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Emergency Medical Technician > Pediatric Emergencies > Flashcards

Pediatric Emergencies Flashcards

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USMLE® Step 1 flashcards Royal College: Emergency Medicine flashcards
1
Q

The specialized medical practice devoted to the care of young patients

A

Pediatrics

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2
Q

The first year of life

A

Infancy

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3
Q

The first month of life

A

Neonatal or newborn period

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4
Q

Infants younger than 2 months spend most of their time ___

A

Sleeping or eating

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5
Q

Infants respond mainly to ___

A

Physical stimuli such as light, warmth, hunger, and sound

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6
Q

Infants sleep for up to ___

A

16 hours a day

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7
Q

An infant should be ___ from a sleeping state

A

Aroused easily

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8
Q

If an infant cannot be aroused easily from a sleeping state ___

A

This is an emergency

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9
Q

Infants less than 2 months have a ___ for feeding

A

Sucking reflex

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10
Q

Separation anxiety may be present at ___

A

6 to 12 months

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11
Q

Toddler age

A

After infancy until 3 years

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12
Q

Preschool age

A

3 to 6

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13
Q

School age

A

6 to 12

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14
Q

Adolescent age

A

12 to 18

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15
Q

Stage of life with the most growth

A

Childhood

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16
Q

Anatomic differences between adult and pediatric airway

A
  1. Airway is smaller in diameter
  2. Airway is shorter
  3. Lungs are smaller
  4. Heart is higher in the chest
  5. Glottic opening is higher and positioned more anteriorly
  6. Neck appears nonexistent
  7. Larger, rounder occiput requiring more careful positioning of the airway
  8. Proportionally larger tongue and more anterior in the mouth
  9. Tongue larger relative to the mandible and can block airway
  10. Long, floppy epiglottis infants and toddlers proportionally larger in relation to the size of the airway
  11. Less-developed rings of cartilage in the trachea, may collapse if the neck is flexed or hyperextended
  12. Narrowing funnel-shaped upper airway to a cylinder-shaped lower airway
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17
Q

Diameter of infant trachea

A

Same as a drinking straw

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18
Q

Infant breathing

A

Obligate nose breathers

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19
Q

Infant respiration rate

A

30 to 60 /min

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20
Q

Toddler respiration rate

A

24 to 40 /min

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21
Q

Preschool respiration rate

A

22 to 34 /min

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22
Q

School age respiration rate

A

18 to 30 /min

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23
Q

Adolescent respiration rate

A

12 to 16 /min

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24
Q

Child oxygen demand is about ___ of an adult

A

Twice

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25
Q

The smaller lungs with higher oxygen demand increases the risk of ___

A

Hypoxia because of apnea or ineffective ventilation efforts

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26
Q

Anything that places pressure on the abdomen of a young child can ___

A

Block movement of the diaphragm and cause respiratory compromise

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27
Q

Auscultating breath sounds in children

A

Easier because of thinner chest walls, but detecting poor air movement or absent breath sounds is harder because less air is exchanged with each breath

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28
Q

Child’s primary method for compensating for decreased perfusion

A

Increase heart rate

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29
Q

Children are able to compensate for decreased perfusion by constricting ___

A

The vessels in the skin

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30
Q

Constriction of the blood vessels can be so profound that ___

A

Blood flow to the extremities can be diminished

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31
Q

Signs of vasoconstriction include ___

A
  1. Pallor (early sign)
  2. Weak distal pulses
  3. Delayed capillary refill time
  4. Cool hands or feet
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32
Q

Newborn to 3 months pulse rate

A

85 to 205 /min

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33
Q

3 months to 2 years pulse rate

A

100 to 190

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34
Q

2 to 10 years pulse rate

A

60 to 140

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35
Q

> 10 years pulse rate

A

60 to 100

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36
Q

The pediatric brain requires a higher amount of ___

A

Cerebral blood flow, oxygen, and glucose

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37
Q

Glucose stores in the pediatric patient

A

Limited

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38
Q

The pediatric brain is at risk for secondary brain damage from ___

A

Hypotension and hypoxic events

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39
Q

The pediatric brain tissue and cerebral vasculature is fragile and susceptible to bleeding from ___

