During transport a child must be appropriately
Restrained (car seat) . (Limmer & O'keefe pg 878)
The tongue on a child is proportionately ---than adults
Larger. (Limmer & O'keefe pg 879)
Soft spots on the head are called
Fontanelles. (Limmer & O'keefe pg 879)
Bulging Fontanelle can be a sign of
Intracranial pressure. (Limmer & O'keefe pg 879)
Infants rely on their diaphragm to breathe because they are...
Abdominal breathers. (Limmer & O'keefe pg 880)
Normal respirations for a newborn are
30 to 50. (Limmer & O'keefe pg 880)
Toddler 1 to 3 years normal pulse rate
80 to 130. (Limmer & O'keefe pg 880)
School age 6 to 10 years normal pulse rate
70 to 110. (Limmer & O'keefe pg 880)
Normal pulse rate for newborn
120 to 160. (Limmer & O'keefe pg 880)
Adolescent 11-14 years normal pulse rate is
60 to 105. (Limmer & O'keefe pg 880)
Normal respiratory rate for infants 6 to 12 months, toddlers and preschoolers is...
20 to 30. (Limmer & O'keefe pg 880)
School age respiratory rate
15 to 30. (Limmer & O'keefe pg 880)
Adolescent 11-14 years normal respiratory rate
12 - 20. (Limmer & O'keefe pg 880)
Blood pressure is not usually taken in a child under
3 years of age. (Limmer & O'keefe pg 880)
Because the head is proportionately larger and heavier, children often fall
Head first. (Limmer & O'keefe pg 881)
The fontanelle normally bulges when...
The infant cries. (Limmer & O'keefe pg 881)
Infant and children typically breathe through their...
Nose. (Limmer & O'keefe pg 881)
Hyperextension or flexion of the neck of infants may result in...
Airway obstruction. (Limmer & O'keefe pg 881)
To help keep the airway in a neutral in-line position you should...
Place a folded towel under the shoulders. (Limmer & O'keefe pg 881)
A child's body surface area is larger in proportion to the body mass, making the child more prone to...
Heat loss through the skin. Hypothermia. (Limmer & O'keefe pg 882)
Typically have minimal stranger anxiety and do not mind being separated from their parents
Newborns. (Limmer & O'keefe pg 883)
While you examine an infant you should
Have parent hold him. (Limmer & O'keefe pg 883)
Because infants don't like to be cold, you should
Warm your hands and stethoscope. (Limmer & O'keefe pg 883)
On infants you should examine the ...first and the .....last
Heart and lungs first and head last. (Limmer & O'keefe pg 883)
Holding the pediatric nonrebreather mask near the face to provide oxygen via...
Blow by. (Limmer & O'keefe pg 883)
Age group does not like to be separated from parents, may believe illness is a punishment, do not like to have their clothing removed and they frighten easily
Toddlers 1 to 3 years. (Limmer & O'keefe pg 883)
You should examine a toddler's head...
Last . (Limmer & O'keefe pg 883)
Age group does not like to be touched or separated from their parents. Do not like their clothing removed. May believe that their illness is a punishment. Fear of blood, pain, and permanent injury.
Pre-school 3 to 6 years. (Limmer & O'keefe pg 884)
Age group cooperates but likes their opinion heard, fear blood, pain, disfigurement, and permanent injury. Are modest and do not like their bodies exposed
School age 6 to 12 years. (Limmer & O'keefe pg 884)
Age group wants to be treated like adults. Feel indestructible but may have fears of permanent injury and disfigurement
Adolescents 12 to 18 years. (Limmer & O'keefe pg 884)
The pediatric assessment triangle (PAT) is a tool that will help you categorize your assessment from...
Across the room, before you approach patient. (Limmer & O'keefe pg 888)
The PAT triangle assessment includes
Appearance , Work of breathing, Circulation to skin. (Limmer & O'keefe pg 888)
For the first side of the triangle, look at the patient's appearance look for...
Child's mental status, muscle tone, interactivity. (Limmer & O'keefe pg 888)
For the second side of the triangle, work of breathing look for abnormal sounds, body positioning, other respiratory and airway problems, like...
Retractions, nasal flaring "seesaw" breathing, head bobbing. (Limmer & O'keefe pg 888)
The base of the triangle, circulation to skin, look for...
