Other Pediatric Emergencies

Question 1

What is considered a mild allergic reaction:

Answer 1

Redness/itching but normal perfusion w/o dypsnea

Question 2

ALS level 1 for mild allergic reaction:

Answer 2

Benadryl - 1 mg/kg (max. 50 mg) IM/IV (dilute in 9mL NS for IV)

Question 3

ALS level 2 for mild allergic reaction:

Answer 3

Epinephrine - (1:1,000) 0.01 mg/kg IM lateral thigh (max. 0.3 mg)

Question 4

What is considered a moderate allergic reaction:

Answer 4

Edema, hives, dyspnea, wheezing and normal perfusion

Question 5

ALS level 1 for moderate allergic reaction

Answer 5

Epi (1:1000) 0.01 mg/kg IM lateral thigh (max. 0.3 mg)
Benadryl - 1 mg/kg IM (max. 50 mg) (IV- dilute w/ 9mL NS)
Albuterol - (less than 1 year/10kg) 1.25 mg/1.5 mL
(greater than 1 year/10kg) 2.5 mg/3 mL

Question 6

What is considered a severe allergic reaction

Answer 6

Edema, hives, severe dyspnea, wheezing, poor perfusion and possible cyanosis and laryngeal edema

Question 7

ALS level 1 for severe allergic reaction

Answer 7

a. EPI (1:1000) x1
b. Benadryl
c. Albuterol/Atrovent (0.5mg/2.5mL)

Question 8

How many times can EPI be given in severe allergic reaction

Answer 8

2 times

Question 9

ALS level 2 for severe allergic reaction

Answer 9

consult medical direction for further orders

Question 10

If no other means of Epinephrine admins. is available what can be used (allergic reaction)

Answer 10

EpiPen (greater than 8 y/o)
EpiPen Jr (1-8 y/o)

Question 11

What is considered hypoglycemia

Answer 11

glucose less than 60 mg/dL (neonates- 40 mg/dL)

Question 12

Hypoglycemic patient less than 1 year old what is admins.

Answer 12

D10 - 5 mL/kg IV/IO

Question 13

Hypoglycemic patient 1-8 years old what is admins

Answer 13

D25 - 2 mL/kg IV/IO

Question 14

Hypoglycemic patient greater than 8 y/o what is admins.

Answer 14

D50 - 1 mL/kg IV/IO

Question 15

If a child is above 3 y/o who is conscious w/ intact gag reflex what is given

Answer 15

Oral glucose - 15 g (1 tube)

Question 16

If unable to obtain IV/IO access what can be admins. (hypoglycemic)

Answer 16

Glucagon (IM)

Question 17

Glucagon dose

Answer 17

a. Less than or equal to 20 kg : 0.5 mg IM

b. Greater than 20 kg: 1 unit IM

Question 18

When a person intentionally inflicts, or allows to be inflicted, physical or psychological injury to a child which causes or results in risk of death, disfigurement, or disress

Answer 18

Child abuse

Question 19

When a child’s physical, mental, or emotional condition is impaired or endangered because of failure of the legal guardian to supply basic necessities, including adequate food, clothing, shelter, education, or medical care

Answer 19

Child neglect

Question 20

Where should child abuse be reported to

Answer 20

Florida Child Abuse Hotline (1800-96 ABUSE)

Question 21

Is reporting child abuse required by law

Answer 21

YES

Question 22

What are concerns for abuse

Answer 22

Multiple bruises or injuries that are in different stages of healing

Question 23

What is the proper term for drowning victims

Answer 23

Drowning, fatal or drowning, non-fatal

Question 24

Are drowning Trauma Alerts

Answer 24

No

Question 25

Should all non-fatal drowning patients be transported

Answer 25

Yes, regardless of how well they may seem to have recovered

Question 26

What is the most devastating injury in drowning patients

Answer 26

Asphyxia

Question 27

Is the routine use of chest thrusts for drowning, non-fatal patient recommended

Answer 27

No, only used for FBAO

Question 28

Tympanic thermometers should not be used in patients of what age group

Answer 28

Less than 1 year old

Question 29

Signs and symptoms of Heat cramps

Answer 29

Muscle cramps, hot/sweaty skin, W/D, Tachycardia, Normal BP & Temp

Question 30

Signs and symptoms of Heat exhaustion

Answer 30

Cold/clammy skin, profuse sweating, N/V, Diarrhea, Tachycardia, W/D, Syncope, Muscle cramps, Headache, Positive ortho vital signs, Normal/slightly elevated temp