A

Shearing forces

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40
Q

If a child’s cervical spine is injured, it is most likely to be an injury to the ___

A

Ligaments as the result of a fall

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41
Q

Pediatric GI differences

A
  1. Muscle structures less developed, less protection from trauma
  2. Liver and spleen are proportionally larger and situation more anteriorly
  3. Organs closer together, more prone to multi organ trauma
  4. Liver, spleen, and kidneys are injured more frequently
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42
Q

At the ends of the long bones, enable the bones to grow during childhood

A

Growth plates

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43
Q

The open growth plates are ___ than ligaments and tendons

A

Weaker

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44
Q

Immobilize extremities with suspected sprains or strains because they may be ___

A

Fractures through the growth plates

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45
Q

Soft spots on the newborn skull anterior and posterior

A

Fontanelles

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46
Q

The anterior fontanelle will close at ___

A

18 months

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47
Q

The posterior fontanelle will close at ___

A

6 months

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48
Q

Some bulging of the fontanelles is a normal assessment finding when the infant is ___

A

Either crying, coughing, or lying on the back or stomach

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49
Q

Fontanelles of an infant can be an important assessment tool for such issues as ___

A
  1. ICP (bulging in a non-crying infant)
  2. Dehydration (sunken appearance)
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50
Q

Structured assessment tool that allows you to rapidly form a general impression of the child’s condition without touching the child

A

Pediatric assessment triangle

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51
Q

PAT

A

Pediatric assessment triangle

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52
Q

When you assess an infant or child, use the PAT to determine if the patient is ___

A

Sick or not sick

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53
Q

The PAT can be performed in less than ___

A

30 seconds

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54
Q

Components of the PAT

A
  1. Appearance
  2. Circulation to skin
  3. Work of breathing
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55
Q

Appearance portion of the PAT

A

Muscle tone and mental status

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56
Q

Can also help to determine if the patient is sick or not sick

A

TICLS (or tickles)

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57
Q

TICLS

A
  1. Tone
  2. Interactiveness
  3. Consolability
  4. Look or gaze
  5. Speech or cry
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58
Q

Tone (TICLS)

A
  1. Is the child moving or resisting examination vigorously?
  2. Does the child have good muscle tone?
  3. Is the child limp, listless, or flaccid?
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59
Q

Interactiveness (TICLS)

A
  1. How alert is the child?
  2. How readily does a person, object, or sound distract or draw their attention?
  3. Will the child reach for, grasp, and play with a toy or examination instrument?
  4. Is the child uninterested in playing or interacting with anyone?
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60
Q

Consolability (TICLS)

A
  1. Can the child be consoled or comforted by anyone?
  2. Is the crying or agitation unrelieved by gentle reassurance?
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61
Q

Look or gaze (TICLS)

A

Does the child fix the gaze on a face, or is there a vacant, glassy-eyed stare?

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62
Q

Speech or cry (TICLS)

A
  1. Is the cry strong and spontaneous or weak or high-pitched?
  2. Is the content of speech age-appropriate or confused or garbled?
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63
Q

Increased work of breathing often manifests as ___

A
  1. Abnormal airway noise (grunting or wheezing)
  2. Accessory muscle use (contractions of the muscles above the clavicles)
  3. Retractions (drawing in of the muscles between the ribs or of the sternum during inspiration)
  4. Head bobbing (head lifting and tilting back during inspiration and forward during expiration)
  5. Nasal flaring (nares widening, usually during inspiration)
  6. Tachypnea
  7. Tripod position (Used by older children to maximize effectiveness of airway)
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64
Q