Pallor, mottling, or cyanosis. (Limmer & O'keefe pg 888)
A great deal of information can and should be gathered form
The doorway, before you approach. (Limmer & O'keefe pg 889)
How would a sick child respond to your presence?
Give little attention to stranger. (Limmer & O'keefe pg 889)
Pulling of the skin and soft tissue between the ribs when breathing
Retractions. (Limmer & O'keefe pg 889)
Visible efforts of breathing for a sick child include
Flared nostrils and retractions. (Limmer & O'keefe pg 890)
A pediatric patient who is breathing inadequately should receive...
Artificial ventilations with supplemental oxygen. (Limmer & O'keefe pg 890)
A pediatric patient in respiratory distress should receive...
NRB with oxygen. (Limmer & O'keefe pg )
Cyanosis indicates that the patient is
Not getting enough oxygen. (Limmer & O'keefe pg 890)
For assessment check the ---pulse in a child and the ...pulse in an infant
Radial pulse and brachial pulse. (Limmer & O'keefe pg 890)
For BLS check the ---pulse in a child and ht e--- or --- in an infant
Carotid...brachial or femoral . (Limmer & O'keefe pg 890)
Check capillary refill on patients younger than...
5 years old. (Limmer & O'keefe pg 890)
Normal capillary refill the color should return in less than
<2 seconds. (Limmer & O'keefe pg 890)
A patient who gives a poor general impression, does not recognize the parent or primary caregiver, is not comforted when held by a parent but becomes calm and quite when set down is considered...
High priority transport. (Limmer & O'keefe pg 890)
The skin over the anterior fontanelle may bulge naturally
When the infant cries. (Limmer & O'keefe pg 893)
The skin over the anterior fontanelle may be abnormally sunken if
Infant is dehydrated. (Limmer & O'keefe pg 893)
Meningitis and head trauma cause the fontanelle to...
Bulge due to increased intracranial pressure. (Limmer & O'keefe pg 893)
Children are vulnerable to spinal cord injuries because of their proportionately
Larger and heavier heads. (Limmer & O'keefe pg 893)
Keep the infant's head in the ---position and the child's head in the --- or ----position
Neutral position, neutral-plus or sniffing. (Limmer & O'keefe pg 893)
If there is no suspicion of spinal injury, place a flat, folded towel ---to get the appropriate airway alignment
Under the patient's shoulders. (Limmer & O'keefe pg 893)
A child's soft ribs may not break, but there may be...
Injuries to the organs within the chest. (Limmer & O'keefe pg 893)
These organs are more susceptible to damage on pediatric patients than on adults
Liver and spleen. (Limmer & O'keefe pg 896)
Children younger than 8 are abdominal breathers, injury that impedes movement of the diaphragm may...
Compromise breathing. (Limmer & O'keefe pg 896)
When positioning the airway in a pediatric patient, use a tongue depressor and insert with the tip
Pointing downward. (Limmer & O'keefe pg 896)
Noisy breathing (stridor, crowing), retractions, normal skin color, CRT <2 min. conscious, are signs of......airway obstruction
Partial airway obstruction. (Limmer & O'keefe pg 900)
A child with signs of a partial airway obstruction, you should, let the child assume a position of comfort, offer high concentration oxygen by NRB or blow by and...
Transport, do not agitate the child. (Limmer & O'keefe pg 901)
Cyanosis, ineffective cough, cannot cry or speak, increased respiratory difficulty accompanied by stridor or respiratory arrest, altered mental status are signs of...
Severe airway obstruction. (Limmer & O'keefe pg 902)
To care for severe airway obstruction on a conscious infant
Alternate 5 back blows and 5 chest thrusts. (Limmer & O'keefe pg 902)
If the infant with airway obstruction becomes unconscious you
Begin CPR. (Limmer & O'keefe pg 902)
While treating unconscious infant with severe airway obstruction, after 30 compressions, you should...then attempt to ventilate and continue chest compressions
Visualize the airway. Remove object if seen. (Limmer & O'keefe pg 902)
Conscious child (over 1 year) with severe airway obstruction you should.
Abdominal thrusts. (Limmer & O'keefe pg 902)
If child with severe airway obstruction becomes unconscious you should...
