Pediatrics

Question 1

What fracture patterns suggest

child abuse?

Answer 1

• long bone in child <1yr (non-ambulatory)
• posterior rib fractures,
• fractures of different ages
• “bucket-handle” or metaphyseal “corner fracture,”
• lateral/parietal skull fractures
• spiral fx EXCEPT distal tibia (toddler fx)

Question 2

What is a standard weight-based dose of packed red blood cells when transfusing a child?

Answer 2

10 mL/kg

Question 3

Under what age is a surgical cricothyrotomy not recommended?

Answer 3

Age 4

Question 4

Pediatric Needle cricothyrotomy Steps

Answer 4

Use large gauge needle with angiocatheter ( 14 or 16 gauge)

A syringe with saline may be attached to the needle when making the puncture and once the needle has entered the trachea, air bubbles will appear on aspiration of the syringe.

After the angiocatheter is advanced into the trachea, a 3.5-mm endotracheal tube cap may be attached to the angiocatheter and bag mask ventilation is performed.

Question 5

Surgical airway of choice in children < 10-12

Answer 5

Needle Cricothyrotomy

surgical cricothyrotomy not recommended under 4 yo

Question 6

Patients with moderate to severe croup (stridor at rest) may benefit from ____________.

Answer 6

nebulized epinephrine treatment

The mainstay of treatment for all forms of croup is corticosteroid therapy

Question 7

What is the single oral dose of dexamethasone that is recommended for the treatment of croup in children?

Answer 7

0.6 mg/kg orally