An “uh” sound heard during exhalation

A

Grunting

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65
Q

The grunting reflects the child’s ___

A

Attempt to keep the alveoli open

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66
Q

Above the clavicles

A

Supraclavicular

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67
Q

Drawing in of the muscles between the ribs

A

Intercostal retractions

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68
Q

Drawing in of the sternum

A

Substernal retractions

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69
Q

External opening of the nose

A

Nares

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70
Q

Pallor of the skin and mucous membranes may be seen in ___

A

Compensated shock or with anemia or hypoxia

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71
Q

Mottling is caused by ___

A

Constriction of peripheral blood vessels

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72
Q

Mottling is a sign of ___

A

Poor perfusion

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73
Q

Cyanosis reflects ___

A

A decreased level of oxygen in the blood

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74
Q

Cyanosis is a ___ sign of respiratory failure or shock

A

Late sign

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75
Q

XABCDE

A
  1. Exsanguination
  2. Airway
  3. Breathing
  4. Circulation
  5. Disability
  6. Exposure
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76
Q

Always position the pediatric airway in a ___

A

Neutral sniffing position

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77
Q

Keeping the airway in a neural sniffing position accomplishes two goals

A
  1. Keeping the trachea from kinking
  2. Maintaining proper alignment to restrict spinal motion
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78
Q

Bradypnea indicates ___

A

Impending respiratory arrest

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79
Q

Where to take infant pulse

A

Brachial or femoral

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80
Q

In children older than 1 year, where to take the pulse

A

Carotid

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81
Q

A strong central pulse does not rule out the possibility of ___

A

Compensated shock

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82
Q

Bradycardia in children

A

Less than 80 /min

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83
Q

Bradycardia in newborns

A

Less than 100 /min

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84
Q

Bradycardia in a pediatric patient indicates ___

A

Impending cardiopulmonary arrest

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85
Q

Tachycardia may indicate ___

A

Early sign of hypoxia or shock, but may also indicate fever, anxiety, pain, and excitement

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86
Q

Capillary refill is most reliable in ___

A

Children younger than 6

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87
Q

BLSCPR

A

Blood pressure
LOC
Skin: color, temp, moisture
Capillary refill time
Pulse: rate, rhythm, strength
Respiratory rate, effort, pattern

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88
Q

The Wong-Baker FACES Pain Rating Scale may help assess pain in children aged ___

A

3 and older

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89
Q

Why are children susceptible to hypothermia?

A
  1. Thermoregulatory system is immature
  2. Thin skin
  3. Lack of subcutaneous fat
  4. Larger skin surface area to mass ratio
  5. Infants younger than 6 cannot shiver
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90
Q

Newborns younger than ___ are the most susceptible to hypothermia

A

1 month

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91
Q

Infant GCS score

A

Eye opening
4 - Open spontaneously
3 - Open to speech or sound
2 - Open to pressure
1 - No response

Verbal
5 - Coos, babbles
4 - Irritable cry
3 - Cries to pain
2 - Moans to pain
1 - No response

Motor
6 - Normal spontaneous movement
5 - Localizes to pressure
4 - Withdraws from pressure
3 - Abnormal flexion (decorticate)
2 - Abnormal extension (decerebrate)
1 - No response (flaccid)

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92
Q

Child GCS score

A

Eye opening
4 - Open spontaneously
3 - Open to speech
2 - Open to pressure
1 - No response

Verbal
5 - Oriented conversation
4 - Confused conversation
3 - Cries
2 - Moans
1 - No response

Motor
6 - Obeys verbal commands
5 - Localizes to pressure
4 - Withdraws from pressure
3 - Abnormal flexion (decorticate)
2 - Abnormal extension (decerebrate)
1 - No response (flaccid)

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93
Q

Significant MOIs

A

Same as adult except:
1. Any fall higher than the child especially a head-first landing
2. Bicycle crash (when not wearing a helmet)

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94
Q

Rapid transport is indicated for ___

A
  1. Significant MOI
  2. History compatible with a serious illness
  3. Physical abnormality noted during primary assessment
  4. Potential serious anatomic abnormality
  5. Significant pain
  6. Abnormal LOC, altered mental status, or signs of shock
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95
Q