Begin CPR sequence. (Limmer & O'keefe pg 902)
The underlying reason for many of the most serious medical problems with children is
Oxygen starvation (hypoxia) . (Limmer & O'keefe pg 902)
Artificial ventilation for infant and child should be provided...
12 to 20 breaths/minute. (Limmer & O'keefe pg 903)
Ventilation duration should last
1 second. (Limmer & O'keefe pg 903)
When ventilating a patient avoid excessive pressure. Use only enough force to make...
The chest rise. (Limmer & O'keefe pg 903)
Devices to provide ventilation that is contraindicated in infants and children...
FROPVD (flow restricted, oxygen powered ventilation device). (Limmer & O'keefe pg 903)
If ventilation is not successful in raising the patient's chest, you should...then try to ventilate again.
Perform procedures for clearing an obstructed airway. (Limmer & O'keefe pg 905)
A failure of heart function or of the cardiovascular system is ----in infants and children
Rare. (Limmer & O'keefe pg 905)
Common causes of shock in infants and children include
Diarrhea/ vomiting, infection, trauma. (Limmer & O'keefe pg 905)
To treat and prevent hypothermia keep patient warm, cover the head, warm up the ambulance, and consult medical direction for advice on ...
Active rewarming. (Limmer & O'keefe pg 907)
Emergency care for shock include....
Open airway, control hemorrhage, provide oxygen, lay pt flat, keep patient warm, rapid transport. (Limmer & O'keefe pg 907)
Rapid heart rate, altered mental status, rapid respiration, pale, cool, clammy skin, weak or absent peripheral pulses, delayed capillary refill, (5 years or younger), decrease urine output (ask about diaper wetting; look at diaper) absence of tears, even
Shock. (Limmer & O'keefe pg 906)
Emergency care for shock include....
Open airway, control hemorrhage, provide oxygen, lay pt flat, keep patient warm, rapid transport. (Limmer & O'keefe pg 907)
Because children have a large surface area in proportion to their body mass, exposure to cool weather and water can result in...
Hypothermia. (Limmer & O'keefe pg 907)
To treat and prevent hypothermia keep patient warm, cover the head, warm up the ambulance, and consult medical direction for advice on...
Active rewarming . (Limmer & O'keefe pg 907)
Application of hot water bottle or other heat sources if patient is awake and responding appropriately is......rewarming
Active rewarming. (Limmer & O'keefe pg 907)
Avoid rough handling and inserting anything in the patient's mouth as these actions may cause.... In the severely hypothermic patient
Ventricular fibrillation or cardiac arrest. (Limmer & O'keefe pg 907)
The most likely cause of cardiac arrest in a child other than trauma is...
Respiratory arrest. (Limmer & O'keefe pg 908)
The upper airway starts at the mouth and nose and ends at...
Opening of the trachea. (Limmer & O'keefe pg 908)
Airway disorders identified by the presence of stridor or difficulty speaking are considered....
Upper airway disorders. (Limmer & O'keefe pg 908)
Distinguishing signs of lower airway disorders include lung sounds such as
Wheezing. (Limmer & O'keefe pg 909)
With some diseases, it is dangerous to perform finger sweeps or to place a tongue depressor or any other instrument in the patient's mouth or pharynx, because this may...
Set off spasms along the airway. (Limmer & O'keefe pg 909)
Do not attempt to clear the airway of a foreign obstruction unless
It is clear that is the problem. (Limmer & O'keefe pg 909)
Altered mental status, flared nostrils, pale or bluish lips, stridor, grunting, breathing rate greater than 60, retractions wheezing, struggling to breathe, decreased muscle tone, poor peripheral perfusion, use of abdominal muscles, are sings of...
Respiratory distress. (Limmer & O'keefe pg 909)
Treat a patient with early respiratory failure (respiratory distress and altered mental status, cyanosis poor muscle tone, or inadequate breathing) or respiratory arrest by...
PPV pocket mask or BVM with supplemental oxygen. (Limmer & O'keefe pg 910)
Respiratory failure will rapidly deteriorate to
Respiratory arrest if left untreated. (Limmer & O'keefe pg 910)
Two illnesses that sometimes cause upper airway problems in children
Croup and epiglottitis. (Limmer & O'keefe pg 910)
Mild fever, some hoarseness during the day, a loud "seal bark" cough, difficulty breathing, signs of respiratory distress, restlessness, paleness with cyanosis
Croup. (Limmer & O'keefe pg 910)
Treatment for croup includes, place patient in a position of comfort, administer oxygen, if possible humidified, and...
