Breathing and Ventilation

Question 1

PRIMARY B Breathing and Ventilation Assessment

Answer 1

1. Look
   a. are they breathing? Is it adequate?
   b. rate/rythm/rise–depth and symmetry (R3DS)
   c. posture? (tripod, sniffing, head bobbing )
   d. retraction/nasal flaring
   e. injuries (LACE, flail)
2. Listen
   a. sounds? (snoring/wheezing/grunting/gurgling/stridor
   b. equal on auscualtion? decreased?
3. Feel
   a. crepitus
   b. SC empysema

Question 2

Breathing and ventilation Interventions (4)

Answer 2

1. postion to < WOB
2. provide O2
3. support respiration with BVM
4. Intubate

Question 3

PRIMARY C Circulation Assessment

Answer 3

LOOK 4 Cs (color, carotid, clammy, cap refill)

1. uncontrolled bleeding
2. skin color
3. cap refill < 2 sec.
   FEEL
4. warmth/cool
5. dry/clammy
6. central and peripheral pulses
   - brachial infant
   - carotid or femoral > 1 yo

Question 4

Circulation Interventions (3)  
bolus amount and rate for NEO and child

Answer 4

1. control bleeding
2. INFANT fluid bolus 20ml/kg over 5-10 min. x 2 then blood
3. NEO 5-10 ml/kg over 10-20 min.

Question 5

Fluid bolus amounts for NEO

Answer 5

5-10 ml/kg over 10-20 min

Question 6

Fluid bolus amount for Infants

Answer 6

20 ml/kg over 5-10 min x 2 , then consider blood

Question 7

How do you perform a Disability assessment under Primary Survey D?

Answer 7

Pedi GCS, if intubated FOUR Score

Question 8

PRIMARY A Alertness and airway assessment criteria?

Answer 8

1. AVPU
2. Inspect airway patency
   - breathing/talking/crying
   - tongue/teeth/trash occlusions
   - edema of tongue/lips
   - positioning (tripod/sniffing/bobbing)
   - drooling
   - abnormal sounds (wheeze/stridor/f]grunting/
   - dysphagia

Question 9

Pediatric GCS

Answer 9

1. eye opening
2. verbal response
3. motor response

Question 10

Primary Assessment E

Answer 10

Expose/environment

1. undress and inspect
2. keep warm

Question 11

Primary Assessment F

Answer 11

Full set of vital and family presence

Question 12

Primary Assessment G

Answer 12

Get Adjuncts

Question 13

LMNOP

Answer 13

1. labs
2. monitors
3. NG/OG tube
4. oxygen
5. pain assessment and control

Question 14

What is assessed in the Secondary Survey H? Name two mneumonics to help with the assessment.

Answer 14

Head to Toe and History

SAMPLE/MIST

Question 15

SAMPLE/MIST

Answer 15

signs and symptoms of illness or injury
allergies
medications
past med HX
last intake/output
Mechanism of injury 
injury sustained
signs and symptoms in field
treatment in feild

Question 16

Secondary survey I and considerations?

Answer 16

Inspect posterior surfaces

• may need XR clearance
• assess pelvis first
• log roll not best practice
• immobilize c-spine

Question 17

What is the Tertiary survey?

Answer 17

“complete summation of all signs of illness or injury identified in the 1* and 2* survey “

Question 18

What does the “IT CRIES(S)” mneumonic stand for and what is it designed to assess?

Answer 18

Possible causes of crying in an infant when no obvious cause is noted `
infection
trauma
cardiac
reflux
insect bites/immunizations
eye issue
surgical –intucesption. volvus
strangulation- hair tourniquet
~~~

Question 19

What does the TEN-4-FACES mneumonic stand for and what does it assess?

Answer 19

In a child less than 4 mos injuries to

Torso / ear / neck
Frenulum
auricle(e
cheek
eyelid
sclera

increased likelyhood of abuse as a cause

Question 20

Five types or locations of suspicious fractures?

Answer 20

1. non-ambulating child
2. bucket handle
3. corner fx
4. ribs
5. skull >3mm wide

Question 21

Pinpoint Pupils

Answer 21

1. opiod ingestion

2. pontine lesion

Question 22

What is one cause of Nystagmus?

Answer 22

cerebellar injury

Question 23

H’s (5)

Answer 23

1. hypovolemia
2. hypoglycemia
3. hypothermia
4. hydrogen ions (acidosis)
5. hypo/er kalemia

Question 24

What are the four T’s of the “Hs and Ts” mnemonic?

Answer 24

1. tamponade
2. tension pneumo
3. toxins
4. thrombosis

Question 25

What does the "SIREN" mneumonic stand for and what does it address?

Answer 25

TOXIN/POISONING response 1. stabilize 2. identify toxin 3. reverse agent 4. eliminate 5. notify specialist and poison control

Question 26

What does the "OLD/CARTS" mneumonic stand for and what does it assess?

Answer 26

Pain assessment 1. onset 2. location. 3. duration 4. charateristics 5. aggravating factors 6. relieving factors 7. treatment 8. severity

Question 27

What does the SLUDGE menumonic stand for?

Answer 27

1. salivation 2. lacrimation 3. urination 4. defecation 5. GI upset 6. emesis

Question 28

DUMBBELLS

Answer 28

1. diarrhea/diaphoresis 2. urination 3. miosis (constricted pupils) 4. bradycardia 5. broncorrhea 6. emesis 6. lacrimation 7. lethargy 8. salivation

Question 29

Which toxidrome is SLUDGE/DUMBELLS mneumonic used to assess?

Answer 29

organophosphates/ cholinergic toxidrome

Question 30

Uncuffedd ETT size formula

Answer 30

(age in yrs./4) +4

Question 31

Cuffed ETT size formula

Answer 31

(age in yrs. /4) + 3.5

Question 32

Fluids for burns

Answer 32

for patients under 40kg 3ml/kg/% surface area burned 1/2 over 8 hours from TIME OF BURN 1/2 over 16 hours

Question 33

6 Ps of compartment syndrome?

Answer 33

1. pain 2. pallor 3. pulses 4. parathesia 5. paralysis 6. pressure coolness--poikilothermia- inablity to maintain temprature

Question 34

Normal eye pH

Answer 34

7.0-7.3

Question 35

Four S/SX of a thoracic cord injury above T7?

Answer 35

1. bradycardia 2. hypotension 3. vasodilation- warm/pink skin 4. temperature instability

Question 36

What might an Injury at c3-c5 cause and why?

Answer 36

1. loss of phrenic nerve 2. paralyzes diaphragm 3. inability to breath