Considerations when making a transport decision

A
  1. Type of clinical problem
  2. Expected benefits of ALS treatment in the field
  3. Local EMS system protocols
  4. Your comfort level
  5. Transport time to the hospital
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96
Q

Children ___ should be transported in a car seat if the situation allows

A

Weighing less than 40 lbs who do not require spinal motion restriction

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97
Q

Children younger than ___ should be transported in a rear-facing position

A

2

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98
Q

Why do children under 2 need to be transported in a rear-facing position

A

Lack of mature neck muscles

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99
Q

Questions to ask during history taking

A
  1. NOI or MOI
  2. How long has it been happening
  3. Key events leading to it
  4. Presence of fever
  5. Effects on the child’s behavior
  6. Activity level
  7. Recent eating, drinking, and urine output
  8. Change in bowel or bladder habits
  9. Vomiting, diarrhea, abdominal pain
  10. Rashes
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100
Q

A ___ should be suspected in any child who refuses to bear weight

A

Lower extremity injury

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101
Q

When should the assessment begin at the feet and end at the head?

A

Infants, toddlers, and preschool age children who do not have apparent life-threatening injuries or illnesses

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102
Q

The presence of pus in the ear may indicate ___

A

An ear infection or perforation in the ear drum

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103
Q

Acidosis may impart a ___ odor on the breath

A

Fruity

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104
Q

If the pediatric patient cannot move their neck and has a high fever, this may indicate ___

A

Meningitis

105
Q

BP cuff should cover ___

A

2/3 of the upper arm

106
Q

A BP cuff that is too small may give a ___

A

Falsely high reading

107
Q

A BP cuff that is too big may give a ___

A

Falsely low reading

108
Q

Equation to determine BP in children under 10

A

70 + (2 X Child’s age in years) = lowest expected systolic BP

109
Q

How long to assess respirations

A

30 seconds

110
Q

How long to assess pulse rate

A

60 seconds, unless rushed

111
Q

Neonate 1-4 days systolic BP

A

60 to 76

112
Q

Neonate 4 days to 1 months systolic BP

A

67 to 84

113
Q

Infant 1-3 months systolic BP

A

73 to 94

114
Q

Infant 3-6 months systolic BP

A

78 to 103

115
Q

Infant 6 months to 1 year systolic BP

A

82 to 105

116
Q

Child 1-2 years systolic BP

A

85 to 104

117
Q

Child 2-7 years systolic BP

A

88 to 106

118
Q

Child 7-15 years systolic BP

A

96 to 115

119
Q

Adolescent 15-18 years systolic BP

A

110 to 131

120
Q

Child’s possible behavioral changes in the early stages of respiratory distress

A

Anxiety, restlessness, or combativeness

121
Q

Signs of respiratory distress

A

Nasal flaring, abnormal breath sounds, accessory muscle use, and the tripod position

122
Q

If the heart rate is less than ___ despite ventilations with high-flow oxygen, begin CPR

A

60 /min

123
Q

Consider infections as a possible cause of airway obstruction if a child has ___

A

Congestion, fever, drooling, and cold symptoms

124
Q

Suspect anaphylaxis if ___ accompany a sudden onset of dyspnea

A

Hives, hypotension, nausea, or vomiting

125
Q

Signs and symptoms that are frequently associated with a partial upper airway obstruction

A

Hoarse voice, decreased or absent breath sounds, and stridor

126
Q

Stridor is usually caused by ___

A

Swelling of the area surrounding the vocal cords or upper airway obstruction

127
Q

Signs and symptoms of a lower airway obstruction

A

Wheezing

128
Q

Best way to auscultate breath sounds in a pediatric patient

A

Listen on both sides of the chest at the level of the armpit

129
Q

Condition in which the smaller air passages (bronchioles) become inflamed, swell, and produce excessive mucus, leading to difficulty breathing

A

Asthma

130
Q

Common asthma triggers

A
  1. Upper respiratory infection
  2. Exercise
  3. Exposure to cold air or smoke
  4. Emotional distress
131
Q

