AEMCA Pediatric Emergencies 2 — Questions and Answers
Question 1: A 3-year-old presents with inspiratory stridor, a barking cough, and low-grade fever. What is the most likely diagnosis?
- Epiglottitis
- Croup (laryngotracheobronchitis) (Correct answer)
- Foreign body aspiration
- Bronchiolitis
Correct answer: Croup (laryngotracheobronchitis)
Croup classically presents with a barking seal-like cough, inspiratory stridor, and low-grade fever in children aged 6 months to 3 years.
Question 2: When assessing a pediatric patient, which component of the Pediatric Assessment Triangle (PAT) evaluates skin color, moisture, and temperature?
- Appearance
- Work of breathing
- Circulation to skin (Correct answer)
- Mental status
Correct answer: Circulation to skin
Circulation to skin in the PAT evaluates skin color (pallor, mottling, cyanosis), moisture, and temperature as indirect indicators of perfusion.
Question 3: A 6-week-old infant presents with projectile vomiting after every feeding, hunger after vomiting, and an olive-shaped mass in the epigastrium. What condition should the AEMCA suspect?
- Intussusception
- Pyloric stenosis (Correct answer)
- Gastroenteritis
- Malrotation with volvulus
Correct answer: Pyloric stenosis
Pyloric stenosis typically presents at 2–6 weeks of age with nonbilious projectile vomiting, persistent hunger, and a palpable pyloric 'olive' mass.
Question 4: Which fluid bolus volume is recommended for a pediatric patient in hemorrhagic shock?
- 5 mL/kg normal saline
- 10 mL/kg normal saline or lactated Ringer's
- 20 mL/kg normal saline or lactated Ringer's (Correct answer)
- 40 mL/kg normal saline
Correct answer: 20 mL/kg normal saline or lactated Ringer's
Initial fluid resuscitation for pediatric shock is 20 mL/kg of isotonic crystalloid (normal saline or lactated Ringer's), which may be repeated up to three times.
Question 5: A 4-year-old is found unresponsive after suspected submersion. After 5 initial rescue breaths, you find no pulse. What is the correct CPR compression-to-ventilation ratio for a two-rescuer pediatric resuscitation?
- 30:2
- 15:2 (Correct answer)
- 30:1
- 15:1
Correct answer: 15:2
Two-rescuer pediatric CPR uses a 15:2 compression-to-ventilation ratio, optimizing coronary perfusion pressure while accounting for the often respiratory-cause of pediatric arrest.
Question 6: A 2-year-old with known febrile seizures presents with a generalized tonic-clonic seizure lasting 8 minutes. The child remains postictal. What is the most appropriate prehospital intervention?
- Administer oral diazepam and observe at home
- Provide supplemental oxygen, obtain IV access, and transport (Correct answer)
- Administer IM epinephrine for anaphylaxis
- Apply ice packs to reduce fever immediately
Correct answer: Provide supplemental oxygen, obtain IV access, and transport
A febrile seizure lasting more than 5 minutes is considered prolonged and warrants oxygen, IV/IO access for potential benzodiazepine administration, and transport for evaluation.
Question 7: Which anatomical feature of a pediatric airway makes children more susceptible to airway obstruction compared to adults?
- Larger glottic opening relative to body size
- Proportionally larger tongue and more anterior, superior larynx (Correct answer)
- Longer trachea with more cartilaginous support
- Wider subglottic space
Correct answer: Proportionally larger tongue and more anterior, superior larynx
Children have a proportionally larger tongue and a more anterior and cephalad larynx, making visualization and management of the pediatric airway more challenging.
AEMCA Pediatric Emergencies 2
A 3-year-old presents with inspiratory stridor, a barking cough, and low-grade fever.
What is the most likely diagnosis?