Pediatric Emergencies Flashcards

A 2-year-old has ingested an unknown quantity of acetaminophen 4 hours ago. The child appears well with no vomiting. What is the primary concern and prehospital action?

Answer: Delayed hepatotoxicity risk; contact poison control and transport for N-acetylcysteine evaluation

Acetaminophen overdose causes delayed hepatotoxicity 24–72 hours after ingestion; prehospital care includes contacting poison control and transporting for antidote evaluation.

Which of the following findings in a pediatric trauma patient most strongly suggests non-accidental trauma (child abuse)?

Answer: Multiple bruises in various stages of healing on the trunk and posterior of a non-ambulatory infant

Multiple bruises in various stages of healing on the trunk or posterior of a non-ambulatory infant are highly suspicious for non-accidental trauma, as healthy infants cannot inflict these injuries on themselves.

A full-term neonate is delivered in the field. After drying, warming, and stimulation, the infant remains apneic with a heart rate of 55 bpm at 60 seconds of life. What is the next intervention?

Answer: Initiate positive pressure ventilation (PPV) with 100% oxygen

PPV with supplemental oxygen is the priority intervention for an apneic or bradycardic neonate; chest compressions begin only if HR remains below 60 bpm after 30 seconds of effective PPV.

A 3-year-old presents with sudden onset of stridor and cyanosis while eating. The child is conscious but cannot cough effectively. What is the most appropriate intervention?

Answer: Administer five back blows followed by five abdominal thrusts (Heimlich maneuver)

For a conscious child over 1 year with an ineffective cough and severe foreign body airway obstruction, alternating back blows and abdominal thrusts (Heimlich maneuver) are indicated.

What is the most common shockable cardiac rhythm encountered in pediatric cardiac arrest?

Answer: Asystole

Unlike adults, pediatric cardiac arrest is most commonly caused by respiratory failure or shock, resulting in asystole or PEA as the predominant initial rhythms rather than shockable rhythms.

A 7-year-old with sickle cell disease presents with severe bone pain in the extremities, fever of 38.8°C, and pallor. What is this presentation most consistent with?

Answer: Vaso-occlusive (pain) crisis

Vaso-occlusive crisis is the most common acute complication of sickle cell disease, presenting with severe extremity and back pain due to microvascular occlusion by sickled erythrocytes.

When assessing a pediatric burn patient, which rule is used to more accurately estimate total body surface area (TBSA) burned in children compared to the Rule of Nines?

Answer: Lund and Browder chart

The Lund and Browder chart accounts for age-related differences in body proportions (larger head, smaller legs in children) and is more accurate than the Rule of Nines for estimating pediatric burns.