Breathing sound of asthma

A

Wheezing

132
Q

Care for asthma

A

Supplemental oxygen, keep calm, and maybe administering bronchodilator

133
Q

If you must assist ventilations in a child having an asthma attack ___

A

Use slow, gentle breaths

134
Q

The problem in asthma is getting air ___

A

Out of the lungs, not into them

135
Q

Prolonged asthma attack that is unrelieved may progress into ___

A

Status asthmaticus

136
Q

Treatment for status asthmaticus

A

Administer oxygen, ventilate if needed, and provide rapid transport

137
Q

Pneumonia is often a ___ infection

A

Secondary

138
Q

Signs and symptoms of pneumonia

A
  1. Tachypnea
  2. Grunting or wheezing
  3. Nasal flaring
  4. Hypothermia
  5. Fever
  6. Unilateral diminished breath sounds or crackles
139
Q

If a child with pneumonia is wheezing ___

A

Administer a bronchodilator

140
Q

Laryngotracheobronchitis

A

Croup

141
Q

Infection of the airway below the level of the vocal cords, usually caused by a virus

A

Croup

142
Q

Croup is typically seen in ___

A

Children from 6 months to 3 years

143
Q

Croup starts with ___

A

A cold, cough, and a low-grade fever that develops over 2 days

144
Q

Hallmark signs of croup

A

Stridor and a seal-bark cough

145
Q

Croup often responds well to ___

A

Humidified oxygen

146
Q

___ are not indicated for croup and could make it worse

A

Bronchodilators

147
Q

Epiglottis is also called ___

A

Supraglottis

148
Q

An infection of the soft tissue in the area above the vocal cords

A

Epiglottis

149
Q

Most common cause of epiglottis

A

Bacterial infection

150
Q

Sings and symptoms of epiglottis in children

A

Look very sick, report a sore throat, and have a high fever. Often found in the tripod position and drooling

151
Q

Specific viral illness of newborns and toddlers, often caused by respiratory syncytial virus that leads to inflammation of the bronchioles

A

Bronchiolitis

152
Q

RSV

A

Respiratory syncytial virus

153
Q

RSV is spread through ___

A

Droplets with coughing or sneezing

154
Q

Infants with RSV often refuse ___

A

Liquids

155
Q

Treat Bronchiolitis

A

Position of comfort, humidified oxygen, and transport

156
Q

Signs and symptoms of pertussis

A
  1. Similar to common cold: coughing, sneezing, and a runny nose.
  2. As it progresses, coughing gets worse and the whoop sound is heard on inspiration
157
Q

Infants with pertussis may develop ___

A

Pneumonia or respiratory failure

158
Q

Broselow tape

A

Length-based resuscitation tape

159
Q

Color coded tool that can estimate weight as well as height in pediatric patients up to 75 lbs

A

Broselow tape

160
Q

Oxygen percentage with blow by technique

A

More than 21%

161
Q

Oxygen percentage with nasal cannula at 1 to 6 L/min

A

24% to 44%

162
Q

Oxygen percentage with nonrebreathing mask at 10 to 15 L/min

A

Up to 95%

163
Q

Oxygen percentage with bag mask device with 15 L/min

A

100%

164
Q

Pediatric patients with respirations less than ___ or more than ___, ___, and/or ___ should receive assisted ventilation with a bag-mask device

A
  1. 12 breaths/min
  2. 60 breaths/min
  3. An altered LOC
  4. An inadequate tidal volume
165
Q

Bag-mask ventilation rate

A

1 breath every 2 - 3 seconds (20 - 30 /min)

166
Q

Signs of shock in infants and children

A
  1. Tachycardia
  2. Poor capillary refill time
  3. Mental status changes
167
Q

When assessing for shock, any pulse over ___ (except a newborn)

A

160 /min

168
Q

When assessing for shock, ask ___

A
  1. Decreased urine output (less than 6 to 10 wet diapers a day for an infant)
  2. Absence of tears even when crying
  3. Sunken or depressed fontanelle (infant)
  4. Changes in LOC and behavior
169
Q