Move slowly to the ambulance to transport. (Limmer & O'keefe pg 911)
Symptoms include, a sudden onset of high fever, painful swallowing (drool), tripod position, sniffing position, patient sits very still but muscles work hard to breathe
Epiglottitis. (Limmer & O'keefe pg 911)
Treatment of patient with Epiglottitis includes, contact ALSL, immediate transport with the child on parent's lap, and provide oxygen with humidification and ....
Do not place anything into the child's mouth. (Limmer & O'keefe pg 911)
One of the most important signs of an existing impending acute illness usually accompanies infection...
Fever. (Limmer & O'keefe pg 912)
May accompany a high fever...
Seizure. (Limmer & O'keefe pg 912)
Fever with a rash is a sign of
Potentially serious condition. (Limmer & O'keefe pg 912)
Rather than the high temperature it is the .....that causes the seizure
Rapid rise in temperature. (Limmer & O'keefe pg 912)
A seizure caused by fever is known as
Febrile seizure. (Limmer & O'keefe pg 912)
When treating a child with a high fever you should not....
Submerge the child in cold water... no rubbing alcohol. (Limmer & O'keefe pg 913)
Infection of the lining of the brain and spinal cord
Meningitis. (Limmer & O'keefe pg913 )
Fever, stiff neck, lethargy, irritability, headache, sensitivity to light, in infants; bulging fontanelle unless dehydrated, seizures, a rash if bacterial infection are symptoms of ...
Meningitis. (Limmer & O'keefe pg 913)
EMTs have to be aware that some forms of meningitis are highly...and require antibiotic treatment by a physician
Contagious. (Limmer & O'keefe pg 913)
Diarrhea and vomiting are common in childhood and may lead to..
Dehydration. (Limmer & O'keefe pg 914)
Treatment for diarrhea and vomiting include: maintain an open airway be prepared to suction. Provide oxygen, if your protocols permits...protocols may require to bring sample of vomitus or soiled diapers
Offer the child sips of clear liquid or chipped ice. (nothing by mouth if nausea exists) . (Limmer & O'keefe pg 914)
The most common cause of seizures include
Epilepsy, infections, poisoning, trauma hypoglycemia. (Limmer & O'keefe pg 914)
Patient care for pediatric patient with altered mental status includes...airway, suction as needed, spinal protection if needed, oxygen NRB or blow-by technique. BVM treat for shock and...
Transport. (Limmer & O'keefe pg 915)
Poisoning with ....initially no abnormal signs or symptoms. Child may be restless (early) or drowsy. Nausea, vomiting, and heavy perspiration may occur. May lose consciousness
Acetaminophen (Tylenol) . (Limmer & O'keefe pg 915)
Chronic condition, type of poisoning that causes nausea with abdominal pain and vomiting. Muscle cramps, headache, muscle weakness, and irritability
Lead poisoning. (Limmer & O'keefe pg916 )
As little as 1 gram of this poison can be lethal to a child. Nausea and bloody vomiting, often accompanied by diarrhea. Will typically develop shock, may be delayed for up to 24 hours as the child appears to be getting better
Iron poisoning. (Limmer & O'keefe pg 916)
Symptoms are usually vomiting with coughing or chocking. Smell the odor of a product....
Petroleum product poisoning. (Limmer & O'keefe pg 916)
The process of experiencing respiratory impairment from submersion/immersion in liquid, which may result in death or illness
Drowning. (Limmer & O'keefe pg 916)
Patients who have been submerged in cold water have been revived....minutes or more after submersion
30 minutes. (Limmer & O'keefe pg 916)
For a victim of drowning who is pulseless, unresponsive, and breathless, you should...
Perform five cycles of compressions and ventilations. (Limmer & O'keefe pg 916)
For a victim of drowning consider the possibility of "secondary drowning syndrome" which causes....minutes to hours after the event.
Deterioration after normal breathing resumes. (Limmer & O'keefe pg 916)
Caring for a drowning victim includes...