Question 31

Signs and symptoms of Heat stroke

Answer 31

Hot dry skin, confusion/disorient, Rapid/bounding pulse followed by slow/weak pulse, Hypotension , Rapid/shallow breathing, Seizures, Coma, Elevated Temp (greater than 105*F)

Question 32

What temp is considered heat stroke

Answer 32

above 105*F

Question 33

Patient's should be cooled to what temp

Answer 33

102*F

Question 34

ALS level 1 for Heat cramps, exhaustion, stroke

Answer 34

Cramps are severe or LOC is diminished, hypotensive: | Fluid challenge - 20 mL/kg (neonate - 10mL/kg) IV/IO

Question 35

Temp for mild hypothermia

Answer 35

94-97*F

Question 36

Temp for moderate hypothermia

Answer 36

86-94*F

Question 37

Temp for severe hypothermia

Answer 37

below 86*F

Question 38

Most oral thermometers will not register below

Answer 38

96*F

Question 39

Severe hypothermia will frequently produce what wave on the ECG

Answer 39

Osborn wave or J wave

Question 40

Warm saline admins should only be done if temp is above

Answer 40

86*F

Question 41

Dysrhythmias should not be treated if temp is below

Answer 41

86*F (continue CPR and rewarming)

Question 42

How should frostbites be treated

Answer 42

bandaged with dry sterile dressings

Question 43

Should patients with frostbite be rewarmed in the field

Answer 43

No, Transported w/o rewarming in the prehospital setting

Question 44

What is considered as high voltage

Answer 44

500 volts or more

Question 45

Fluid challenge dose for pediatric trauma patient

Answer 45

20 mL/kg (neonate - 10mL/kg) repeat at 20 mL/kg to a max of 60 mL/kg

Question 46

If signs of brain stem herniation exist, ventilation is done at

Answer 46

Child - 20 bpm | Infant - 30 bpm

Question 47

ALS level 2 for head/spine injuries for pediatric

Answer 47

Avoid admins. of glucose-containing solutions/meds

Question 48

If patient is impaled, object should be cut to no less than

Answer 48

6 inches

Question 49

If the flail chest does not cause severe respiratory compromise how should the chest be stabilized

Answer 49

Placing the ipsilateral arm in a sling and swath

Question 50

ALS level 1 for crush injury/compartment syndrome

Answer 50

Establish IV 1L NS Admins. Morphine Release compression and extricate patient

Question 51

Crush syndrome is stated as

Answer 51

a. Entrapment w/ compression lasting longer than 4 hours or on the thorax for 20 mins b. Suspicion of hyperkalemia

Question 52

Hyperkalmeia is noted as

Answer 52

a. Peaked T-waves b. Absent P-waves c. Widened QRS

Question 53

ALS level 1 for crush syndrome

Answer 53

a. Morphine b. Calcium Chloride c. Sodium Bicarbonate d. IV fluids e. Albuterol

Question 54

Calcium chloride dose for crush syndrome

Answer 54

20 mg/kg in 50 mL NS slow IV over 10 mins (follow w/ 20 mL flush)

Question 55

Sodium Bicarbonate dose for crush syndrome

Answer 55

50 mEq to 1 L NS (25 mEq to 500 mL NS) infuse just prior to extrication. May repeat x1 for prolonged extrication

Question 56

In crush syndrome: IV fluids are admins at a rate of

Answer 56

500 mL/hour

Question 57

Albuterol dose for crush syndrome

Answer 57

2.5 mg/2.5 mL NS

Question 58

Ventilator Alarms:

Answer 58

a. Low Pressure/Apnea: loose, disconnect, or air leak b. Low Power: depleted battery c. High Pressure: plugged or obstructed airway d. Setting Error: Vent setting exceeds capacity of equipment

Question 59

If unable to clear a tracheostomy tube what should be done

Answer 59

Remove and insert new tube (same size or one smaller)

Question 60

If an air embolism is suspected with a Central Line what should be done

Answer 60

Clamp line and place patient on left side

Question 61

If a feeding tube is completely out, cover the site with

Answer 61

Vaseline gauze and apply direct pressure