Positioning of child when transporting for shock

A

Position of comfort

170
Q

Pediatric signs of anaphylaxis

A
  1. Hypoperfusion
  2. Stridor
  3. Wheezing
  4. Increased work of breathing
  5. Altered appearance
  6. Restlessness
  7. Agitation
  8. Sense of impending doom
  9. Hives
171
Q

How to treat a bleeding pediatric patient with hemophilia

A

Transport immediately and dont delay tourniquet application

172
Q

Most common causes of altered mental status in children

A
  1. Hypoglycemia
  2. Hypoxia
  3. Seizure
  4. Drug or alcohol ingestion
173
Q

Management of altered mental status focuses on ___

A

The ABCs and transport

174
Q

Seizures in infants may manifest as ___

A

Abnormal gaze, sucking motions, or bicycling motions

175
Q

Postictal state muscles and breathing

A

Flaccid and labored breathing

176
Q

Some children will have been given ___ to stop the seizure prior to your arrival

A

A rectal dose of diazepam (Diastat)

177
Q

Meningitis is caused by ___

A

An infection of the meninges by bacteria, viruses, fungi, or parasites

178
Q

Untreated meningitis can lead to ___

A

Permanent brain damage or death

179
Q

Pediatric patients at a greater risk of meningitis

A
  1. Males
  2. Newborns
  3. Compromised immune systems
  4. History or brain, spinal cord, or back surgery
  5. Head trauma
  6. Shunts, pins, or other foreign bodies within the brain or spinal cord
180
Q

Drain excess fluids around the brain into the abdomen

A

Ventriculoperitoneal (VP) shunt

181
Q

The tubing from a VP shunt can usually be seen and felt ___

A

Just under the scalp

182
Q

Common symptoms of meningitis in children of all ages

A

Fever and altered LOC

183
Q

A ___ may be the first sign of meningitis

A

Seizure

184
Q

Infants younger than 2 to 3 months with meningitis can have ___

A

Apnea, cyanosis, fever, a distinct high-pitched cry, or hypothermia

185
Q

Describe pain that accompanies movement in children with meningitis by physicians

A

Meningeal irritation or meningeal signs

186
Q

With meningitis, bending the neck forward or back increases ___

A

Tension within the spinal canal and stretches the meninges

187
Q

An infant with increasing irritability, especially when being handled or with a bulging fontanelle without crying is a sign of ___

A

Meningitis

188
Q

Bacterium that causes rapid onset of meningitis symptoms, often leading to shock and death

A

Neisseria meningitidis

189
Q

Children infected with N meningitidis typically have ___

A

Small, pinpoint, cherry-red spots or a larger purple or black rash. May be on part of the face or body

190
Q

Children infected with N meningitidis are at a serious risk of ___

A

Sepsis, shock, and death

191
Q

If you are exposed to saliva and respiratory secretions from a child infected with N meningitidis, you should ___

A

Receive antibiotics

192
Q

Appendicitis, if untreated, can lead to ___

A

Peritonitis or shock

193
Q

Appendicitis will typically present with ___

A

A fever and pain on palpation of the RLQ commonly with rebound tenderness

194
Q

Questions to ask to determine dehydration level in children

A
  1. How many wet diapers today?
  2. Tolerating liquids or able to keep them down?
  3. How many times of diarrhea and for how long?
  4. Are tears present with crying?
195
Q

Questions to ask for poisoning

A
  1. What substance?
  2. How much?
  3. What time?
  4. Any changes in behavior or LOC?
  5. Any choking or coughing after exposure?
196
Q

Activated charcoal is not indicated for children who have ingested ___

A

An acid, an alkali, or a petroleum product. Have a decreased LOC and cannot protect airway, or are unable to swallow

197
Q

Usual form of activated charcoal

A

Plastic bottle of premixed suspension with up to 50 g of activated charcoal

198
Q

Common trade names for activated charcoal suspension

A
  1. InstaChar
  2. Actidose
  3. LiquiChar
199
Q

Dose of activated charcoal

A

1 g per kg of body weight

200
Q

Usual pediatric dose of activated charcoal

A

12.5 to 25 g

201
Q

Most common cause of dehydration in children

A

Vomiting and diarrhea

202
Q

Infants and children are at a greater risk of dehydration than adults because ___

