ECare - Chapter 33 (Pediatric Emergencies)

Question 1

airway and respiratory system

Answer 1

suction infant’s nose, place folded towel under shoulders for supine position,

Question 2

body surface

Answer 2

children more prone to heat lost bc more SA than mass

Question 3

pediatric assessment triangle (PAT)

Answer 3

assessment from a general impression and the primary assessment; evaluates appearance, work of breathing, circulation to skin

Question 4

retraction

Answer 4

pulling in of the skin between ribs when breathing

Question 5

primary assessment of child

Answer 5

mental status
airway
breathing
assessing circulation
patient priority

Question 6

assessing breathing

Answer 6

chest expansion, work of breathing, sounds of breathing, cyanosis, and breathing rate

Question 7

assessing circulation

Answer 7

skin color but also capillary refill if less than 5 yo

Question 8

physical exam

Answer 8

toe to head

Question 9

physical exam: head

Answer 9

infant’s fontanelles may bulge if crying or intracranial pressure OR sunk if dehydrated

Question 10

physical exam: neck

Answer 10

spinal bones are not developed so force may be transferred to spine

Question 11

physical exam: abdomen

Answer 11

organs are larger in relation to abdominal cavity

Question 12

reassessment

Answer 12

mental status
ABC (pulse + skin)
vitals

Question 13

patient care: partial airway obstruction

Answer 13

1. position of comfort (sitting up)
2. oxygen
3. transport

Question 14

inserting a nasopharyngeal airway

Answer 14

should be as thick as the pt’s pinky

measure from nostril to tragus

Question 15

patient care: sever airway obstruction

Answer 15

infants: 5 back blows and 5 chest thrust; if unconscious: CPR. After 30 compressions look at airway

1yo+: Heimlich maneuver; if unconscious: CPR and airway visualization

2. ventilations

Question 16

common causes of shock

Answer 16

diarrhea and/or vomiting w/ dehydration, infection, trauma, blood loss

Question 17

patient assessment: shock

Answer 17

rapid heart rate
mental status change
rapid R
pale, cool, and clammy skin
weak or present pulses
delayed capillary refill
decreased urine output
no tear when crying

Question 18

patient care: shock

Answer 18

1. open airway
2. external hemorrhage
3. oxygen
4. lay pt flat
5. keep pt warm
6. transport

Question 19

upper airway vs lower airway

Answer 19

upper: diseases affect mouth and throat; ex. foreign body obstructions, trauma, swelling, presence of stridor or difficulty speaking
lower: asthma, pneumonia, other infections, difficulty breathing, and wheezing

Question 20

patient care: difficulty breathing

Answer 20

early respiratory distress: oxygen

respiratory failure (distress + altered mental status, cyanosis even with oxygen, poor muscle tone, bad breathing): ventilations

Question 21

croup

Answer 21

inflammation of the larynx, trachea, and bronchi; follows a cold, tissues in airway (upper) become swollen, seal bark cough

Question 22

epiglottitis

Answer 22

stridor + inflammation

Question 23

patient care: croup

Answer 23

1. position of comfort
2. oxygen
3. move slowly to ambulance

Question 24

patient care: epiglottis

Answer 24

1. ALS
2. transport
3. oxygen
4. monitor for respiratory arrest
5. don’t place anything on mouth

Question 25

patient care: fever

Answer 25

1. remove cloths
2. cover with cool towel if due to heat exposure
3. monitor for shivering
4. fluids by mouth if protocol allows
5. prepare to transport if gets more hot

Question 26

patient care: meningitis

Answer 26

1. ABC and vitals
2. oxygen
3. ventilate
4. CPR
5. Be alert for seizures
6. transport

Question 27

patient care: diarrhea and vomiting

Answer 27

1. open airway
2. oxygen if needed
3. shock (if present, transport)
4. clear liquids or chipped ice if diarrhea if protocol allow
5. save sample

Question 28

patient care: seizures

Answer 28

1. open airway, no OPA
2. position on the side if no spinal injury
3. alert for vomit
4. oxygen
5. transport
6. monitor for inadequate breathing

Question 29

patient care: altered mental status

Answer 29

1. open airway
2. protect spine if trauma
3. oxygen
4. shock
5. blood glucose
6. treat hypoglycemia with oral glucose
7. transport

Question 30

patient care: poisoning

Answer 30

1. medical direction or poison control center
2. administer activated charcoal
3. oxygen
4. transport
5. monitor pt

if unresponsive

1. open airway
2. oxygen
3. artificial ventilation
4. transport
5. medical direction/poison control center
6. rule out trauma

Question 31

patient care: drowning

Answer 31

1. artificial ventilation or CPR
2. protect airway
3. consider spinal immobilization
4. protect against possible hypothermia
5. treat trauma
6. transport

Question 32

patient care: SIDS

Answer 32

treat as if in respiratory/cardiac arrest

if rigor mortis: resuscitation

Question 33

patient care: trauma

Answer 33

1. open airway; jaw thrust
2. suction
3. oxygen
4. ventilate
5. provide spinal immobilization
6. transport
7. continue to reassess

Question 34

patient care: physical or sexual abuse

Answer 34

1. address injuries
2. preserve evidence of sexual abuse
3. discourage going to the bathroom, NPO, no changing clothes
4. transport