Prevention of hypothermia. (Limmer & O'keefe pg 917)
The sudden unexplained death during sleep of an apparently healthy baby in its first year of life
Sudden Infant Death Syndrome (SIDS). (Limmer & O'keefe pg 917)
When caring for a child who may have died on his sleep, you should provide resuscitation, unless...
There is rigor mortis...stiffening of the body. (Limmer & O'keefe pg 917)
Parent who lose a child to SIDS often suffer intense feelings of...
Guilt. (Limmer & O'keefe pg 917)
The number one cause of death in infants and children
Blunt trauma. (Limmer & O'keefe pg 917)
Unrestrained passengers tend to have....injuries
Head and neck. (Limmer & O'keefe pg 918)
Restrained passengers may have injuries to.....
Abdominal and lower spine injuries. (Limmer & O'keefe pg 918)
Children riding bicycle are struck by autos often have..., and....injuries
Head spinal, and abdominal. (Limmer & O'keefe pg 918)
The child who has been struck by a vehicle may present with ...., ....., and ......injuries
Head, abdominal, lower extremities. (Limmer & O'keefe pg 918)
Suspect....whenever a child with a head injury presents with shock
Internal injuries. (Limmer & O'keefe pg 918)
A common secondary effect of head injury is....
Respiratory arrest. (Limmer & O'keefe pg 918)
Most frequent sign of head injury is an altered mental status, .......and.......may also occur
Nausea and vomiting. (Limmer & O'keefe pg 918)
Children's more elastic ribs seldom fracture, however you should suspect injuries of...
structures beneath the ribs. (Limmer & O'keefe pg 918)
Falls over.... Feet are significant in patient over 15 years... On patient under 15 years old falls over ..........feet or ....height
20 feet greater than 10 feet or 2 to 3 times pt. height. (Limmer & O'keefe pg 919)
On a child who was struck by deployed air bag, you should suspect injuries to...
Head and neck. Burns to the eyes and face. (Limmer & O'keefe pg 919)
Infants and young children are abdominal breathers; therefore you should evaluate breathing by...
What their abdomen. (Limmer & O'keefe pg 919)
Burns are a common pediatric injury. The head counts as.... % BSA each arm a total .....% and each leg total .....%
18%, 9% (4 � & 4 1/2 ), 14% (7 & 7) . (Limmer & O'keefe pg 920)
Treatment for burns includes covering the burn with....
Sterile dressings. (Limmer & O'keefe pg 920)
Child abuse can take different forms to include...
Psychological, neglect, physical and sexual. (Limmer & O'keefe pg 921)
Slap marks, bruises, abrasions, lacerations, and incisions of all sizes and with shapes matching the item used. Multiple fractures in various stage of healing. Signs of....
Child abuse. (Limmer & O'keefe pg 921)
A bulging fontanelle may be an indication of...
Shaking an infant. (Limmer & O'keefe pg 921)
Repeated responses to same patient, indications of past injuries, back and buttocks. Indications of past burns both hands, fear form the child to tell you how the injury occurred, parent does not wish to leave you alone with child....
Possible child abuse . (Limmer & O'keefe pg 922)
Caring for pt. with suspected child abuse includes...
Preserve evidence of sexual abuse. (Limmer & O'keefe pg 923)
When you suspect child abuse you should not accuse the caregivers or ask the child if...
He has been abused`. (Limmer & O'keefe pg 924)
When reporting child abuse you should be ....and report only the facts
Objective. (Limmer & O'keefe pg 924)
Emergency care for patient with Tracheostomy tube includes allowing patient to remain in a position of comfort...
Maintain airway, suctioning the tube as needed, transport. (Limmer & O'keefe pg 926)
Emergency care for patient on home ventilators includes...
Maintain open airway, ventilate with pocket mask or BVM and transport. (Limmer & O'keefe pg 926)
Possible complications of the use of central lines are...
Infection, bleeding, clotting-off of the line, cracked line. (Limmer & O'keefe pg 927)
The most dangerous potential problem associated with gastrostomy tubes is
Respiratory distress. (Limmer & O'keefe pg 927)
Emergency care for patient with gastrostomy tube includes...open airway, suctioning, oxygen if needed and transport.....in what position?
On the right side, with the head elevated. (Limmer & O'keefe pg 927)
Patients with a shunt are prone to....
Respiratory arrest. (Limmer & O'keefe pg 927)