A

Their fluid reserves are smaller than adults

203
Q

Loose skin with no elasticity

A

Poor skin turgor

204
Q

Treatment of dehydration includes ___

A

Assessing ABCs and obtaining baseline vital signs

205
Q

Treatment of severe dehydration ___

A

ALS backup to administer IV

206
Q

All pediatric patients with ___ dehydration should be transported to the ED

A

Moderate to severe

207
Q

Mild dehydration
Pulse:
Level of activity:
Urine output:
Skin:
Mouth:
Eyes:
Anterior fontanelle:
LOC:
BP:

A

Pulse: Normal
Level of activity: Normal or slowed
Urine output: Decreased
Skin: Normal
Mouth: Decreased saliva
Eyes: Normal
Anterior fontanelle: Normal to sunken
LOC: Normal
BP: Normal

208
Q

Moderate dehydration
Pulse:
Level of activity:
Urine output:
Skin:
Mouth:
Eyes:
Anterior fontanelle:
LOC:
BP:

A

Pulse: Increased
Level of activity: Slowed
Urine output: Decreased
Skin: Cool, mottled, poor turgor
Mouth: Dry mucous membranes
Eyes: No tears
Anterior fontanelle: Sunken
LOC: Altered
BP: Normal

209
Q

Severe dehydration
Pulse:
Level of activity:
Urine output:
Skin:
Mouth:
Eyes:
Anterior fontanelle:
LOC:
BP:

A

Pulse: Increased (160 /min sign of impending shock, except newborns)
Level of activity: Variable, weak to unresponsive
Urine output: No output
Skin: Cool, clammy, poor turgor; delayed capillary refill time
Mouth: Dry mucous membranes
Eyes: Sunken eyes
Anterior fontanelle: Very sunken
LOC: Altered; lethargic
BP: Normal to low

210
Q

Body temp of ___ is considered abnormal

A

100.4°F or higher

211
Q

A fever that occurs in conjunction with a ___, is a signs of a serious illness such as meningitis

A

Rash

212
Q

Hyperthermia differs from fever in that it ___

A

Is an increase in body temp caused by an inability of the body to cool itself

213
Q

Most accurate temperature in an infant or toddler

A

Rectal

214
Q

Febrile fevers are common in ___

A

Children 6 months to 6 years

215
Q

Most pediatric seizures are the result of ___

A

Fever alone

216
Q

Febrile seizures typically occur on ___

A

The first day of febrile illness

217
Q

Febrile seizures are characterized by ___

A

Generalized (tonic-clonic) seizure, lasts less than 15 minutes with a short or nonexistent postictal phase

218
Q

When called to a febrile seizure, you will often find the patient ___

A

Awake, alert, and fully interactive when you arrive

219
Q

How to treat febrile seizure

A

Assess ABCs, cool with tepid water, and provide prompt transport

220
Q

Once a child has been removed from the water ___

A

Administer oxygen at 100%, be prepared to suction, CPR if needed

221
Q

Sprains are less common in children because ___

A

Ligaments are more developed than the growth plates of the bones

222
Q

Children turn ___ a car approaching

A

Towards

223
Q

Children can compensate for significant blood loss ___ than adults

A

Better

224
Q

Suspect ___ when a child has burns around the face and mouth

A

Internal injuries from chemical ingestion

225
Q

Blood loss in child that increases the risk for shock

A

Greater than 25%

226
Q

Blood loss in an adult that increases the risk for shock

A

Greater than 30% to 40%

227
Q

Minor pediatric burn

A

Partial-thickness less than 10% TBSA

228
Q

Moderate pediatric burn

A

Partial-thickness 10% to 20% TBSA

229
Q

Severe pediatric burn

A
  1. Any full-thickness burn
  2. Any partial-thickness greater than 20% TBSA
  3. Any burn involving the hands, feet, face, airway, or genitalia
230
Q

