Treament

Answer 17

Age: 6mo-6y/o

S/S: Seal bark cough, Stridor, Fever

Treatment: Humidified-cool O2, Corticosteroids, Racemic Epi, Ventilation

Question 18

Anaphylaxis; Age, S/S, Treament

Answer 18

Age: Any

S/S: Hives, Resp distress, Circulatory compromise, GI symptoms

Treatment: IM Epi, Diphenhydramine, O2, Fluids

Question 19

Epiglottitis; Age, S/S, Treament

Answer 19

Age: 2-7y/o

S/S: Sick and anxious, Drooling-Hurts to swallow, Sniffing position, Stridor

Treatment: Position of Comfort, Humidified O2, A size or two smaller ETT if needed

Question 20

Bacterial Tracheitis; Age, S/S, Treament

Answer 20

Age: About 1-12 y/o

S/S: Cough, Stridor, Resp distress, Often febrile, Sniffing position

Treatment: Position of comfort, Keep patient calm, O2 as tolerated, A size of two smaller ETT if needed

Question 21

Asthma; Age, S/S, Treament

Answer 21

Age: Over 1 y/o

S/S: Asthma Triad- 1.Bronchospasm 2. Bronchial edema 3. Mucous production, Signs of Resp distress

Treatment: O2, 2.5-5 mg Albuterol, .01 mg/kg Epi IM, .6 mg/kg Dexamethasone IM

Question 22

Bronchiolitis; Age, S/S, Treament

Answer 22

Age: Under 2 y/o

S/S: Wheezing, Retractions, Tachypnea, Diminished breath sounds

Treatment: Position of comfort, O2, Suction, Racemic Epi/CPAP if severe

Question 23

Pneumonia: Age, S/S, Treament

Answer 23

Age: Any

S/S: Respiratory infection, History of cold and fever, 1 sided lung sound deficits

Treatment: O2, Albuterol

Question 24

Pertussis: Age, S/S, Treament

Answer 24

Age: Any

S/S: Signs of a cold, Repetitive and severe cough, Whoop sound during inspiration between coughs

Treatment: Ensure patent airway, Extra BSI as needed

Question 25

Cystic Fibrosis: Age, S/S, Treament

Answer 25

Age: Any S/S: Recurrent resp infection, Excess mucous production, Tachypnea, Chest pain, Crackles, Accessory muscle use Treatment: O2 as needed

Question 26

Bronchopulmonary Dysplasia: Age, S/S, Treament

Answer 26

Age: Full/pre-term infants S/S: Home vents, Tracy, History of multiple resp infections Treatment: Ipratropium as needed, O2 to maintain baseline, Steroids if no infection is present

Question 27

Altered LOC Etiologies

Answer 27

``` Alcohol Epilepsy, Endocrine, Electrolytes Insulin Opiates Uremia ``` ``` Trauma, Temperature Infection Psychogenic Poison Schlock, Space occupying lesion, Subarachnoid Hemorrhage ```

Question 28

Hypoglycemia; S/S and Treatment

Answer 28

S/S = <60 infants/child, <40 newborn, Lethargy, Pallor, Sweating, Tachycardia, Newborn-Cats eyes, Cats cries Treatment =

Question 29

Hyperglycemia; S/S and Treatment

Answer 29

S/S = Increased thirst and urination, signs of chock may be present Treatment =

Question 30

Meningitis; S/S and Treatment

Answer 30

S/S = Nuchal rigidity, Headache, Decreased appetite, Fever/chills Treatment =

Question 31

Nausea/Vomiting/Diarrhea; S/S and Treatment

Answer 31

S/S = Determine how sick they are, determine how low they are on fluid Treatment =

Question 32

Toxicology ABCDS

Answer 32

``` Airway Breathing Circulation Decontamination Sugar, Seizure control and Supportive care ```

Question 33

One “Pill” Killers (6)

Answer 33

``` Theophylline Imipramine (Tricyclics) Clonidine Camphor Verapamil Propranolol ```

Question 34

Shock definition

Answer 34

Inadequate Tissue perfusion

Question 35

Respiratory Distress definition

Answer 35

Increased work of breathing

Question 36

Respiratory Failure definition

Answer 36

Decreased O2 to the brain

Question 37

Cardiopulmonary Failure definition

Answer 37

End result of either severe respiratory or severe shock state