Pediatrics

Question 1

T/F: 70% of pediatric critical care transports will require some form of respiratory support.

Answer 1

True

Question 2

Infants typically lose _____% of weight immediately after birth.

Answer 2

5 - 10

Question 3

What is the “rule of thumb” for determining normotensive systolic pressures in pediatrics?

Answer 3

90 + (2 x child’s age in years)

Question 4

T/F: Children have higher metabolic rates and consume more oxygen than adults.

Answer 4

True

Question 5

Place the following respiratory distress signs in order from least concerning to most concerning.

retractions
see-saw respirations
nasal flaring

Answer 5

nasal flaring
retractions
see-saw respirations

Question 6

Children should not typically drool after the age of _____.

Answer 6

2

Question 7

T/F: Heart rate, blood pressure, and cardiac auscultation are the three key indicators that form an accurate general impression of a child.

Answer 7

False, it is appearance, work of breathing, and circulation (pediatric assessment triangle)

Question 8

Which of the following represents a critical finding during a pediatric assessment?

a) Heart rate of 150
b) Expiratory wheezing
c) Nasal flaring
d) Vigorous crying

Answer 8

c) Nasal flaring

Question 9

T/F: The progression leading to arrest is much more subtle in children than it is in adults.

Answer 9

True

Question 10

You are treating a 5-year-old patient with severe RSV. Which of the following is a sign of actual failure (vs potential respiratory failure)?

a) tachypnea
b) hypoxemia (as noted on the pulse oximeter)
c) altered mental status
d) bradycardia

Answer 10

bradycardia

Question 11

What is the correct pediatric dose for succinycholine?

Answer 11

2 mg/kg

Question 12

T/F: Defasciculating agents are not given to children because they do not have pronounced fasciculations like adults, and it can result in medication error.

Answer 12

True

Question 13

You are preparing to intubate a 5-year-old in respiratory failure. What is the correct size ET tube for this patient?

Answer 13

5.5
[(age in years) / 4] + 4

Question 14

T/F: It is well documented that the pediatric endotracheal tube is at high risk for displacement during patient movement and especially during transport.

Answer 14

True

Question 15

What will first detect loss of endotracheal tube patency?

Answer 15

waveform capnography

Question 16

In regards to mechanical ventilation, _______-limited is typically used for larger infants and children, where as ________-limited is typically used for neonates and small infants.

Answer 16

volume, pressure

Question 17

You are treating a 3-year-old who presents with rapid onset of fever, respiratory distress, drooling, muffled voice, and stridor. The child appears to be “air hungry” and is near respiratory failure. What respiratory condition should you suspect?

Answer 17

Epiglottitis

Question 18

Is croup a bacterial or viral infection?

Answer 18

viral

Question 19

What is characteristically seen on x-rays of children with croup?

Answer 19

Steeple sign

Question 20

You have just unsuccessfully attempted to intubate a 4-year-old with epiglottitis. Which of the following statements is true?

a) Immediately attempt a nasotracheal intubation using direct visualization of the cords if necessary
b) Immediately resort to needle cricothyroidotomy
c) Attempt bag mask ventilation using long, slow ventilations with two people
d) Wait 60 seconds for the swelling to reduce, then reattempt intubating using video assistance

Answer 20

c) Attempt bag mask ventilation using long, slow ventilations with two people

Question 21

T/F: Respiratory syncytial virus (RSV) is extremely rare in children, typically affecting less than 1% of children.

Answer 21

False

Question 22

T/F: The primary treatment of RSV is centered on supportive care and ensuring adequate patient hydration.

Answer 22

True

Question 23

What is the most important treatment that can be given to a child with bronchiolitis?

Answer 23

humidified oxygen

Question 24

T/F: In utero, blood enters the right atrium, travels through the right ventricle, and then enters the left ventricle through the foramen ovale. This allows for blood to bypass the lungs.

Answer 24

False, when the blood enters the right atrium, most of it flows through the foramen ovale into the left atrium, and then passes through the left ventricle.

Question 25

T/F: Acyanotic heart defects result in a left-to-right shunt.

Answer 25

True

Question 26

You are transporting a two-day-old infant with a ventricular septal defect. Your partner insists on placing the patient on high flow oxygen. You state that this should be avoided unless absolutely necessary. Which of the following reasons are the correct justification for your answer?

a) Oxygen is contraindicated in infants because it can cause injury to the eyes
b) Oxygen is typically not required in infants, and administration can cause hypercarbia
c) Oxygen can cause a fall in the PVR increasing the left-to-right shunt
d) Oxygen is contraindicated because it will fool the brain into not utilizing compensatory mechanisms to prevent shock

Answer 26

c) Oxygen can cause a fall in the PVR increasing the left-to-right shunt

Question 27

You are treating a 3-year-old who is having a symptomatic Tetralogy of Fallot (TET) spell. Which of the following treatments is most appropriate?

a) No treatment is indicated as these spells typically resolve without treatment
b) Oxygen, IV fluids, and dopamine
c) Oxygen, morphine, and knee-chest position
d) Propanolol, trendelenburg position, and dopamine

Answer 27

c) Oxygen, morphine, and knee-chest position

Question 28

What is the most common cause of bradycardia in infants?

Answer 28

hypoxia/anoxia

Question 29

You responded to a 2-year-old with a heart rate of 200 and a blood pressure of 48/P. What condition should you suspect first?

Answer 29

Hypovolemia

Question 30

T/F: Infants and children develop dehydration much more quickly than adults.

Answer 30

True

Question 31

You are transporting a 1-year-old that has been diagnosed with dehydration. The patient weigh 22 pounds. You have been asked to administer a fluid bolus, and then call the receiving physician back. What is the correct dose for this patient’s initial fluid bolus?

Answer 31

200cc
20ml/kg

Question 32

By definition, febrile seizures do not occur after which age?

Answer 32

5

Question 33

T/F: Hypotension is typically not seen in pediatric patients until 25% of their circulating volume is absent.

Answer 33

True

Question 34

What is the typical urinary output in a pediatric patient?

Answer 34

1 - 2cc/kg/hr