Developed for pediatric patients triage

A

JumpSTART Pediatric MCI Triage

231
Q

Evaluate ___ first in secondary triage

A

Infants

232
Q

The JumpSTART pediatric MCI triage is intended for ___

A

Children younger than 8 or who appear to weigh less than 100 lbs

233
Q

Mnemonic for assessing possible child abuse

A

CHILD ABUSE

234
Q

CHILD ABUSE

A
  1. Consistency of the injury with the child’s developmental age
  2. History inconsistent with injury
  3. Inappropriate parental concerns
  4. Lack of supervision
  5. Delay in seeking care
  6. Affect
  7. Bruises in varying stages
  8. Unusual injury patterns
  9. Suspicious circumstances
  10. Environmental clues
235
Q

Bruises to the ___ are suspicious

A

Back, buttocks, ears, or face

236
Q

Bruise color progression

A
  1. Pink or red
  2. Blue, then green, then yellow-brown, then faded
237
Q

Suspicious burns

A
  1. Penis, testicles, vagina, or buttocks
  2. Burns that encircle a hand or foot to look like a glove
  3. Cigarette burns or grid pattern
238
Q

Syndrome seen in abused infants in children. The patient has been subjected to violent, whiplash-type shaking injuries

A

Shaken baby syndrome

239
Q

Shaken baby syndrome effects caused by ___

A

Bleeding in the head and damage to the c-spine

240
Q

A baby with shaken baby syndrome will typically be found ___, and the call for help may be ___

A
  1. Unconscious, often without evidence of external trauma, may appear to be in cardiopulmonary arrest
  2. Infant who has stopped breathing or is unresponsive
241
Q

Any improper or excessive action that injures or otherwise harms a child or infant

A

Child abuse

242
Q

Child abuse includes ___

A
  1. Physical abuse
  2. Sexual abuse
  3. Neglect
  4. Emotional abuse
243
Q

Refusal or failure on the part of the parent or caregiver to provide life necessities, such as food, water, clothing, shelter, personal hygiene, medicine, comfort, and personal safety

A

Neglect

244
Q

Children who are neglected are often ___

A

Dirty, or too thin, or appear developmentally delayed because of a lack of stimulation

245
Q

SUID

A

Sudden Unexpected Infant Death

246
Q

Sudden unexpected death where the cause is not known until an investigation is completed

A

SUID

247
Q

Death that cannot be explained by another cause

A

Sudden Infant Death Syndrome (SIDS)

248
Q

Infants should sleep ___

A

Placed on their back on a firm mattress in a crib that is free of bumpers, blankets, and toys

249
Q

Risk factors for SIDS

A
  1. Mother younger than 20
  2. Mother smoked during pregnancy or after birth
  3. Mother used alcohol or drugs during pregnancy or after birth
  4. Low birth weight
250
Q

Three tasks of first provider at the scene of suspected SIDS

A
  1. Assess the scene
  2. Assess and manage the patient
  3. Communication and support of the family
251
Q

SIDS is a diagnosis of ___

A

Exclusion

252
Q

An infant who has been a victim of SIDS will be ___

A

Pale or blue, unresponsive, and not breathing

253
Q

If the child shows post-mortem changes ___

A

Call medical control

254
Q

As you assess the suspected SIDS patient, pay special attention to ___

A

Any marks or bruises on the child prior to starting CPR. Also note any interventions done by the parents before arrival

255
Q

Infants who have cyanosis and apnea, and are unresponsive that resume breathing and color with stimulation

A

Apparent life-threatening event

256
Q

ALTE

A

Apparent life-threatening event

257
Q

In addition to cyanosis and apnea, a classic ALTE is characterized by ___

A

Distinct change in muscle tone (limpness) and choking or gagging

258
Q

BRUE

A

Brief Resolved Unexplained Event

259
Q

BRUE can happen to an ___

A

Infant less than 1 year old

Emergency Medical Technician (100 decks)

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